malinda
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A 68-year-old female who recently had a cholecystectomy develops a fever of 103°F and has persistent drainage
from her biliary catheter. She is given cephalothin and gentamicin for 10 days. Her serum creatinine level
increases to 7.6 mg/dL. Her urine output is 1.3 L/day and has not diminished over the past few days. There is no
history of hypotension and her vital signs are normal. Renal ultrasonography shows no evidence of obstruction.
The most likely etiology of the patient's condition is
A. acute glomerulonephritis
B. acute renal failure secondary to cephalothin
C. gentamicin nephrotoxicity
D. renal artery occlusion
E. sepsis
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| robin082006
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Increased blood creatinine without decrease urine volume and urinary obstruction--> I go with Sepsis.
But not sure about the correct answer.
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| malinda
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in sepsis there will be hypotension.Pt doesnot have hypotension
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| robin082006
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C?
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| druas
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I will go with C..
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| sarika
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c
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| robin082006
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If C, why isn't urine volume decreased?
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| robin082006
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If C, why isn't urine volume decreased?
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| malinda
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yes aminoglycoside nephrotoxicity that caused acute renal failure.I will ask the same q as robin?
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| kleila
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"In acute renal failure, the glomerular filtration rate decreases over days to weeks. As a result, excretion of nitrogenous waste is reduced, and fluid and electrolyte balances cannot be maintained. Patients with acute renal failure are often asymptomatic, and the condition is diagnosed by observed elevations of blood urea nitrogen (BUN) and serum creatinine levels. Most authorities define the condition as an acute increase of the serum creatinine level from baseline (i.e., an increase of at least 0.5 mg per dL [44.2 µmol per L]).3 Complete renal shutdown is present when the serum creatinine level rises by at least 0.5 mg per dL per day and the urine output is less than 400 mL per day (oliguria)..."
http://www.aafp.org/afp/20000401/2077.html --> check this article 4 details
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| docarchana
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gentamicin causes acute tubular necrosis.
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