Question Easy: A 23-year-old male presents with sudden onset excruciating right flank pain radiating to the groin. He feels nauseated and has vomited twice. There is no dysuria but he is pacing around the room due to pain. What is the most likely diagnosis? 🤔
A) Appendicitis
B) Urinary tract infection
C) Pyelonephritis
D) Renal colic
E) Inguinal hernia
Explanations & Answers:
Question Easy Answer: D
Question Easy Explanation: The classic presentation of renal colic involves sudden, severe flank pain that often radiates to the groin, typically caused by kidney stones. The patient’s restlessness due to pain is characteristic. According to NICE, the primary management involves pain relief, and a diagnostic CT scan if needed.
Question Medium: A 67-year-old male with a history of hypertension and diabetes presents with fatigue, pruritus, and decreased urine output. Laboratory tests reveal elevated serum creatinine and blood urea nitrogen levels. What is the most likely underlying cause of his condition? 📉
A) Benign prostatic hyperplasia
B) Acute tubular necrosis
C) Hypertensive nephropathy
D) Diabetic nephropathy
E) Chronic glomerulonephritis
Question Medium Answer: D
Question Medium Explanation: Diabetic nephropathy often begins with hyperglycaemia-induced damage, leading to progressive changes within the kidney architecture. It commonly presents with albuminuria and a gradual decline in renal function, becoming evident as elevated creatinine and urea levels. NICE guidelines recommend routine screening and management through glucose and blood pressure control.
Question Hard: A 56-year-old lady presents with recurrent urinary tract infections. A renal ultrasound reveals multiple cysts in both kidneys, and her family history includes a parent who died of a stroke. What genetic mutation is most likely responsible for her condition? 🚨
A) PKD1
B) PKHD1
C) HNF1B
D) COL4A3
E) WT1
Question Hard Answer: A
Question Hard Explanation: Autosomal dominant polycystic kidney disease (ADPKD), often associated with mutations in the PKD1 gene, is characterized by cyst formation in the kidneys and an increased risk of hypertension and renal failure. Family history of stroke and recurrent UTIs are common due to associated complications like aneurysms and cystic infections. NICE recommends genetic testing and management of hypertension to slow disease progression.
Medical fact of the day: The kidney is responsible for filtering approximately 180 litres of blood daily, yet only about 1-2 litres are excreted as urine! Kidney function is crucial in regulating electrolytes, acid-base balance, and blood pressure.🩺
Quote of the day: “In the tapestry of health care, each compassionate interaction becomes a thread weaving hope and healing.” 🌟