UWorld Internal Medicine Practice Test 2025 - Free Internal Medicine Practice Questions and Study Guide

The symptoms presented—a combination of malaise, dark urine, and periorbital swelling—suggest a renal process, particularly one involving glomerular injury. After treatment with oral Dicloxacillin, the timeline is also significant as it implicates a possible post-infectious glomerulonephritis, especially given that this type of glomerulonephritis often follows streptococcal infections.

Post-streptococcal glomerulonephritis typically arises after a throat or skin infection caused by specific strains of Streptococcus, and it is characterized by the sudden onset of hematuria (which can cause dark urine), proteinuria, edema (which accounts for periorbital swelling), and potentially hypertension. In adults, this condition can occur, though it is more commonly seen in children.

In this scenario, the patient's recent skin infection treated with Dicloxacillin suggests a possible underlying strep infection, leading to the immune-mediated response seen in post-streptococcal glomerulonephritis. The association of the symptoms with medication treatment reinforces the likelihood of a post-infectious process.

Given these ties to streptococcal infection and the manifestation of symptoms, post-st