Question Easy:
A 65-year-old man presents to the GP with symptoms of urinary frequency, urgency, and nocturia. He has a history of benign prostatic hyperplasia (BPH). Which medication is most likely to improve his symptoms?
A) Furosemide
B) Tamsulosin
C) Amoxicillin
D) Omeprazole
E) Metformin
Question Medium:
A 28-year-old woman presents to the emergency department with severe right flank pain, nausea, and hematuria. A CT scan confirms the presence of a 5 mm ureteric stone. What is the most appropriate initial management for this patient?
A) Surgical removal
B) Extracorporeal shock wave lithotripsy
C) Intravenous fluids and analgesia
D) Antibiotics
E) Percutaneous nephrolithotomy
Question Hard:
A 45-year-old patient with chronic kidney disease (CKD) stage 4 is being managed for associated complications. His recent blood tests show hemoglobin of 9 g/dL. What is the most appropriate next step in managing his anemia according to NICE guidelines?
A) Start oral iron supplementation
B) Start erythropoiesis-stimulating agents
C) Perform a blood transfusion
D) Continue monitoring without intervention
E) Start vitamin B12 and folic acid supplements
Explanations & Answers:
Question Easy Answer: B) Tamsulosin
Question Easy Explanation: Tamsulosin is an alpha-1 blocker that helps relax the muscles in the prostate and bladder neck, making it easier to urinate. This is typically used to relieve symptoms of BPH, such as urinary frequency and urgency. According to NHS guidelines, medications like tamsulosin are often first-line treatments for symptomatic BPH.
Question Medium Answer: C) Intravenous fluids and analgesia
Question Medium Explanation: The initial management of renal colic due to ureteric stones typically involves pain control and ensuring adequate hydration. NICE guidelines recommend providing strong analgesics such as NSAIDs (e.g., diclofenac) and ensuring the patient remains well-hydrated to facilitate possible stone passage.
Question Hard Answer: B) Start erythropoiesis-stimulating agents
Question Hard Explanation: For patients with CKD stage 4 who develop anemia, NICE guidelines recommend the use of erythropoiesis-stimulating agents (ESAs) if the hemoglobin level is less than 10.5 g/dL and iron stores are sufficient. ESAs help stimulate red blood cell production and alleviate anemia associated with advanced CKD.
Medical fact of the day: Did you know that the kidneys filter around 180 liters of blood each day, directing about 1.5 liters to be excreted as urine? This incredible filtration capacity is crucial for maintaining the body’s fluid balance and eliminating waste.
Quote of the day: “In the rush of healing lives, take a moment to cherish the quiet victories – the smiles shared, the lives touched, the hope ignited.”