HY USMLE Q #1150 – Renal

A 46-year-old man comes to the physician for a 2-day history of body rash. He has hypertension managed with hydrochlorothiazide. He was started on allopurinol one week ago for recurrent podagra. Physical examination shows a diffuse maculopapular rash on the trunk and arms. Laboratory studies show:

Hemoglobin                                                         14 g/dL
Serum WBCs                                                       8,000/μL
Platelets                                                                 190,000/μL
Urine RBCs                                                           0-2/hpf
Urine WBCs                                                         120/hpf
Urine protein                                                       1+

Which of the following is the most likely diagnosis?

  Acute tubular necrosis
  Diffuse proliferative glomerulonephritis
  Membranoproliferative glomerulonephritis
  Membranous glomerulonephropathy
  Tubulointerstitial nephritis

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