Rheumatoid Arthritis On Hydroxychloroquine in Medicine / Internal Medicine — 35yo Woman | Nephrology | SMLE Q#12143

SMLE Question #12143

Medicine / Internal Medicine Nephrology

Objective: OBJ-188

Last updated: February 2026
A 35-year-old woman with rheumatoid arthritis on hydroxychloroquine is admitted for community-acquired pneumonia and started on intravenous cefuroxime with clinical improvement. Baseline renal function was normal. On day 5 of antibiotic therapy, she develops an acute rise in serum creatinine and urea. Urinalysis shows mild proteinuria, leukocyturia, and occasional eosinophils, without hematuria or casts. She has had no episodes of hypotension or clinical volume depletion. Which of the following is the most likely cause of her kidney function deterioration?

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