Question Easy:
A 60-year-old man presents with sudden onset of severe right flank pain, radiating towards the groin. He is writhing in pain and there is visible hematuria. What is the most likely diagnosis?
A) Pyelonephritis
B) Upper urinary tract infection
C) Renal colic
D) Acute pancreatitis
E) Appendicitis
Question Medium:
A 40-year-old woman who is a known hypertensive presents with edema and frothy urine. Her blood tests reveal hypoalbuminemia and hyperlipidemia. What is the most likely renal diagnosis?
A) Acute interstitial nephritis
B) Focal segmental glomerulosclerosis
C) Nephrotic syndrome
D) Acute tubular necrosis
E) Goodpasture’s syndrome
Question Hard:
A 35-year-old man with a history of multiple urinary tract infections presents with fatigue and arthralgia. Laboratory tests reveal hematuria, proteinuria, and elevated creatinine levels. ANCA test comes back positive. What’s the most likely diagnosis?
A) IgA nephropathy
B) Membranous nephropathy
C) Anti-glomerular basement membrane disease
D) Microscopic polyangiitis
E) Systemic lupus erythematosus
Explanations & Answers:
Question Easy Answer: C) Renal colic
Question Easy Explanation: The symptom of sudden severe flank pain radiating towards the groin along with hematuria is characteristic of renal colic, often due to a kidney stone. NICE guidelines emphasize considering renal stones in patients presenting with acute flank pain and hematuria.
Question Medium Answer: C) Nephrotic syndrome
Question Medium Explanation: The combination of edema, frothy urine, hypoalbuminemia, and hyperlipidemia is indicative of nephrotic syndrome. According to NHS guidelines, these are classic signs of this condition, which typically involves significant protein loss in the urine.
Question Hard Answer: D) Microscopic polyangiitis
Question Hard Explanation: The presentation of systemic symptoms like fatigue and arthralgia, along with hematuria, proteinuria, and positive ANCA test, is suggestive of microscopic polyangiitis. BNF guidelines list it as one of the ANCA-associated vasculitides affecting the kidneys.
Medical fact of the day: Did you know that the average adult kidney filters approximately 180 liters of blood daily to produce about 1–2 liters of urine? This immense filtering task is crucial for maintaining the body’s balance of water, salts, and waste products!
Quote of the day: “In the tapestry of health care, every thread of kindness weaves resilience and hope.”