Question Easy:
A 45-year-old woman presents with frequent burning urination, urgency, and suprapubic pain. Urinalysis shows positive nitrites and leukocytes. Which of the following is the most likely diagnosis? 🚻
A) Acute pyelonephritis
B) Urinary tract infection
C) Interstitial cystitis
D) Overactive bladder
E) Bladder cancer
Question Medium:
A 60-year-old man with a history of poorly controlled hypertension presents with swelling in his ankles, fatigue, and foamy urine. Blood tests reveal hypoalbuminemia and elevated serum creatinine. Which of the following is the most likely diagnosis? 🧴
A) Acute tubular necrosis
B) Nephrotic syndrome
C) Chronic kidney disease
D) Goodpasture syndrome
E) Renal artery stenosis
Question Hard:
A 55-year-old man presents with haematuria, flank pain, and a palpable mass in the left upper quadrant. Imaging reveals a large left renal mass. Which paraneoplastic syndrome is most commonly associated with this renal condition? 🩸
A) Polycythemia due to erythropoietin production
B) Hypocalcemia due to calcitonin secretion
C) Cushing’s syndrome due to ACTH production
D) Carcinoid syndrome due to serotonin secretion
E) Hypercalcemia due to PTHrP production
Explanations & Answers:
Question Easy Answer:
B) Urinary tract infection
Question Easy Explanation:
The patient’s symptoms of burning urination, urgency, and suprapubic pain combined with positive nitrites and leukocytes in the urine strongly suggest a urinary tract infection (UTI). This aligns with NICE guidelines, which recommend considering a UTI based on these clinical features and urinalysis results.
Question Medium Answer:
B) Nephrotic syndrome
Question Medium Explanation:
The clinical presentation of ankle swelling, fatigue, foamy urine, hypoalbuminemia, and elevated serum creatinine suggests nephrotic syndrome. Nephrotic syndrome is characterized by these features, particularly hypoalbuminemia and proteinuria. The patient’s history of hypertension may contribute to the underlying renal pathology, but the specific constellation of symptoms points to nephrotic syndrome, in line with BNF descriptions.
Question Hard Answer:
A) Polycythemia due to erythropoietin production
Question Hard Explanation:
The presence of haematuria, flank pain, and a palpable renal mass is highly suggestive of renal cell carcinoma. Paraneoplastic syndromes associated with renal cell carcinoma include polycythemia due to ectopic production of erythropoietin, which is the most common paraneoplastic syndrome in this context, as per NHS guidelines.
Medical fact of the day: Did you know that autosomal dominant polycystic kidney disease is the most common inherited kidney disease, affecting up to 1 in 1,000 people in the UK? Monitoring and managing blood pressure can significantly slow its progression.
Quote of the day: “In the care of others, we find the strength to heal ourselves. 🌟 Keep shining, health care warriors!”