Question Easy:
A 28-year-old woman presents to the GP surgery with symptoms of frequency, urgency, and dysuria. She reports no fever or flank pain, and urine dipstick shows leukocytes and nitrites. What is the most likely diagnosis? 🚽
A) Pyelonephritis
B) Urethritis
C) Cystitis
D) Vaginitis
E) Nephrolithiasis
Question Medium:
A 65-year-old man with a history of hypertension and type 2 diabetes presents to the clinic with peripheral oedema and frothy urine. His blood tests reveal hypoalbuminaemia and hyperlipidaemia, while urinalysis shows proteinuria (3.5 g/day). What condition is he most likely suffering from? 💧
A) Acute Glomerulonephritis
B) Nephrotic Syndrome
C) Nephritic Syndrome
D) Chronic Kidney Disease
E) Renal Artery Stenosis
Question Hard:
A 45-year-old man is referred to the urology clinic with intermittent hematuria and weight loss. Ultrasound shows a solid mass in the left kidney. Which of the following is the most appropriate initial investigation to confirm the diagnosis? 🔍
A) Kidney Biopsy
B) Magnetic Resonance Imaging (MRI)
C) Computerized Tomography (CT) Urogram
D) Intravenous Urography
E) X-ray
Explanations & Answers:
Question Easy Answer: C) Cystitis
Question Easy Explanation: The symptoms of frequency, urgency, and dysuria with positive leukocytes and nitrites on urine dipstick suggest a urinary tract infection, most likely cystitis, which is common in young women. This aligns with NICE guidelines that emphasise the characteristic symptoms of lower urinary tract infections.
Question Medium Answer: B) Nephrotic Syndrome
Question Medium Explanation: The combination of peripheral oedema, frothy urine, hypoalbuminaemia, hyperlipidaemia, and proteinuria is indicative of nephrotic syndrome. NICE and NHS guidelines suggest this classical presentation for nephrotic syndrome, which requires appropriate management to prevent complications.
Question Hard Answer: C) Computerized Tomography (CT) Urogram
Question Hard Explanation: In cases of suspected renal cell carcinoma, a CT urogram is typically the initial imaging investigation of choice to assess the renal mass, vascular involvement, and possible metastases. According to BNF guidelines, this provides detailed anatomical information to aid in diagnosis and management planning.
Medical fact of the day: Did you know that kidneys filter about 180 litres of blood daily, yet produce only about 1.5 litres of urine? This is due to the intricate reabsorption processes in the renal tubules which conserve water and essential nutrients.
Quote of the day: “In the silent watch of the night, remember that each kindness rendered is a step towards healing, a whisper of hope in the corridors of care.” 🌟