skip to main content

Post-renal acute kidney injury — SCE Acute Medicine MCQ

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

EasyAcute Renal and Metabolic EmergenciesPost-renal acute kidney injurySCE Acute Medicine

A 63-year-old man presents with vomiting, weakness, confusion or collapse. Relevant history includes diabetes, kidney disease, endocrine disease or a treatment trigger. On assessment, volume status and bedside physiology are abnormal. Investigations show anuria, palpable bladder and bilateral hydronephrosis. What is the most appropriate next step in management?

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

Reveal the answer and explanation

Correct answer: C — Insert urinary catheter and arrange urgent urological decompression

The key discriminator is that anuria, palpable bladder and bilateral hydronephrosis, which makes Insert urinary catheter and arrange urgent urological decompression the single best answer. Provide supportive care and close monitoring is less appropriate because it does not address the dominant acute risk in the vignette; Give intravenous fluids with reassessment would fit a different presentation or later stage of care. Call critical care for escalation and Give targeted antidote or reversal therapy are suboptimal because they would either delay time-critical treatment or follow the wrong acute pathway. Teaching point: SCE-style acute medicine questions usually test prioritisation using physiology, timing and a guideline-defined threshold, rather than isolated factual recall.

Reference: NICE NG148