Question Easy:
A 30-year-old man presents to the GP with pain during urination and increased urinary frequency 💧. On further questioning, he mentions some recent unprotected sexual contacts. Which is the most likely diagnosis?
A) Urinary tract infection (UTI)
B) Interstitial cystitis
C) Acute prostatitis
D) Urethritis
E) Bladder cancer
Question Medium:
A 65-year-old woman is admitted to the hospital with severe abdominal pain and nausea. A CT scan reveals a 5mm calcium oxalate stone in the right ureter. Which of the following is the most appropriate initial management for this patient?
A) Surgical intervention
B) Increase fluid intake and pain management
C) Ureteroscopy
D) Percutaneous nephrolithotomy
E) Ureteral stent placement
Question Hard:
A 45-year-old man with a history of chronic kidney disease (stage 4) presents with shortness of breath and general lethargy. Laboratory tests show a serum hemoglobin level of 9 g/dL. Which treatment would be most appropriate for his anemia, considering current guidelines?
A) Oral ferrous sulfate
B) Erythropoiesis-stimulating agents (ESAs)
C) Blood transfusion
D) Intravenous iron infusion
E) Vitamin B12 supplementation
Explanations & Answers:
Question Easy Answer: D) Urethritis
Question Easy Explanation: Given the patient’s symptoms and recent unprotected sexual activity, urethritis—often caused by sexually transmitted infections such as chlamydia or gonorrhea—is the most likely diagnosis. NICE guidelines stress the importance of considering STI testing in such cases.
Question Medium Answer: B) Increase fluid intake and pain management
Question Medium Explanation: For a 5mm calcium oxalate stone, conservative management with increased fluid intake and pain relief is appropriate because most stones of this size pass spontaneously. NICE guidance suggests this approach initially unless complications arise.
Question Hard Answer: B) Erythropoiesis-stimulating agents (ESAs)
Question Hard Explanation: In chronic kidney disease stage 4 with anemia, ESAs are recommended to stimulate erythropoiesis, as per NICE guidelines. Blood transfusions and iron treatments are more specific to other situations, such as acute anemia or iron deficiency.
Medical fact of the day: Did you know that the kidney filters about 180 liters of blood daily? This meticulous process involves reclaiming approximately 99% of water filtered, highlighting the kidney’s key role in maintaining fluid and electrolyte balance.
Quote of the day: “In the heart of every physician lies a healer, in the hands of every student lies the future.”