Question Easy:
A patient presents with burning micturition, increased frequency, and suprapubic pain. What is the most likely diagnosis?
A) Acute pyelonephritis
B) Acute cystitis
C) Urolithiasis
D) Chronic renal failure
E) Benign prostatic hyperplasia
Explanations & Answers:
Question Easy Answer:
B) Acute cystitis
Question Easy Explanation:
Acute cystitis is primarily characterized by burning micturition, increased frequency, and suprapubic pain. It is commonly seen in females due to shorter urethral length and closer proximity to the anus. NICE guidelines recommend urine dipstick testing and, if positive for nitrites or leukocytes, treatment with appropriate antibiotics.
Question Medium:
A 65-year-old man presents with difficulty in initiating urination, weak stream, and nocturia. What is the most likely diagnosis?
A) Bladder cancer
B) Acute cystitis
C) Benign prostatic hyperplasia
D) Prostatitis
E) Chronic kidney disease
Explanations & Answers:
Question Medium Answer:
C) Benign prostatic hyperplasia
Question Medium Explanation:
Benign prostatic hyperplasia (BPH) is common in older men and is characterized by lower urinary tract symptoms such as difficulty initiating urination, weak stream, and nocturia. The NHS recommends starting with lifestyle changes and possibly prescribing alpha-blockers or 5-alpha reductase inhibitors for symptomatic relief.
Question Hard:
A 40-year-old man presents with hematuria and flank pain. Ultrasound confirms the presence of a 5mm stone in the proximal ureter. What is the most appropriate initial management?
A) Immediate surgical intervention
B) Extracorporeal shock wave lithotripsy (ESWL)
C) Conservative management with increased fluid intake and analgesia
D) Intravenous antibiotics
E) Ureteroscopy and laser lithotripsy
Explanations & Answers:
Question Hard Answer:
C) Conservative management with increased fluid intake and analgesia
Question Hard Explanation:
For a 5mm stone in the proximal ureter, conservative management is often the initial approach. Most stones of this size have a good chance of passing spontaneously. NICE guidelines recommend management with increased fluids and analgesia, reserving surgical interventions or ESWL for cases where stones are larger or not passing naturally.
Medical fact of the day:
The kidneys receive about 20% of the total cardiac output, which translates to roughly 1.2 liters of blood per minute. This highlights their crucial role in filtering blood and maintaining homeostasis.
Quote of the day:
“In the rush to care for others, remember to take care of yourself. A healthy healer is the best healer.” 🌟