Question Easy:
A 65-year-old male presents with a swollen, tender scrotum on one side. He has a high fever and dysuria. What is the most likely diagnosis? 🌡️
A) Epididymitis
B) Testicular Torsion
C) Hydrocele
D) Inguinal Hernia
E) Varicocele
Explanations & Answers:
Question Easy Answer: A)
Question Easy Explanation: Epididymitis often presents with a swollen, tender scrotum, fever, and dysuria. It is commonly caused by bacterial infections, often originating from the urinary tract. Testicular torsion typically presents with acute, severe unilateral testicular pain without fever. Hydrocele, inguinal hernia, and varicocele do not usually present with fever or dysuria. According to NICE guidelines, antibiotic therapy is the mainstay of treatment for epididymitis.
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Question Medium:
A 34-year-old woman is found to have microscopic haematuria on routine urine dipstick. She is asymptomatic and denies any history of trauma or strenuous exercise. What is the next most appropriate step in her management? 💧
A) Reassurance and repeat test in a year
B) Immediate referral to urology
C) Urine culture and sensitivity
D) Wait and watch approach
E) Ultrasound of the urinary tract
Explanations & Answers:
Question Medium Answer: E)
Question Medium Explanation: According to NICE guidelines, if a patient is found to have asymptomatic microscopic haematuria, the next step is usually imaging of the urinary tract to rule out any structural abnormalities or malignancies. An ultrasound is a non-invasive and readily available option for initial investigation. Immediate referral to urology is not indicated unless there are other concerning symptoms. Reassurance and repeat testing in a year may delay diagnosis, and a wait-and-watch approach is not recommended in the absence of specific cause.
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Question Hard:
A 40-year-old woman presents with bilateral flank pain, hypertension, and a family history of renal disease. Ultrasound reveals multiple bilateral renal cysts. Which of the following is the most likely diagnosis? 🏥
A) Autosomal Recessive Polycystic Kidney Disease
B) Medullary Sponge Kidney
C) Autosomal Dominant Polycystic Kidney Disease
D) Simple Renal Cysts
E) Renal Cell Carcinoma
Explanations & Answers:
Question Hard Answer: C)
Question Hard Explanation: Autosomal Dominant Polycystic Kidney Disease (ADPKD) is characterized by multiple bilateral renal cysts, and typically presents with symptoms such as hypertension and flank pain. A family history of renal disease also supports this diagnosis. Autosomal Recessive Polycystic Kidney Disease usually presents in childhood. Medullary sponge kidney and simple renal cysts are not usually associated with a significant family history or systemic symptoms like hypertension. Renal cell carcinoma may present with a solid mass rather than multiple cysts.
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Medical Fact of the Day: Did you know that Polycystic Kidney Disease (PKD) is one of the most common life-threatening genetic disorders? In the UK, it is estimated to affect 1 in 1,000 people, and managing this condition involves regular monitoring and managing complications such as hypertension and renal failure.
Quote of the Day: “Compassion in care is not just a requirement but a commitment. Every patient, every time. 💖”