Question Easy: 🚽 A 30-year-old man presents with dysuria and increased urinary frequency. He reports no fever or flank pain. What is the most likely diagnosis?
A) Acute pyelonephritis
B) Cystitis
C) Prostatitis
D) Urethritis
E) Kidney stones
Question Medium: 🔍 A 58-year-old woman with a history of hypertension and chronic kidney disease (CKD) stage 3 presents for a routine check-up. Which blood test would most accurately reflect her renal function?
A) Blood urea nitrogen (BUN)
B) Serum creatinine
C) Estimated glomerular filtration rate (eGFR)
D) Serum electrolytes
E) Urine dipstick
Question Hard: 🌊 A 40-year-old man presents with periodic flank pain that radiates to the groin, suggesting renal colic. Imaging reveals a 4mm stone in the distal ureter. Which of the following is the most appropriate initial management?
A) Immediate surgical intervention
B) Extracorporeal shock wave lithotripsy (ESWL)
C) Medical expulsive therapy (MET) with alpha-blockers
D) Observation and increased fluid intake
E) Percutaneous nephrolithotomy
Explanations & Answers:
Question Easy Answer: B) Cystitis
Question Easy Explanation: Cystitis, an inflammation of the bladder typically due to infection, is characterized by dysuria and increased urinary frequency. The absence of fever or flank pain makes acute pyelonephritis less likely. NICE guidelines focus on symptom management and, if needed, confirmatory urine cultures.
Question Medium Answer: C) Estimated glomerular filtration rate (eGFR)
Question Medium Explanation: eGFR is the most reliable indicator of renal function and helps stage CKD according to NICE guidelines. Unlike serum creatinine or BUN, eGFR considers factors like age, gender, and body size, providing a more accurate assessment of kidney filtration ability.
Question Hard Answer: C) Medical expulsive therapy (MET) with alpha-blockers
Question Hard Explanation: For a small stone (e.g., 4mm) in the ureter, MET with alpha-blockers like tamsulosin can facilitate passage by relaxing ureteral muscles. NICE guidelines recommend this non-invasive treatment approach, especially when there are no signs of infection or severe pain requiring immediate intervention.
Medical fact of the day: Did you know that the kidneys filter approximately 180 litres of blood daily? That’s equivalent to filtering the entire body’s blood volume around 60 times a day! Understanding this emphasizes the significance of renal function tests in diagnosing and managing kidney health.
Quote of the day: “Healing takes time, energy, and patience. As healthcare warriors, remember that every small step you take leads to a giant leap for your patients’ well-being.”