A Case of Sushi-itis?

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Introducing Medical MCQs

Some of you have reached out with some suggestions as to what would improve Medical Snippets further. Based on this feedback, I’d like to introduce you to the new newsletter format of one medical multiple choice question each week in exam format.

Here's what you can expect:

1. Quality Questions: Carefully written exam-style questions that align with current medical practice.

2. Detailed Explanations: Thorough explanations to help you understand why each answer is right or wrong.

3. Weekly Practice: A question on a different topic each week.

Let me know what you think of this new format - drop me a reply or click the poll at the end of this email. 📩

🗒️ Question 

A 54-year-old woman presents to A and E with severe abdominal pain, diarrhoea and vomiting for the past two days. She reports her symptoms started after she ate sushi at a local restaurant. Her past medical history includes diabetes. 

On physical examination, the patient appears dehydrated with dry mucous membranes and decreased skin turgor. Abdominal examination reveals diffuse tenderness. Her extremities are cold. Her blood pressure is 95/60 mmHg, heart rate is 110 bpm and respiratory rate is 23/min.

Her blood results are as follows:

• Creatinine: 300 μmol/L

• K⁺: 5.0 mmol/L

• Na⁺: 132 mmol/L

• Urinalysis: Muddy brown casts

• Urine osmolarity: 300 mOsm/kg

Which of the following is the most likely diagnosis?

(A) IgA nephropathy

(B) Prerenal azotemia

(C) Acute tubular necrosis

(D) Acute interstitial nephritis

(E) Glomerulonephritis