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Contrast-associated AKI risk — SCE Acute Medicine MCQ

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ModerateAcute Renal and Metabolic EmergenciesContrast-associated AKI riskSCE Acute Medicine

A 74-year-old woman is assessed on the acute medical unit. She has CKD stage 4 and needs urgent contrast CT for suspected bowel ischaemia. She asks how the renal risk will be reduced. Initial assessment includes relevant observations, bedside tests and urgent blood results. What would you advise this patient?

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Reveal the answer and explanation

Correct answer: E — Explain hydration, medicine review and renal-function monitoring

Explain hydration, medicine review and renal-function monitoring is the best answer because risk mitigation includes hydration where appropriate, review of nephrotoxins and post-contrast renal monitoring. Explain the diagnosis, warning symptoms, and the need for follow-up is plausible, but it is less appropriate for the physiology or timing described in this stem. The other distractors either fit a neighbouring presentation, delay definitive treatment, or miss the key immediate risk. Clinical pearl: Do not deny essential imaging when the diagnostic benefit outweighs renal risk.

Reference: https://www.nice.org.uk/guidance/ng148#acute-medicine-order-52-1