A 58-year-old woman hospitalized with infective endocarditis receives intravenous gentamicin therapy. After 7 days, she develops oliguria with BP 128/82 mmHg, HR 92/min, and SpO2 98% on room air. Serum creatinine rises from 0.8 to 2.1 mg/dL; BUN is 38 mg/dL. Urinalysis reveals muddy brown casts and renal tubular epithelial cells. Urine output remains adequate at 800 mL/day. Which nephron segment is most vulnerable to this aminoglycoside-induced toxic injury?
- A)Glomerular mesangium
- B)Proximal tubuleGABARITO
- C)Distal tubule
- D)Thin descending limb
- E)Collecting duct
Explicação
Proximal tubule is correct. Aminoglycosides are nephrotoxins that commonly injure proximal tubular epithelial cells, producing acute tubular necrosis with granular casts. The proximal tubule is highly metabolically active and is especially susceptible to toxic... Ver explicação completa e trilha adaptativa →