USMLE® Step 2 CK
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USMLE 2CK Practice Question for September 23rd

A 71-year-old man is brought to the operating room for elective repair of a growing abdominal aortic aneurysm (AAA). The operation is uncomplicated, and the patient is extubated and brought to the surgical intensive care unit postoperatively for management. On postoperative day 1 his creatinine increases from 1.1 mg/dL to 1.3 mg/dL, but his urine output remains approximately 40 mL/h. On postoperative day 2, he complains of abdominal pain and has an episode of bloody diarrhea. He is hemodynamically stable, and his lower extremities remain warm and well perfused. An urgent complete blood count shows that his hemoglobin has dropped from 10 g/dL to 9 g/dL, and white blood cell count has elevated from 12,000/mm3 in the morning to 15,000/mm3. Which of the following is the most appropriate next step in management?

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