Question Easy:
A 65-year-old man presents with difficulty urinating, a weak stream, and nocturia. He has a prostate-specific antigen (PSA) level within the normal range for his age. What is the most likely diagnosis? 🚽
A) Prostate cancer
B) Bladder cancer
C) Benign prostatic hyperplasia (BPH)
D) Urinary tract infection
E) Overactive bladder
Question Medium:
A 45-year-old woman presents to the GP with a history of recurrent urinary tract infections (UTIs) over the past year. She complains of dysuria, increased frequency, and urgency during episodes. What is the most appropriate long-term management strategy to reduce the risk of recurrence? 🔬
A) Long-term antibiotic prophylaxis
B) Cranberry supplements
C) Increase fluid intake
D) Estrogen therapy
E) Trial of immunotherapy
Question Hard:
A 72-year-old woman is brought to A&E with acute confusion and dehydration. Her blood tests reveal a sodium level of 123 mmol/L (135-145 mmol/L) and a potassium level of 6.5 mmol/L (3.5-5.0 mmol/L). An ECG shows peaked T-waves and a prolonged PR interval. What is the most appropriate immediate management for this patient? ⚡️
A) Intravenous calcium gluconate
B) Intravenous insulin with dextrose
C) Intravenous sodium bicarbonate
D) Haemodialysis
E) Sodium polystyrene sulfonate
Explanations & Answers:
Question Easy Answer: C) Benign prostatic hyperplasia (BPH)
Question Easy Explanation:
Benign prostatic hyperplasia (BPH) is a common condition in older men, characterised by urinary symptoms attributable to an enlarged prostate. Symptoms include difficulty starting urination, weak stream, and nocturia, which align with this patient’s presentation. The normal PSA level also supports BPH rather than prostate cancer. NICE guidelines recommend considering BPH in men with such lower urinary tract symptoms (LUTS).
Question Medium Answer: A) Long-term antibiotic prophylaxis
Question Medium Explanation:
For women with recurrent UTIs, NICE guidelines suggest considering continuous antibiotic prophylaxis as an appropriate strategy for prevention after discussing the potential benefits and adverse effects with the patient. Increasing fluid intake is generally recommended for UTI prevention, but long-term antibiotic use is more effective for patients with recurrent cases.
Question Hard Answer: A) Intravenous calcium gluconate
Question Hard Explanation:
The most immediate threat in hyperkalaemia (high potassium) with ECG changes like peaked T waves is cardiac arrhythmia. Intravenous calcium gluconate is administered to stabilize myocardial membranes and prevent life-threatening cardiac events. NICE guidelines include this as priority treatment in severe hyperkalaemia with ECG changes before other interventions like insulin and dextrose.
Medical fact of the day: The left kidney is typically positioned higher than the right kidney due to the asymmetrical placement of the liver. This anatomical feature is a crucial consideration during renal surgeries and imaging procedures.
Quote of the day: “The tiniest spark in one’s heart can ignite the brightest flame of hope in healing.” 🌟