QuestionSBA
QuestionChoice
The raised creatinine is most likely to have occurred over the last week as she was previously well. Additionally, the fall in urine output for more than eight hours also indicates an AKI. There is no past medical history to indicate a diabetic or drug cause. One week of diarrhoea and nausea indicates possible gastroenteritis causing dehydration, resulting in AKI.
10000736
a
Acute Kidney Injury (AKI) secondary to gastroenteritis
QuestionChoice
T2DM is more likely than T1DM given this patient's age. However, this would usually lead to CKD (chronic kidney injury), which would not fit with the one-week history of this patient's symptoms. Instead, a more acute cause e.g. gastroenteritis causing dehydration and AKI is more likely.
10000739
d
Type 2 Diabetes Mellitus (T2DM)
QuestionChoice
CKD is unlikely given the length of time of the symptoms and the fact that this patient was previously well. The signs of clinical dehydration, and hypotension, both indicate that this patient has lost substantial amounts of fluid due to her diarrhoea - which given the one-week history, likely has an infective cause. This means the most likely diagnosis is AKI secondary to gastroenteritis.
10000737
b
Chronic Kidney Disease (CKD)
QuestionChoice
T1DM is unlikely given the age of this patient, as we would have expected this to have already been diagnosed in childhood, or early adulthood at the latest. Dehydration due to gastroenteritis, causing an AKI is much more likely.
10000738
c
Type 1 Diabetes Mellitus (T1DM)
QuestionChoice
Whilst sepsis is a risk for this patient given her likely infection, it is not possible to say if she is septic without further investigations (blood cultures etc.). However, it is possible to say that she is suffering with an AKI. This is likely due to gastroenteritis given her one-week history of gastrointestinal symptoms.
10000740
e
Sepsis
Concept
Chapter
2693
3817
Management of AKI
Topic
161
Emergency Medicine
12694
A 60-year-old female presents with a one-week history of diarrhoea and nausea, and a two-day history of reduced urine output. On examination, she is clinically dehydrated and has a BP of 84/60. She is normally well with no past medical history. Her blood results are as follows:


||||
|---------------------------|:-------:|--------------------|
|Sodium|151 mmol/L|135 - 145|
|Potassium|6.2 mmol/L|3.5 - 5.3|
|Urea|28 mmol/L|2.5 - 7.8|
|Creatinine|660 µmol/L|60 - 120|
|Fasting Glucose|6.2 mmol/L|<6.1|



Which of the following is the most likely diagnosis?
a