Question Easy:
A 28-year-old woman presents to her GP with symptoms of frequency, urgency, and dysuria. Her urine dipstick is positive for nitrites and leukocytes. What is the most likely diagnosis? 🚻
A) Acute pyelonephritis
B) Interstitial cystitis
C) Urethritis
D) Acute cystitis
E) Renal colic
Question Medium:
A 56-year-old man with a history of poorly controlled hypertension presents to the A&E with a sudden onset of severe, colicky right flank pain that radiates to the groin. His blood tests reveal a raised serum creatinine. What is the most appropriate initial imaging investigation? 🔍
A) Abdominal X-ray
B) Non-contrast CT KUB
C) MRI of the abdomen
D) Intravenous urography
E) Renal ultrasound
Question Hard:
A 65-year-old male patient with a history of chronic kidney disease (CKD) presents with confusion, metallic taste, and pruritus. His latest blood tests demonstrate hyperkalemia, metabolic acidosis, and renal function decline. What is the most definitive treatment to manage his current condition? 💚
A) Potassium-binding agents
B) Sodium bicarbonate
C) Loop diuretics
D) Haemodialysis
E) Calcium resonium
Explanations & Answers:
Question Easy Answer:
D) Acute cystitis
Question Easy Explanation:
The patient’s symptoms of frequency, urgency, and dysuria, along with positive nitrites and leukocytes on urine dipstick, are hallmark indicators of acute cystitis. NICE guidelines recommend urine dipstick and empirical antibiotic treatment for uncomplicated cases in non-pregnant women.
Question Medium Answer:
B) Non-contrast CT KUB
Question Medium Explanation:
The patient exhibits signs typical of acute renal colic with severe, colicky pain and a history of hypertension, which increases the risk of renal stones. NICE guidelines recommend non-contrast CT of the kidney, ureter, and bladder (CT KUB) as the initial imaging choice due to its high sensitivity and specificity.
Question Hard Answer:
D) Haemodialysis
Question Hard Explanation:
The patient presents with severe signs of advanced CKD, including hyperkalemia, metabolic acidosis, and uremic symptoms (confusion, metallic taste, pruritus). These symptoms indicate the need for renal replacement therapy. NICE guidelines and the Renal Association suggest haemodialysis as a definitive treatment to manage these life-threatening complications.
Medical fact of the day:
Did you know that autosomal dominant polycystic kidney disease (ADPKD) is one of the most common inherited kidney disorders in the UK, affecting approximately 1 in 1,000 people? It is a major cause of chronic kidney disease and often leads to end-stage renal disease by age 60.
Quote of the day:
“In the face of adversity, remember that the smallest act of kindness can illuminate a patient’s darkest day. Keep the light shining bright.” 🌟