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AKI Case #3 50 y.o male is receiving ampicillin and gentamicin for the past 2 weeks for treatment of enterococcal endocarditis. He has remained febrile. Labs: • Na 145, K 5.0, CI 110, HCO3 20 • BUN 40, SCr 3.5 • UA 0-1 WBC, Urine Na 20, Cr 35 1. Which of the following is the most likely process implicated in this patient's AKI? Acute tubular necrosis Insensible skin losses 3 Renal artery embolism 4. Decreased cardiac output/ CHF 5. Acute interstitial nephritis 2.
AKI Case #2 65 y.o. male presents 7 days following a diagnostic coronary angiogram; symptoms include abd pain and confusion. PEx reveals diminished peripheral pulses, livedo reticularis, epigastric tenderness, and altered mental status. Labs: BUN 131, SCr 5.2; UA shows 10-15 WBC, 5-10 RBC, one hyaline cast Per HPF 1. The most likely diagnosis is: AIN secondary to NSAIDS pt taking post-cath 2. Rhabdomyolysis with ATN 3 ATN secondary to radiocontrast exposure, nephropathy 4 Cholesterol embolization 5. Renal arterial dissection with prerenal azotemia
AKI Case #1 45 y.o. male presents to ER with subjective weight gain, fatigue, and vomiting. He had a previously normal PEx, serum chemistries 3 months prior to current presentation. Currently he has BP 150/110, perorbital edema. Labs include BUN 85, SCr 9.0; UA shows 2+protein/blood, and cellular casts 1. 2. What statement is least likely to be correct? Renal biopsy is indicated Post-strep GN is in the DDx 3 Extracapillary cell proliferation is likely 4. Spontaneous resolution of this particular AKI is likely 5. High-dose steroids are indicated