Nephrology · NEET PG Preparation Medicine
A 50-year-old man is evaluated for acute kidney injury following a cardiac catheterization procedure. His baseline serum creatinine was 1.0 mg/dL, wh…
Practice question from Nephrology (NEET PG Preparation Medicine), with the correct answer and a step-by-step solution.
hard · MCQ · Q-6B3D64
A 50-year-old man is evaluated for acute kidney injury following a cardiac catheterization procedure. His baseline serum creatinine was 1.0 mg/dL, which has risen to 2.4 mg/dL over 48 hours. Physical examination reveals livedo reticularis on his lower extremities and bilateral Hollenhorst plaques on fundoscopic examination. Urinalysis shows eosinophiluria. Which of the following is the most likely underlying etiology?
- A.Radiocontrast-induced nephropathy
- B.Atheroembolic renal diseaseCorrect answer
- C.Acute interstitial nephritis from antibiotics
- D.Hepatorenal syndrome
Solution
The combination of recent intra-arterial manipulation (cardiac catheterization), cutaneous findings (livedo reticularis), retinal cholesterol emboli (Hollenhorst plaques), and eosinophiluria points to atheroembolic renal disease (cholesterol crystal embolization). Unlike classic radiocontrast nephropathy which peaks within 3-5 days and resolves quickly, atheroembolic renal disease has a more insidious, stepwise decline in renal function and multiorgan involvement due to microvascular cholesterol emboli.
More from Nephrology
- A 45-year-old man with a history of alcohol use disorder is admitted for severe weakness and generalized malaise. Laboratory investigations…
- A 32-year-old woman presents with recurrent macroscopic hematuria, typically occurring 1-2 days following upper respiratory tract infection…
- A 60-year-old man with a 20-year history of poorly controlled type 2 diabetes mellitus is evaluated for progressive proteinuria. His urine…
- A 28-year-old man presents with acute onset oliguria, gross hematuria, and severe hypertension 3 weeks after recovering from a skin infecti…
Practise more Medicine
Sign up free for adaptive practice on this chapter, with instant feedback and hints on every question.
Start practising freeFree to start · No credit card needed