A 65-year-old male patient presents with sudden onset of oliguria and signs of dehydration His blood pressure is 90/60 mmHg, heart rate is 110 bpm and he has poor skin turgor. Laboratory results show elevated blood urea nitrogen (BUN and creatinine levels. Which of the following is the most likely cause of his acute kidney injury (AKI)?
Hypovolemia leading to decreased renal perfusion
Acute tubular necrosis
Urinary tract obstruction
Chronic kidney disease
The Correct Answer is A
A. Hypovolemia leading to decreased renal perfusion. Hypovolemia from dehydration and low blood pressure reduces blood flow to the kidneys, resulting in pre-renal AKI, characterized by elevated BUN and creatinine.
B. Acute tubular necrosis. Acute tubular necrosis may cause AKI but is often due to prolonged hypoperfusion, nephrotoxic drugs, or ischemia, not the immediate presentation seen here.
C. Urinary tract obstruction. A urinary tract obstruction leads to post-renal AKI, often with symptoms like flank pain or difficulty urinating, not dehydration and low blood pressure.
D. Chronic kidney disease. Chronic kidney disease is a long-term condition and would not cause the acute symptoms or sudden onset of AKI as seen in this patient.
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Correct Answer is ["B","C","D","E"]
Explanation
A. Family history. Family history is a non-modifiable risk factor for heart disease, as it is genetic and cannot be changed.
B. Smoking. Smoking is a modifiable risk factor. Quitting smoking can significantly reduce the risk of heart disease.
C. Sedentary Lifestyle. Physical inactivity is a modifiable risk factor. Increasing activity levels can help lower the risk of heart disease.
D. Diabetes. While diabetes itself may be a chronic condition, managing blood sugar through diet, medication, and lifestyle changes can reduce heart disease risk.
E. Hypertension. Hypertension is a modifiable risk factor. Controlling blood pressure through medication, diet, and exercise can reduce heart disease risk.
Correct Answer is A
Explanation
A. Reduction of inflammation and suppression of immune responses. Methylprednisolone is a corticosteroid that reduces inflammation and suppresses immune responses, which can help manage the acute exacerbations of MS.
B. Stimulation of nerve regeneration. Methylprednisolone does not stimulate nerve regeneration; it focuses on reducing inflammation.
C. Improvement in cognitive function. Cognitive improvement is not a primary goal of methylprednisolone in MS management, though reducing inflammation may indirectly benefit cognition.
D. Increase in muscle strength and coordination. While reducing inflammation can improve symptoms, methylprednisolone itself does not directly increase muscle strength or coordination.