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Rapidly progressive glomerulonephritis — RACP Adult Medicine MCQ

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HardNephrologyRapidly progressive glomerulonephritisRACP Adult Medicine

A 55-year-old woman has malaise, haematuria and rising creatinine over 10 days. Urine microscopy shows red-cell casts and proteinuria. Blood pressure is 168/98 mmHg and renal ultrasound shows normal-sized unobstructed kidneys. What is the most appropriate investigation?

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Correct answer: CUrgent renal biopsy with serological work-up

Rapid kidney function decline with red-cell casts suggests rapidly progressive glomerulonephritis, requiring urgent biopsy plus serology to guide treatment. Obstruction has been excluded by ultrasound. The other tests do not identify crescentic glomerular disease or guide urgent immunosuppression.

Reference: Kidney Health Australia/CARI Guidelines; eTG