A 38-Year-Old Woman Gravida 2 Para 1, at 30 Weeks

A 38-year-old woman gravida 2 para 1, at 30 weeks gestation comes to the emergency department because of progressive swelling in her face and hands. At a prenatal visit 2 weeks earlier, she was diagnosed with gestational hypertension. Her current medications include methyldopa and a multivitamin. The patient has not urinated in the last 12 hours despite an increase in fluid intake.  She appears anxious. Her pulse is 95/min, and blood pressure is 160/102 mm Hg. Bladder catheterization yields a total of 15 mL of dark urine. Which of the following pathologic factors is the most likely cause of this patient's decreased urine output?

A) Inflammation of the glomeruli
B) Immune complex deposition within glomeruli
C) Inflammation of the renal interstitium
D) Obstructing stone within the renal calyx
E) Vasospasm of the intrarenal arteries

Correct Answer:

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