Acute Kidney Injury (AKI) MCQ Quiz | Genitourinary

1. A 68-year-old male with severe heart failure presents with oliguria. His blood pressure is 85/50 mmHg. Urinalysis shows hyaline casts, and his fractional excretion of sodium (FENa) is 0.8%. What is the most likely cause of his acute kidney injury?

2. The presence of muddy brown granular casts in urine sediment is most pathognomonic for which condition?

3. According to the KDIGO guidelines, which of the following defines Stage 3 AKI?

4. A patient with AKI has an ECG showing peaked T waves and a widened QRS complex. What is the most appropriate initial step to stabilize the cardiac membrane?

5. Which of the following is NOT considered a standard indication for initiating urgent renal replacement therapy (RRT) in AKI, often remembered by the mnemonic AEIOU?

6. A patient develops fever, rash, and arthralgias a week after starting a new antibiotic. Labs show eosinophilia and a rising creatinine. Urine analysis reveals white blood cell casts and eosinophiluria. This clinical picture is most consistent with:

7. Which of the following statements is true regarding the Fractional Excretion of Sodium (FENa) in differentiating prerenal AKI from ATN?

8. A 75-year-old male with benign prostatic hyperplasia (BPH) presents with anuria for 24 hours. A bladder scan shows 800 mL of urine. What is the first-line diagnostic and therapeutic intervention?

9. Which of the following nephrotoxic agents is most commonly associated with ischemic acute tubular necrosis by causing renal vasoconstriction?

10. Hepatorenal syndrome (HRS) is a form of prerenal AKI that occurs in patients with advanced liver disease. What is the primary pathophysiological mechanism?

11. In a patient with rhabdomyolysis-induced AKI, which finding is expected on urine dipstick and microscopy?

12. A patient with AKI develops metabolic acidosis with an anion gap of 18 mEq/L. Which of the following is the most likely cause?

13. In which phase of ATN is a patient most at risk for hyperkalemia, metabolic acidosis, and fluid overload?

14. Which diagnostic test is most crucial for definitively ruling out a postrenal cause of AKI in a patient with an unclear history?

15. The combination of ACE inhibitors/ARBs and NSAIDs can precipitate AKI, especially in volume-depleted states, by what mechanism?

16. What is the primary role of loop diuretics (e.g., furosemide) in the management of AKI?

17. Cardiorenal syndrome Type 1 is characterized by:

18. A patient on a diuretic for hypertension develops AKI. The FENa is 0.7%, but the Fractional Excretion of Urea (FEUrea) is 45%. What do these findings suggest?

19. In a patient with tumor lysis syndrome, which of the following is the primary cause of AKI?

20. Which uremic symptom is considered an absolute indication for dialysis?

21. A patient with sepsis-induced AKI has a FENa of 1.5%. How is this finding interpreted?

22. Which of the following is a common complication during the recovery (polyuric) phase of ATN?

23. In the context of AKI, atheroembolic disease is typically characterized by which of the following clinical features?

24. What is the main difference between azotemia and uremia?

25. A patient with AKI requires IV contrast for an urgent CT scan. Which of the following is the most evidence-based strategy to reduce the risk of contrast-induced nephropathy (CIN)?