46-year-old man comes to the emergency department due to intermittent severe right flank pain over the past few days

46-year-old man comes to the emergency department due to intermittent severe right flank pain over the past few days. He has had

decreased urination over the last week but has also noted occasional episodes of high urine output along with a feeling of generalized

weakness. The patient has a history of chronic back pain for which he takes oxycodone daily, and he underwent a left total

nephrectomy following a motor vehicle accident 25 years ago He was recently started on low-dose lisinopril for a new diagnosis of

hypertension There is no family history of renal disease. On physical examination, blood pressure is 145/86 mm Hg and heart rate is

86/min. Laboratory results are as follows:

Serum chemistry

Potassium 3.4 mEq/L

Creatinine 1.7 mg/dl

Urinalysis

Protein trace

White blood cells 4/hpf

Red blood cells 2/hpf

Casts none

Which of the following is the most likely cause of this patient’s symptoms?

  • QA Adrenal tumor
  • QB Glomerulonephritis
  • QC Inherited renal disease
  • Q D. Interstitial nephritis
  • Q E. Renal artery stenosis
  • Q F Urinary outflow obstruction

0 voters