Question Easy:
A 32-year-old woman presents with dysuria and increased urinary frequency. She is otherwise healthy and has no allergies. Urinalysis shows nitrites and leukocyte esterase. What is the most likely diagnosis?
A) Acute pyelonephritis
B) Urethritis
C) Interstitial cystitis
D) Bacterial cystitis
E) Kidney stones
Question Medium:
A 47-year-old man comes to the clinic with fatigue, pruritus, and a metallic taste in his mouth. Blood tests reveal elevated urea and creatinine levels, with a glomerular filtration rate of 15 mL/min/1.73m². What is the primary indication for initiating dialysis in this patient?
A) Uncontrolled hypertension
B) Persistent volume overload
C) Refractory hyperkalemia
D) Uremic symptoms
E) Metabolic acidosis
Question Hard:
A 56-year-old man presents with hematuria, flank pain, and a palpable abdominal mass. CT scan of the abdomen shows a renal mass. Which genetic condition is most commonly associated with this presentation?
A) Von Hippel-Lindau syndrome
B) Autosomal dominant polycystic kidney disease
C) Tuberous sclerosis
D) Hereditary papillary renal carcinoma
E) Multiple endocrine neoplasia type 1
Explanations & Answers:
Question Easy Answer: D) Bacterial cystitis
Question Easy Explanation: This patient presents with classic symptoms of a urinary tract infection (UTI), accompanied by urinalysis findings of nitrites and leukocyte esterase, indicating the presence of bacteria and white blood cells. Bacterial cystitis is the most likely diagnosis according to NICE guidelines for managing lower UTIs in adults. 😷
Question Medium Answer: D) Uremic symptoms
Question Medium Explanation: In cases of chronic kidney disease, the presence of uremic symptoms, such as fatigue, pruritus, and altered taste, becomes a critical indicator for starting dialysis. NICE guidelines emphasize the importance of addressing uremic symptoms alongside other factors like refractory hyperkalemia or severe metabolic acidosis.
Question Hard Answer: A) Von Hippel-Lindau syndrome
Question Hard Explanation: Von Hippel-Lindau syndrome is a genetic condition often associated with renal cell carcinoma, characterized by hematuria, flank pain, and abdominal masses. The presentation aligns with a hereditary disorder, reflecting the syndrome’s propensity for developing renal tumors. Clinical practice in the UK adheres to regular monitoring and evaluation under such conditions. 🧬
Medical fact of the day: The kidneys filter approximately 180 liters of blood every day, ensuring the body’s fluid, electrolyte, and acid-base balance—a testament to the kidneys’ remarkable role in maintaining homeostasis!
Quote of the day: “In the realm of healing, diligence and compassion are the twin guardians of hope.”