Louis, a 60-year-old man, has not been feeling himself lately.

Louis, a 60-year-old man, has not been feeling himself lately. He has been drowsy and fatigued. He becomes short of breath walking from one room to the next. On a recent visit, his daughter noticed that he seemed to be scratching a lot. His legs, ankles, and feet were extremely swollen, and his shortness of breath was becoming worse. He began to complain of chest pain and was immediately taken to the emergency room. A review of Louis’ medical history revealed that he was currently being treated for a urinary tract infection. His infection was resistant to the antibiotics with which he was initially treated. He began treatment with gentamicin 5 days ago. Physical examination confirms the observations of Louis’ daughter. A urinary catheter was placed in Louis’ bladder to determine urine output. A sample was sent to the laboratory for analysis. His urine analysis showed cloudy, dark urine. Casts were seen. A diagnosis of acute renal failure caused by nephrotoxic acute tubular necrosis (ATN) was made.

1. What is the pathophysiology associated with nephrotoxic ATN?

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2. What is the most likely cause of Louis’ condition?

3. What are the clinical manifestations of pain that Louis demonstrates?

4. How can Louis be diagnosed?

5. What is the treatment for Louis?

6. What is Louis’s prognosis?

PLEASE BE AS Specific as possible