Question Easy:
A 25-year-old female presents with symptoms of dysuria, increased frequency, and suprapubic pain for the last two days. She has no fever, no flank pain, and is otherwise well. What is the most likely diagnosis?
A) Interstitial cystitis
B) Acute pyelonephritis
C) Urethritis
D) Acute cystitis
E) Pelvic inflammatory disease
Explanations & Answers:
Question Easy Answer:
D) Acute cystitis
Question Easy Explanation:
This patient’s presentation is characteristic of acute cystitis (💧), commonly known as a bladder infection. According to NICE guidelines, common symptoms include dysuria, increased urinary frequency, and suprapubic pain without systemic symptoms like fever or back pain, which would suggest pyelonephritis.
Question Medium:
A 60-year-old male with a history of hypertension and diabetes presents with sudden onset of gross haematuria. He denies any pain or trauma. Examination and basic blood tests are unremarkable except for microcytic anaemia. Ultrasound shows a left renal mass. What is the most appropriate next step in management?
A) Start antibiotics
B) CT scan of the abdomen and pelvis
C) Intravenous pyelogram
D) Cystoscopy
E) MRI of the abdomen
Explanations & Answers:
Question Medium Answer:
B) CT scan of the abdomen and pelvis
Question Medium Explanation:
In this scenario, a CT scan of the abdomen and pelvis with contrast is the most appropriate initial imaging modality to further evaluate the renal mass (🏥). NICE guidelines recommend this approach as it provides detailed information about the mass, which is essential for determining the nature of the mass and planning further management.
Question Hard:
A 45-year-old woman presents to the A&E department with sudden onset of severe right-sided flank pain radiating to the groin, nausea, and vomiting. Her urinalysis reveals microscopic haematuria. Vital signs show a temperature of 37.5°C, BP of 150/95 mmHg, and a pulse of 98 bpm. What is the most likely type of kidney stone in this patient?
A) Calcium oxalate
B) Struvite
C) Uric acid
D) Cystine
E) Calcium phosphate
Explanations & Answers:
Question Hard Answer:
A) Calcium oxalate
Question Hard Explanation:
Calcium oxalate stones are the most common type of kidney stones, accounting for approximately 70–80% of cases in the UK. The sudden onset of severe flank pain radiating to the groin, accompanied by microscopic haematuria (🪨), is characteristic of renal colic due to a stone passing through the urinary tract. It aligns with typical presentations seen in clinical practice and supported by NHS guidelines.
Medical fact of the day: Did you know that drinking adequate amounts of water is one of the simplest measures to prevent kidney stones, as it dilutes the urine, reducing the likelihood of stones forming? 🚰
Quote of the day: “In healthcare, every day is a chance to create a positive impact. You are the light in someone’s darkest moment.” ✨