You are looking after a 50 year old man who has severe acute pancreatitis secondary to biliary tract stones. He develops chills and rigors, and spikes a fever of 39.5 Celsius. He is complaining of increasing abdominal pain. On exam he is jaundiced, and his blood pressure is 100/70 mmHg when supine falling to 90/60 mmHg when sitting, with an increase in heart rate from 95 to 120 beats per minute. His jugular venous pressure appears to be low. His abdomen is distended and clinically consistent with ascites. Over the next few hours his urine output falls from 50 ml/h to 15 ml/h. Which of the following statements is FALSE? a) This man is at high risk of acute kidney injury due to obstructive jaundice and hypovolemia b) Urine sodium of 10 mmol/L would be consistent with ischemic ATN c) He should receive boluses of isotonic saline or colloid until the JVP and BP are normalized, with frequent review of the physical findings d) At this time administration of furosemide to increase urine flow is contraindicated e) Renal function should be monitored at least daily using serum creatinine
Posted on: Sat, 07 Sep 2013 15:25:44 +0000
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