skip to main content

Acute kidney injury from sepsis — SCE Acute Medicine MCQ

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

EasyAcute Renal and Metabolic EmergenciesAcute kidney injury from sepsisSCE Acute Medicine

A 70-year-old woman is assessed on the acute medical unit. She has sepsis, oliguria and creatinine rising from 82 to 210 micromol/L. Blood pressure is 88/50 mmHg and lactate is 3.6 mmol/L. Initial assessment includes relevant observations, bedside tests and urgent blood results. 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 — Give isotonic crystalloid boluses with frequent reassessment

Give isotonic crystalloid boluses with frequent reassessment is the best answer because hypoperfusion-related AKI in sepsis requires careful fluid resuscitation and reassessment. Commence fixed-rate intravenous insulin infusion 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: Urine output is a key real-time marker in acute illness.

Reference: NICE NG148; NICE NG253