Question Easy:
A 28-year-old woman presents to the GP with dysuria and increased urinary frequency for the past 2 days. She has no fever or back pain. She reports no recent sexual activity changes. What is the most appropriate initial step in management?
A) Immediate referral to urology
B) Reassurance and advise fluids
C) Empirical antibiotic therapy
D) Urinary dipstick
E) Request ultrasound scan
Question Medium:
A 45-year-old man with a history of hypertension presents with abdominal pain and haematuria. A CT scan reveals multiple cysts bilaterally on the kidneys. What is the most likely diagnosis?
A) Polycystic kidney disease
B) Simple renal cysts
C) Renal cell carcinoma
D) Medullary sponge kidney
E) Hydronephrosis
Question Hard:
A 66-year-old man with a long history of T2DM and chronic kidney disease presents with generalized edema and fatigue. Lab results reveal serum creatinine at 300 µmol/L, eGFR 30 ml/min/1.73m², and urine ACR of 250 mg/mmol. Which of the following medications should be considered to delay the progression of his renal disease?
A) NSAIDs
B) ACE inhibitor
C) Calcium channel blocker
D) Beta-blocker
E) Thiazide diuretic
Explanations & Answers:
Question Easy Answer: D) Urinary dipstick
Question Easy Explanation: According to NICE guidelines, the initial step for suspected uncomplicated urinary tract infection (UTI) in a young woman is a urinary dipstick test. This helps to confirm the presence of nitrates and leukocytes that indicate a UTI, guiding appropriate treatment. 🚑
Question Medium Answer: A) Polycystic kidney disease
Question Medium Explanation: Polycystic kidney disease, an inherited disorder, is characterized by numerous cysts in both kidneys, often presenting with hypertension, haematuria, and abdominal or flank pain. It aligns with the patient’s symptoms and CT findings. 🏥
Question Hard Answer: B) ACE inhibitor
Question Hard Explanation: ACE inhibitors are recommended to reduce proteinuria and slow the progression of chronic kidney disease in patients with diabetes, as per NICE guidelines. They help by lowering glomerular pressure and thus reducing damage to the kidneys. 📈
Medical fact of the day: Did you know that the average human kidney filters about 180 liters of blood per day, allowing it to excrete approximately 1 to 2 liters of urine? This is why maintaining kidney function is crucial for metabolic homeostasis! 🌊
Quote of the day: “In every patient’s story lies a lesson in empathy and healing, waiting for the diligent heart to uncover.” 💡