Physician Assistant Genitourinary and Renal System Disorders 2

Question 1

A 68-year-old man develops a creatinine rise 48 hours after CT with IV contrast; urinalysis shows muddy brown granular casts. What is the most likely diagnosis?

Accepted Answer

Acute tubular necrosis

Answer

Muddy brown granular casts are the hallmark of acute tubular necrosis, including contrast-induced injury.

Question 2

Which laboratory finding best supports prerenal acute kidney injury?

Accepted Answer

FENa less than 1%

Answer

Intact tubules avidly reabsorb sodium in prerenal states, giving a FENa below 1%.

Question 3

A patient started on a new antibiotic develops fever, rash, and AKI with urine eosinophils. What is the most likely diagnosis?

Accepted Answer

Acute interstitial nephritis

Answer

The triad of fever, rash, and eosinophiluria after drug exposure suggests drug-induced acute interstitial nephritis.

Question 4

A marathon runner presents with dark urine; dipstick is positive for blood but microscopy shows no RBCs. What is the most likely cause?

Accepted Answer

Myoglobinuria from rhabdomyolysis

Answer

Heme-positive dipstick without RBCs on microscopy indicates myoglobin or hemoglobin, here from rhabdomyolysis.

Question 5

Which ECG finding is typically the earliest sign of hyperkalemia?

Accepted Answer

Peaked T waves

Answer

Peaked T waves are the earliest ECG change as potassium rises.

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Physician Assistant Practice Test

Physician Assistant Genitourinary and Renal System Disorders 2