Long-standing Rheumatoid Arthritis Is in Medicine / Internal Medicine — 35yo Woman | Nephrology | SMLE Q#17215
SMLE Question #17215
Medicine / Internal Medicine
Nephrology
Objective: OBJ-188
Last updated: February 2026
A 35-year-old woman with long-standing rheumatoid arthritis is admitted with fever, productive cough, and dyspnea. Chest radiograph shows right lower lobe consolidation. She receives IV cefuroxime and IV fluids with clinical improvement after 48 hours. On day 3, she develops oliguria with poor oral intake. Urinalysis shows minimal protein and no hematuria or casts. She has no rash, eosinophilia, arthralgias flare, or other features of systemic vasculitis. What is the most likely cause of her kidney function deterioration?
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