Question Easy:
A 32-year-old woman presents to her GP with recurrent urinary tract infections (UTIs). She reports needing to urinate frequently, experiencing burning during urination, and having lower abdominal discomfort. Which organism is most commonly responsible for uncomplicated UTIs in women?
A) Klebsiella pneumoniae
B) Staphylococcus saprophyticus
C) Escherichia coli
D) Proteus mirabilis
E) Enterococcus faecalis
Question Medium:
A 65-year-old man presents with swelling in his lower limbs, elevated blood pressure, and proteinuria on urinalysis. His history includes type 2 diabetes mellitus. Which of the following is the most appropriate first-line treatment to reduce proteinuria in this patient?
A) Calcium channel blocker
B) Thiazide diuretic
C) ACE inhibitor
D) Beta-blocker
E) Alpha-blocker
Question Hard:
A 45-year-old man is admitted to the hospital with acute onset right flank pain radiating to the groin. A CT scan of his abdomen reveals a 6 mm stone in the right proximal ureter. Which of the following treatments is the initial management for acute renal colic due to a ureteric stone?
A) Extracorporeal shock wave lithotripsy (ESWL)
B) Intravenous fluids and bed rest
C) Immediate surgical removal of the stone
D) Non-steroidal anti-inflammatory drugs (NSAIDs)
E) Alpha-blockers
Explanations & Answers:
Question Easy Answer:
C) Escherichia coli
Question Easy Explanation:
Escherichia coli is the most common causative organism of uncomplicated urinary tract infections, responsible for up to 80-85% of cases, especially in women due to its ability to colonize the urethral meatus easily.
Question Medium Answer:
C) ACE inhibitor
Question Medium Explanation:
In patients with diabetes mellitus and proteinuria, ACE inhibitors are recommended as the first-line treatment due to their renal protective effects, including reducing proteinuria and slowing the progression of kidney disease, as per NICE guidelines.
Question Hard Answer:
D) Non-steroidal anti-inflammatory drugs (NSAIDs)
Question Hard Explanation:
Initial management of acute renal colic due to a stone includes pain relief, and NSAIDs are often the first-line analgesics used. They help reduce renal ureteric colic pain through their action on prostaglandins. Opiates are alternatives if NSAIDs are contraindicated or ineffective.
Medical fact of the day:
The kidney’s filtration rate is measured by the glomerular filtration rate (GFR). In the UK, chronic kidney disease (CKD) is staged using the GFR, with stage 3 CKD often remaining asymptomatic but requiring monitoring and management to prevent progression.
Quote of the day:
“Compassion is the heartbeat of healthcare; it fuels our resilience and inspires hope in every patient we care for.”