Question Easy:
A 24-year-old man comes to the GP with dysuria and increased urinary frequency. There is no fever or back pain. A urine dipstick reveals nitrites and leukocytes. Which of the following is the most likely diagnosis? 🚽
A) Acute pyelonephritis
B) Cystitis
C) Urethritis
D) Prostatitis
E) Ureteric colic
Explanations & Answers:
Question Easy Answer:
B) Cystitis
Question Easy Explanation:
Cystitis is a common lower urinary tract infection characterized by dysuria and increased frequency without systemic symptoms like fever or loin pain, unlike pyelonephritis. The presence of nitrites and leukocytes on a urine dipstick strongly suggests a bacterial infection, supporting the diagnosis of cystitis according to NICE guidelines.
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Question Medium:
A 65-year-old woman with a history of hypertension and diabetes presents with generalized oedema and frothy urine. Laboratory tests reveal heavy proteinuria (>3.5 g/24h) and hypoalbuminemia. Which of the following conditions is most consistent with her presentation? 🌊
A) Acute glomerulonephritis
B) Nephritic syndrome
C) Nephrotic syndrome
D) Renal artery stenosis
E) Chronic kidney disease
Explanations & Answers:
Question Medium Answer:
C) Nephrotic syndrome
Question Medium Explanation:
Nephrotic syndrome is defined by heavy proteinuria, hypoalbuminemia, and oedema. The presence of these symptoms, along with the frothy urine, fits the classic presentation of nephrotic syndrome. This condition requires careful management of fluid balance and the underlying cause, in accordance with NHS guidelines.
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Question Hard:
A 58-year-old man presents with flank pain, fever, and haematuria. An ultrasound reveals a solid mass in the left kidney. What is the most likely initial diagnostic step to confirm the diagnosis of renal cell carcinoma in this patient? 🔬
A) Abdominal CT scan
B) Renal biopsy
C) MRI of the abdomen
D) PET scan
E) Intravenous urography
Explanations & Answers:
Question Hard Answer:
A) Abdominal CT scan
Question Hard Explanation:
The abdominal CT scan is the imaging modality of choice for evaluating a suspected renal mass, such as renal cell carcinoma. It provides detailed information on the size, location, and extension of the tumour, which is critical for staging and treatment planning. Current NICE guidelines recommend CT for the diagnostic assessment of renal lesions.
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Medical fact of the day:
Did you know that polycystic kidney disease is one of the most common inherited disorders and can lead to end-stage renal failure? In the UK, it affects approximately 1 in 1,000 people.
Quote of the day:
“Caring for others is not just a duty, but a calling. Let your passion to care guide you through the toughest of days.”