You should suspect a kidney injury anytime the patient presents with _______.

• A. abdominal distention
• B. a hematoma in the flank region
• C. dyspnea
• D. nausea

Answer: (B)

The key idea is that signs of kidney injury often show up as bleeding in the retroperitoneal area where the kidneys sit. A hematoma in the flank region directly signals that bleeding has occurred around the kidney, making renal trauma a plausible diagnosis. The kidneys are protected but located retroperitoneally, so a flank hematoma points to injury or bleeding near them and should trigger renal-focused evaluation (imaging, urinalysis for blood, etc.). The other options are less specific to kidney injury: abdominal distention can come from many abdominal issues, dyspnea points to respiratory or cardiopulmonary problems, and nausea is a nonspecific symptom that could accompany numerous conditions.