Question Easy:
A 55-year-old man presents with burning micturition and increased frequency of urination. He also complains of suprapubic pain. What is the most likely diagnosis? 🚽
A) Acute pyelonephritis
B) Bacterial cystitis
C) Urinary retention
D) Renal colic
E) Prostatitis
Question Medium:
A 40-year-old woman with a history of lupus presents with fatigue, hypertension, and swelling in her legs. Her urinalysis reveals proteinuria and hematuria. What is the most likely underlying pathology? 🌊
A) Diabetic nephropathy
B) Acute tubular necrosis
C) Nephrotic syndrome
D) Chronic kidney disease
E) Lupus nephritis
Question Hard:
A patient with known chronic kidney disease (CKD) comes to your clinic for a routine follow-up. Recent blood tests reveal the following: eGFR 25 mL/min/1.73 m², serum potassium 6.0 mmol/L, and bicarbonate 17 mmol/L. What is the most appropriate next step in managing this patient? 🔍
A) Initiate haemodialysis
B) Start oral sodium bicarbonate
C) Increase dietary potassium intake
D) Prescribe loop diuretics
E) Immediate hospital admission for emergency treatment
Explanations & Answers:
Question Easy Answer:
B) Bacterial cystitis
Question Easy Explanation:
Bacterial cystitis, a urinary tract infection (UTI), commonly presents with symptoms like burning micturition, increased urinary frequency, and suprapubic pain. NICE guidelines endorse antibiotic treatment for bacterial cystitis based on severity and clinical diagnosis. Acute pyelonephritis often presents with flank pain and fever, while renal colic is characterized by severe loin pain radiating to the groin.
Question Medium Answer:
E) Lupus nephritis
Question Medium Explanation:
Lupus nephritis is a possible and severe complication of systemic lupus erythematosus (SLE). It often presents with proteinuria, hematuria, hypertension, and edema. NICE guidelines recommend regular urinalysis and renal function tests in patients with SLE to monitor for potential renal involvement. Early diagnosis and treatment are crucial to prevent progression to end-stage renal disease.
Question Hard Answer:
B) Start oral sodium bicarbonate
Question Hard Explanation:
In chronic kidney disease (CKD) with metabolic acidosis (as indicated by low bicarbonate levels), NICE guidelines recommend oral sodium bicarbonate supplementation to correct acidosis, which can slow the progression of CKD. An eGFR of 25 mL/min/1.73 m² and hyperkalemia are serious but not immediate indications for dialysis unless other symptoms of acute renal failure are present.
Medical fact of the day: Approximately 1 in 3 adults in the UK at risk of developing chronic kidney disease (CKD) due to factors such as hypertension, diabetes, and aging. Early detection through regular screening can significantly improve management and outcomes.
Quote of the day: “The art of medicine consists of keeping the patient inspired while nature heals the body. Keep striving, for every day brings new hope and healing.”