skip to main content

Acute kidney injury from obstruction — MCCQE Part 1 MCQ

Instant feedback + full explanation. One question, done properly.

ModerateEdemaAcute kidney injury from obstructionMCCQE Part 1

A 78-year-old man with known benign prostatic enlargement presents with confusion and oliguria. Creatinine has risen from 90 to 360 µmol/L, bladder is palpable and ultrasound shows bilateral hydronephrosis. Which of the following is the most appropriate next step?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: B — Immediate bladder catheterization and monitoring for post-obstructive diuresis

AKI with a palpable bladder and bilateral hydronephrosis is post-renal obstruction requiring prompt decompression. ACE inhibitors and fluid restriction do not relieve the obstruction and may worsen renal perfusion. After catheterization, patients require monitoring for post-obstructive diuresis and electrolyte disturbance.

Reference: Canadian nephrology and urology practice pathways