In my opinion the answer doesn’t seem to be parsimonious or allow much gamemanship by the question stem. The patient has post procedure back pain and lower ext

In my opinion the answer doesn’t seem to be parsimonious or allow much gamemanship by the question stem. The patient has post procedure back pain and lower extremity pain (likely femoral access for his angioplasty) and acute kidney injury. Normally I would go for a few things such as an iatrogenic complication like aortic dissection from the angiocath. His anemia, back pain, AKI, and malaise are also be worrisome for retroperitoneal hemorrhage, especially with recent anticoagulation with heparin and catheterization. I might also think of heparin induced thrombocytopenia and get a HIT panel given recent heparinization and anemia. Although I’m pretty sure it’s not this, info was given in the stem for it. The patient already had a CABG so he’s got multivessel coronary artery disease, now he’s also had a POBA. Does he also have ischemic cardiomyopathy? It wouldn’t be a surprise - acute decompensation could cause his AKI due to renal perfusion deficit. And lastly to get back and extremity pain with renal failure after an angio sounds like the catheter would have needed to disrupt a plaque in the descending aorta somewhere and then shower the kidneys and lower extremities with emboli. Anyways I’m a radiologist not a clinician so I’m sure there’s plenty of things I’m not thinking of. Plain old multifocal cholesterol embolism must be more common than I thought. So maybe strange for me but not for GPT or others.