QuestionSBA
QuestionChoice
This typically presents a few weeks following a streptococcal infection with self resolving haematuria.
10035549
c
Post-streptococcal glomerulonephritis
QuestionChoice
This clinical picture is more suggestive of renal damage. Acute liver failure would present with jaundice, ascities, abdominal pain and coagulation disturbance.
10035550
d
Acute liver failure
QuestionChoice
Membranous nephropathy causes a nephrotic syndrome and can be triggered by medications such as gold and penicillamine but tends to present less acutely with symptoms of proteinuria and peripheral oedema.
10035551
e
Membranous nephropathy
QuestionChoice
This is another cause of intrinsic renal AKI, which can also be triggered by medications. However, antifreeze consumption is more likely to cause an acute tubular necrosis picture and acute interstitial nephritis would present with a triad of fever, rash and eosinophilia.
10035548
b
Acute interstitial nephritis
QuestionChoice
This is correct. This is suggestive of a diagnosis of acute kidney injury secondary to acute tubular necrosis which is an intrinsic cause of AKI, whereby ethylene glycol in antifreeze directly damages the cells in the renal tubules.
10035547
a
Acute tubular necrosis.
Concept
Chapter
2693
6140
Acute Tubular Necrosis
Topic
142
Nephrology
19513
Acute tubular necrosis can occur following exposure to nephrotoxins, such as ethylene glycol, leading to acute kidney injury and anuria.
A 5-year-old boy is brought to the emergency department after accidentally drinking a significant amount of antifreeze which he mistook for a soft drink. He appears significantly dehydrated and is hypotensive on examination. He is anuric for 6 hours.

What is the most likely diagnosis?
a