Prescribing Safety Assessment (PSA) Practice Exam

What can a raised urea level indicate?

1. Only acute kidney injury

2. Only liver failure

3. Acute kidney injury or upper GI bleed

4. Normal kidney function

The correct answer is: Acute kidney injury or upper GI bleed

A raised urea level can indicate both acute kidney injury and an upper gastrointestinal (GI) bleed due to the body's response to these conditions. In the case of acute kidney injury, the kidneys are unable to filter waste products effectively, leading to an accumulation of urea in the bloodstream. This situation reflects the kidneys' impaired function and is a critical parameter for assessing renal health. Additionally, in the context of an upper GI bleed, the digestion of blood increases the synthesis of urea in the liver, which can subsequently lead to elevated levels in the blood. This occurs because the body metabolizes the protein components in the blood, producing more urea. The other scenarios presented do not encapsulate the full range of possible interpretations of elevated urea. An isolated raised urea level would not necessarily correspond only to acute kidney injury or only to liver failure, as those conditions could also present different biochemical profiles. Furthermore, a normal kidney function would not typically result in elevated urea levels. Understanding these specific implications of elevated urea levels helps inform clinical assessments and guide appropriate management in various medical conditions.