12-01-2010, 08:47 PM
A 71-year-old woman is transferred to your hospital
with new-onset renal failure requiring hemodialysis.
On hospital day 1 at the outside hospital, she was admitted
with a Killip class III inferior myocardial infarction.
She underwent percutaneous coronary intervention on
day 1 with successful angioplasty. On day 2, she spiked a
fever and was started on gentamicin and a fluoroquinolone
for pneumonia. A chest x-ray showed pulmonary
vascular congestion on day 3, which was treated with IV
loop diuretic. She complained of leg pain on day 4 which
responded well to potassium repletion and ibuprofen.
She is transferred to you with a urinalysis that shows 17
white blood cells, 1 red blood cell, 0 epithelial cells, no
leukocyte esterase. Hansel’s stain is positive for eosinophils.
Serum laboratory studies show a creatinine of 4.2
mg/dL and undetectable complement levels. It is now
hospital day 7. On which hospital day was her renal failure
caused?
A. 1
B. 2
C. 3
D. 4
with new-onset renal failure requiring hemodialysis.
On hospital day 1 at the outside hospital, she was admitted
with a Killip class III inferior myocardial infarction.
She underwent percutaneous coronary intervention on
day 1 with successful angioplasty. On day 2, she spiked a
fever and was started on gentamicin and a fluoroquinolone
for pneumonia. A chest x-ray showed pulmonary
vascular congestion on day 3, which was treated with IV
loop diuretic. She complained of leg pain on day 4 which
responded well to potassium repletion and ibuprofen.
She is transferred to you with a urinalysis that shows 17
white blood cells, 1 red blood cell, 0 epithelial cells, no
leukocyte esterase. Hansel’s stain is positive for eosinophils.
Serum laboratory studies show a creatinine of 4.2
mg/dL and undetectable complement levels. It is now
hospital day 7. On which hospital day was her renal failure
caused?
A. 1
B. 2
C. 3
D. 4