Renal Quiz #21Acute Tubular Necrosis and Renal Papillary Necrosis

1. A 25-year-old man is brought to the emergency department after being found unconscious in an alley during winter. His temperature is 32°C (89.6°F), and his serum creatinine is significantly elevated compared to baseline. Urinalysis shows muddy brown casts. Which of the following is the most likely diagnosis? 

Question 1 of 5

2. A 55-year-old woman with a history of chronic analgesic abuse presents with intermittent gross hematuria and flank pain. Imaging studies reveal necrosis of the renal papillae. Which of the following substances is most likely responsible for her condition? 

Question 2 of 5

3. A patient in the ICU following major surgery develops oliguria. Lab tests reveal elevated blood urea nitrogen (BUN) and creatinine levels. The patient's urine output does not improve despite adequate fluid resuscitation. Urinalysis shows pigmented granular casts. What is the most likely diagnosis? 

Question 3 of 5

4. A patient with a history of diabetes mellitus presents with the inability to concentrate urine, flank pain, and recent onset of polyuria. Imaging studies reveal sloughing of renal papillae. Which of the following conditions is most closely associated with this patient's imaging findings? 

Question 4 of 5

5. A 40-year-old man with a history of alcoholism and recent binge drinking episode is admitted with severe abdominal pain. His serum creatinine and blood urea nitrogen (BUN) levels are elevated. Urinalysis is notable for epithelial cell casts and muddy brown casts. Which of the following is the most likely cause of these findings? 

Question 5 of 5


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