Question Easy:
A 25-year-old woman presents with dysuria, increased urinary frequency, and suprapubic pain. 🤕 What is the most likely diagnosis?
A) Cystitis
B) Pyelonephritis
C) Renal colic
D) Pelvic inflammatory disease
E) Urethral stricture
Explanations & Answers:
Question Easy Answer:
A) Cystitis
Question Easy Explanation:
Cystitis, a lower urinary tract infection (UTI), is most likely given the patient’s symptoms of dysuria, increased urinary frequency, and suprapubic pain. NICE guidelines recommend considering a UTI in women presenting with these symptoms.
Question Medium:
A 55-year-old man has chronic kidney disease (CKD) and a serum creatinine level of 300 µmol/L. He feels relatively well but experiences some mild fatigue. According to NICE guidelines, what is the most likely stage of his CKD?
A) Stage 1
B) Stage 2
C) Stage 3a
D) Stage 3b
E) Stage 5
Explanations & Answers:
Question Medium Answer:
D) Stage 3b
Question Medium Explanation:
According to NICE guidelines, CKD is staged based on the estimated glomerular filtration rate (eGFR). A serum creatinine level correlating to eGFR between 30-44 mL/min/1.73m² indicates stage 3b CKD.
Question Hard:
A 67-year-old woman presents with gross hematuria and flank pain. A CT scan reveals a 4 cm renal mass. What is the most appropriate initial management according to NHS guidelines?
A) Radical nephrectomy
B) Partial nephrectomy
C) Renal biopsy
D) Watchful waiting
E) Radiotherapy
Explanations & Answers:
Question Hard Answer:
B) Partial nephrectomy
Question Hard Explanation:
NHS guidelines recommend partial nephrectomy for renal tumors ≤4 cm when feasible to preserve renal function. Radical nephrectomy might be considered for larger or more complex lesions but is not the first-line approach in this scenario.
Medical fact of the day: Did you know that the prevalence of CKD stages 3-5 in the UK adult population is estimated to be about 6.1%? Early detection and management are crucial for preventing progression to end-stage renal disease.
Quote of the day: “Every patient is a story of resilience. Keep writing theirs with your dedication and compassion.”