2 Days Of Progressive in Medicine / Internal Medicine — 33yo Woman | Nephrology | SMLE Q#12105
SMLE Question #12105
Medicine / Internal Medicine
Nephrology
Objective: OBJ-188
Last updated: February 2026
A 33-year-old woman with systemic sclerosis and previously normal kidney function presents with 2 days of progressive drowsiness and blurred vision. She is confused. Examination shows raised JVP, bilateral pitting edema to the knees, and retinal hemorrhages. She has acute kidney injury with heavy proteinuria and microscopic hematuria. What is the most appropriate immediate management?
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