American Board of Internal Medicine (ABIM) Certification Practice Exam

How does the time frame for acute tubular necrosis manifest in patients receiving aminoglycosides and anticancer drugs?

1. Within 1-3 days

2. 5-10 days

3. 10-15 days

4. More than 15 days

The correct answer is: 5-10 days

Acute tubular necrosis (ATN) is a type of kidney injury that is often precipitated by various factors, including the use of specific medications like aminoglycosides and certain anticancer drugs. The time frame for the development of ATN following exposure to these nephrotoxic agents is critical for diagnosing and managing the condition effectively. When patients receive aminoglycosides, renal injury typically manifests within 5 to 10 days after the initiation of therapy. This timeframe aligns with the pharmacokinetics and nephrotoxic potential of these medications, where accumulation in the renal tubular cells leads to cellular injury and ultimately, tubular necrosis. In the context of anticancer drugs, the onset of ATN can also occur within a similar time frame. Drug-induced injury often stems from rapid cell turnover in the kidneys, particularly after initial doses of chemotherapeutic agents that have known nephrotoxic effects. Understanding this time frame is crucial when monitoring patients who are receiving these treatments, as early detection and intervention can mitigate the extent of renal damage. This timely recognition allows for adjustments in medication, hydration status, and supportive care to help protect renal function. In contrast, the other time frames presented do not commonly reflect the