10-05-2007, 08:59 PM
A 72-year-old woman with rheumatic heart disease is being treated with ampicillin and gentamicin for enterococcal endocarditis. One week into the course she develops a morbilliform skin rash and fever.
Laboratory evaluation is remarkable for a doubling of serum creatinine and blood urea nitrogen from their baseline values.
Urinalysis dipstick is positive for blood, protein, and white cells. Ultrasonography reveals bilaterally enlarged kidneys. Based on the available data, the most likely cause of the patientâ„¢s azotemia is
A) tubular necrosis caused by aminoglycoside
B) membranous nephropathy resulting from endocarditis
C) enterococcal pyelonephritis
D) cystitis
E) hypersensitivity reaction to ampicillin
Laboratory evaluation is remarkable for a doubling of serum creatinine and blood urea nitrogen from their baseline values.
Urinalysis dipstick is positive for blood, protein, and white cells. Ultrasonography reveals bilaterally enlarged kidneys. Based on the available data, the most likely cause of the patientâ„¢s azotemia is
A) tubular necrosis caused by aminoglycoside
B) membranous nephropathy resulting from endocarditis
C) enterococcal pyelonephritis
D) cystitis
E) hypersensitivity reaction to ampicillin