skip to main content

Rapidly progressive glomerulonephritis — SCE Acute Medicine MCQ

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

HardAcute Renal and Metabolic EmergenciesRapidly progressive glomerulonephritisSCE Acute Medicine

Creatinine rises from 82 to 390 micromol/L over three weeks with blood 3+, protein 2+ and red-cell casts. Ultrasound excludes obstruction. What is the next step?

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

Reveal the answer and explanation

Correct answer: D — Give anticoagulation and arrange drainage

The best answer is “Give anticoagulation and arrange drainage”. This is correct because rapidly progressive kidney injury with active nephritic sediment suggests crescentic glomerulonephritis and requires time-critical diagnosis and treatment. Serology and biopsy distinguish ANCA, anti-GBM, immune-complex and other causes. Cystitis, delayed chronicity assessment, contrast and NSAIDs risk irreversible renal loss.

Reference: NICE NG148 acute-kidney-injury recommendations: https://www.nice.org.uk/guidance/ng148/chapter/Recommendations