Renal Infarction Cancer — SCE Medical Oncology MCQ
Instant feedback + full explanation. One question, done properly.
Educational content. Not a substitute for clinical judgement or local policy.
Reveal the answer and explanation
Correct answer: B — Cardioembolic renal infarction from inadequately anticoagulated mechanical valve
A mechanical valve at INR 1.4 provides a direct high-risk embolic source for bilateral renal cortical infarction. In-situ renal-artery thrombosis associated with cancer-related arterial hypercoagulability: bilateral cortical infarcts plus a subtherapeutic mechanical valve make cardiac emboli more likely. Non-bacterial thrombotic endocarditis associated with metastatic adenocarcinoma: this is possible in cancer but the established valve and inadequate anticoagulation provide the stronger source. Cholesterol crystal embolisation associated with recent arterial catheterisation: no arterial procedure or systemic cholesterol-embolus signs are provided. Renal-vein thrombosis associated with cancer-related nephrotic-range proteinuria: venous thrombosis does not produce the described bilateral cortical arterial infarcts.
Reference: Aetiology of renal infarction: systematic review (Published July 2019): https://pubmed.ncbi.nlm.nih.gov/31859988/; Acute bilateral renal infarction after mechanical mitral-valve replacement (Published April 2021): https://pmc.ncbi.nlm.nih.gov/articles/PMC8059103/; ESC review of prosthetic heart valves and thromboembolic risk (Current ESC educational review, accessed July 2026): https://www.escardio.org/communities/councils/cardiology-practice/scientific-documents-and-publications/ejournal/volume-20/prosthetic-heart-valves-part-1-selection/