QuestionSBA
QuestionChoice
Acute interstitial nephritis would typically present with a fever or a rash alongside signs of acute kidney injury. Additionally, brown granular casts are quite specific for acute tubular necrosis.
10002348
b
Acute interstitial nephritis
QuestionChoice
Whilst renal artery stenosis may lead to pre-renal acute kidney injury, the presence of brown granular casts in the urine is more suggestive of acute tubular necrosis secondary to gentamicin use.
10002351
e
Renal artery stenosis
QuestionChoice
Whilst ureteric obstruction may lead to post-renal acute kidney injury, the presence of brown granular casts in the urine is more suggestive of acute tubular necrosis secondary to gentamicin use.
10002350
d
Ureteric obstruction
QuestionChoice
Acute glomerulonephritis would classically present with protein or blood in the urine alongside other signs of acute kidney injury (e.g. peripheral oedema). The presence of brown granular casts in the urine is more specific for acute tubular necrosis.
10002349
c
Acute glomerulonephritis
QuestionChoice
This patient is presenting with signs characteristic of acute kidney injury, given the rise in serum creatinine over a short period of time. This is most likely to have been triggered by gentamicin, which can be nephrotoxic. The presence of brown granular casts in the urine indicates that this is most likely to be acute tubular necrosis, as opposed to other causes of acute kidney injury.
10002347
a
Acute tubular necrosis
Concept
Chapter
2693
3752
Acute Kidney Injury
Topic
142
Nephrology
13016
An 84-year-old female is admitted to the hospital with signs and symptoms of sepsis. She has a past medical history of hypertension and hypercholesterolaemia for which she is taking amlodipine, candesartan and atorvastatin. She is started on IV 0.9% sodium chloride and IV gentamicin for sepsis. Two days after being admitted, the patient's serum creatinine rises from 82 micromol/l to 170 micromol/l (normal range 60-120 micromol/L). Her urine is examined under microscopy and is found to contain brown granular casts.


What is the most likely diagnosis?
a