Question Easy:
A 28-year-old man presents with sudden onset of severe right flank pain radiating to the groin, along with nausea and vomiting. The pain started a few hours ago and he reports a burning sensation when urinating. What is the most likely diagnosis?
A) Urinary tract infection
B) Appendicitis
C) Renal colic due to kidney stones
D) Testicular torsion
E) Pyelonephritis
Question Medium:
A 65-year-old man with a long history of poorly controlled hypertension presents with swollen ankles, frothy urine, and fatigue. His blood tests reveal low serum albumin and increased cholesterol levels. Which one of the following is the most likely diagnosis?
A) Acute glomerulonephritis
B) Chronic kidney disease
C) Nephrotic syndrome
D) Urinary tract infection
E) Prostate cancer
Question Hard:
A 47-year-old female with a past medical history of type 2 diabetes complains of persistent urinary incontinence, associated with a loss of bladder sensation. She also reports recurrent urinary tract infections. What is the most likely underlying condition causing her symptoms?
A) Stress incontinence
B) Ureteric stone
C) Diabetic autonomic neuropathy
D) Overactive bladder syndrome
E) Pelvic organ prolapse
Explanations & Answers:
Question Easy Answer: C)
Question Easy Explanation: The patient’s symptoms are highly suggestive of renal colic due to kidney stones. The sudden onset of severe flank pain that radiates to the groin, accompanied by urinary symptoms, is classic for nephrolithiasis. The NICE guidelines recommend further investigation with imaging to confirm the presence of stones.
Question Medium Answer: C)
Question Medium Explanation: The clinical picture is indicative of nephrotic syndrome, which includes oedema, frothy urine due to proteinuria, hypoalbuminemia, and hyperlipidaemia. According to NICE, management involves dealing with the underlying cause and managing the complications such as hypertension and hyperlipidaemia.
Question Hard Answer: C)
Question Hard Explanation: The combination of persistent urinary incontinence, loss of bladder sensation, and recurrent infections in a diabetic patient suggests diabetic autonomic neuropathy. This condition affects the nerves that control the bladder, leading to dysfunction. NICE guidelines usually recommend focusing on diabetes management and treating urinary tract infections where present.
Medical fact of the day: Did you know that the kidneys filter around 180 litres of blood each day? Keeping them healthy is vital, as they regulate electrolytes, maintain fluid balance, and remove waste products from the body, alongside producing hormones that regulate blood pressure.
Quote of the day: “In the midst of care, remember to care for yourself, for the strength you give measures your own well-being.” 🌟