Question Easy:
A 35-year-old man presents with dysuria, frequency, and urgency. He has no fever and the physical examination is unremarkable. What is the most likely diagnosis? 🚽
A) Pyelonephritis
B) Prostatitis
C) Urethritis
D) Cystitis
E) Renal colic
Question Medium:
A 50-year-old woman with a history of hypertension presents with sudden onset of severe left flank pain radiating to the groin. A urinalysis shows hematuria but no signs of infection. What is the most appropriate next step in management? 🔍
A) Abdominal X-ray
B) Intravenous pyelogram
C) Non-contrast CT of the abdomen
D) Urine dipstick
E) Renal ultrasound
Question Hard:
A 55-year-old man with a history of type 2 diabetes presents with a new onset of oedema, increased serum creatinine, and 3+ proteinuria on urine dipstick. An ultrasound shows enlarged, echogenic kidneys. What underlying kidney condition is he most likely suffering from? 🩺
A) Focal segmental glomerulosclerosis
B) Diabetic nephropathy
C) Membranous nephropathy
D) IgA nephropathy
E) Acute tubular necrosis
Explanations & Answers:
Question Easy Answer: D) Cystitis
Question Easy Explanation: The symptoms of dysuria, frequency, and urgency without systemic signs like fever suggest cystitis, a common urinary bladder infection. NICE guidelines emphasize uncomplicated cases often involve bacterial infection with no significant findings on physical examination.
Question Medium Answer: C) Non-contrast CT of the abdomen
Question Medium Explanation: The presentation is classic for renal colic, likely due to kidney stones. A non-contrast CT is the gold standard for the diagnosis of urolithiasis, offering a clear view of stones that an ultrasound or X-ray might miss.
Question Hard Answer: B) Diabetic nephropathy
Question Hard Explanation: The combination of proteinuria, oedema, and enlarged echogenic kidneys strongly indicates diabetic nephropathy. NICE guidelines state that diabetes can lead to glomerular damage, resulting in these findings, particularly in longstanding unmanaged cases.
Medical fact of the day: The human bladder, on average, can comfortably hold around 500ml of urine before needing to be emptied. However, the urge to void is usually felt when it contains about 200 to 300ml, showcasing the bladder’s remarkable elasticity!
Quote of the day: “In the intricate world of healthcare, compassion and understanding are the most potent treatments we can offer.” 🌟