Question Easy:
A 45-year-old patient presents with frequent urination, particularly at night. His blood tests reveal a higher-than-normal blood glucose level. Which condition is most likely causing these symptoms? 🩺
A) Urinary tract infection
B) Diabetes mellitus
C) Prostate enlargement
D) Dehydration
E) Nephrolithiasis
Explanations & Answers:
Question Easy Answer: B)
Question Easy Explanation: The symptoms described, particularly frequent urination and a higher-than-normal blood glucose level, match with diabetes mellitus. Polyuria is a common symptom due to osmotic diuresis caused by hyperglycemia. According to NICE guidelines, frequent urination, especially at night (nocturia), is often due to poor glycemic control in diabetes.
Question Medium:
A 65-year-old man with a history of smoking presents with painless hematuria 🚬. His ultrasound shows a solid mass in the bladder. What is the most likely diagnosis?
A) Bladder infection
B) Bladder cancer
C) Kidney stones
D) Benign prostatic hyperplasia
E) Glomerulonephritis
Explanations & Answers:
Question Medium Answer: B)
Question Medium Explanation: Painless hematuria in an older patient, especially one with a history of smoking, raises significant concern for bladder cancer, as per NHS guidelines. The presence of a solid mass in the bladder seen on ultrasound further supports this diagnosis.
Question Hard:
A 37-year-old woman presents to the ED with severe flank pain and hematuria. A CT scan confirms the presence of a 7mm stone in the ureter. What is the most appropriate initial management? 🏥
A) Emergent lithotripsy
B) Oral fluids and analgesia
C) Surgical removal
D) Intravenous antibiotics
E) Ureteric stent placement
Explanations & Answers:
Question Hard Answer: B)
Question Hard Explanation: According to NICE guidance, a stone of 7mm often may pass spontaneously, especially if located in the lower ureter. Initial management includes adequate analgesia (often NSAIDs or opioids) and oral fluid intake to facilitate stone passage. Emergent interventions like lithotripsy or surgery are usually reserved for larger stones or if there’s evidence of complications such as infection or obstruction.
Medical fact of the day: Did you know? The kidneys filter about 150 quarts of blood each day to form around 1 to 2 quarts of urine, consisting of wastes and extra fluids. This is a critical function that maintains homeostasis in the body. 🧪
Quote of the day: “Healing is a matter of time, but it is sometimes also a matter of opportunity. Keep believing in the difference you can make each day.” 🌟