A 57-year-old woman comes to the physician because of a 12-hour history of left-sided abdominal pain that radiates to her back. She has a history of type II diabetes mellitus, hypertension, hyperlipidemia, and atrial fibrillation. Current medications are lisinopril, metoprolol, metformin, and warfarin. She has smoked 2 packs of cigarettes daily for 35 years. Temperature is 98.6 F. Physical examination shows flank tenderness on the left. Abdominal CT shows a wedge-shaped area of hypodensity in the left kidney; there is no evidence of stones. Which of the following is the most likely explanation for this patient’s findings?
Adverse effect of medication
Atrial fibrillation
Endocarditis
Polycystin mutation
Smoking
