Question Easy:
A 35-year-old woman presents to her GP with frequent urination, burning sensation during urination, and lower abdominal pain. She also mentions feeling generally unwell with mild fever. What is the most likely diagnosis? 🤔
A) Pyelonephritis
B) Cystitis
C) Urethritis
D) Vaginitis
E) Appendicitis
Explanations & Answers:
Question Easy Answer: B) Cystitis
Question Easy Explanation: This clinical presentation is classic for a urinary tract infection affecting the bladder, known as cystitis. According to NICE guidelines, symptoms such as frequent urination, dysuria (burning sensation), and lower abdominal pain are indicative of cystitis. Pyelonephritis would present with more systemic symptoms, such as a high fever and flank pain.
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Question Medium:
A 60-year-old man with a history of hypertension and type 2 diabetes presents with fatigue, swelling in the ankles, and urine that appears foamy. Blood tests reveal a high serum creatinine and urea level. What is the most likely underlying condition causing these symptoms? 🧪
A) Diabetic nephropathy
B) Hypertensive nephropathy
C) Acute tubular necrosis
D) Polycystic kidney disease
E) Glomerulonephritis
Explanations & Answers:
Question Medium Answer: A) Diabetic nephropathy
Question Medium Explanation: In individuals with diabetes, symptoms such as proteinuria (indicated by foamy urine) and declining renal function (high serum creatinine and urea) are highly suggestive of diabetic nephropathy. NICE guidelines emphasize the role of good glycaemic and blood pressure control to slow the progression of kidney damage in diabetes.
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Question Hard:
A 72-year-old man is rushed to the emergency department with sudden-onset severe left-sided flank pain radiating to the groin, hematuria, and nausea. He has a history of hypertension and hyperparathyroidism. A CT scan shows a 6mm stone in the left ureter. Considering his medical history, what is the most likely composition of the kidney stone? 💎
A) Calcium oxalate
B) Struvite
C) Uric acid
D) Cystine
E) Calcium phosphate
Explanations & Answers:
Question Hard Answer: E) Calcium phosphate
Question Hard Explanation: The presence of both hypertension and hyperparathyroidism suggests a predisposition to calcium phosphate stones. Hyperparathyroidism can lead to hypercalcemia and hypercalciuria, contributing to the formation of calcium-containing stones. According to NHS resources, calcium oxalate stones are more common, but the patient’s history makes calcium phosphate the more likely composition in this case.
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Medical fact of the day: Did you know that maintaining well-controlled blood pressure significantly reduces the risk of chronic kidney disease progression? In the UK, the target blood pressure for patients with chronic kidney disease and proteinuria is generally <130/80 mmHg, as per NICE guidelines.
Quote of the day: “In the rhythm of caring, the heartbeats of dedication and compassion nourish one another, illuminating the path of healing.” 🌟