Question Easy: 👩⚕️ A 30-year-old woman presents with dysuria and increased urinary frequency. She is afebrile and otherwise well. What is the most appropriate initial management in primary care?
A) Nitrofurantoin
B) Ciprofloxacin
C) Trimethoprim-sulfamethoxazole
D) Amoxicillin
E) Cefalexin
Question Medium: 🌊 A 55-year-old man with chronic kidney disease (CKD) stage 4 is being reviewed in clinic. His eGFR is 20 mL/min/1.73 m². According to NICE guidelines, which of the following medications should be reviewed for dose adjustment or discontinuation?
A) Lisinopril
B) Metformin
C) Amlodipine
D) Paracetamol
E) Atorvastatin
Question Hard: 🧪 A 68-year-old male patient is diagnosed with advanced prostate cancer. He is started on androgen deprivation therapy. Which of the following is most commonly used as first-line monotherapy in this context?
A) Flutamide
B) Bicalutamide
C) Leuprorelin
D) Finasteride
E) Tamsulosin
Explanations & Answers:
Question Easy Answer: A) Nitrofurantoin
Question Easy Explanation: For an uncomplicated urinary tract infection (UTI) in a non-pregnant woman, NICE guidelines recommend nitrofurantoin as a first-line treatment option, provided there is no known allergy or significant renal impairment.
Question Medium Answer: B) Metformin
Question Medium Explanation: NICE guidelines advise that metformin should be reviewed and usually reduced in dose or discontinued if the patient has an eGFR below 30 mL/min/1.73 m², due to the risk of lactic acidosis.
Question Hard Answer: C) Leuprorelin
Question Hard Explanation: Leuprorelin, a type of gonadotropin-releasing hormone (GnRH) agonist, is commonly used as first-line treatment for androgen deprivation therapy in advanced prostate cancer as outlined in both NICE and NHS guidelines.
Medical fact of the day: Did you know that the glomerular filtration rate (GFR) decreases by approximately 1 mL/min/1.73 m² per year after the age of 40? This is a natural part of the aging process.
Quote of the day: “Healing begins with empathy, continues with knowledge, and triumphs with perseverance. 💪”