Question Easy:
A 25-year-old man presents with a painful lump in his right groin. On examination, there is a tender, fluctuant mass that transilluminates with light. What is the most likely diagnosis? 🌟
A) Inguinal hernia
B) Hydrocele
C) Epididymal cyst
D) Testicular torsion
E) Varicocele
Explanations & Answers:
Question Easy Answer: B) Hydrocele
Question Easy Explanation: A hydrocele is an accumulation of fluid around the testicle, which can cause a fluctuant, transilluminating mass in the groin area. This is consistent with the presentation in this case. According to NICE guidelines, hydroceles are often painless unless very large, but they are known for their classic transillumination sign.
Question Medium:
A 55-year-old woman attends the GP with fatigue, weakness, and polyuria. Laboratory findings reveal hypercalcaemia. Which of the following conditions is the most likely cause of her symptoms?
A) Chronic kidney disease
B) Primary hyperparathyroidism
C) Addison’s disease
D) Diabetes insipidus
E) Osteoporosis
Question Medium Answer: B) Primary hyperparathyroidism
Question Medium Explanation: Primary hyperparathyroidism is characterised by excessive secretion of parathyroid hormone (PTH), leading to increased calcium levels, causing symptoms such as fatigue, weakness, and polyuria. NICE guidelines recommend evaluating persistent hypercalcaemia with a parallel assessment of PTH levels, often showing elevated or inappropriately normal results.
Question Hard:
A 40-year-old man presents with flank pain, hematuria, and hypertension. An ultrasound of the kidneys shows bilateral enlargement with multiple cysts. He reports that his father had a similar condition. Which gene mutation is most likely responsible for this presentation? 🧬
A) PKHD1
B) PKD1
C) TSC1
D) VHL
E) WT1
Question Hard Answer: B) PKD1
Question Hard Explanation: The presentation is suggestive of Autosomal Dominant Polycystic Kidney Disease (ADPKD), most commonly caused by mutations in the PKD1 gene. The patient’s symptoms, family history, and ultrasound findings align with ADPKD, and NICE guidelines suggest genetic counselling as an important component of management.
Medical fact of the day: Did you know that the kidneys filter about 180 litres of blood daily? This fact highlights the impressive capacity of the renal system to maintain homeostasis, crucial for managing fluid and electrolyte balance in the body.
Quote of the day: “In the heart of every challenge lies a chance to grow. Remember, even the strongest rivers start from humble springs.”