Question Easy: A 50-year-old man presents with painful urination and increased frequency. His urine dipstick test shows positive nitrites and leukocyte esterase. What is the most likely diagnosis? 🚽
A) Acute pyelonephritis
B) Chronic kidney disease
C) Cystitis
D) Urethritis
E) Prostatitis
Explanations & Answers:
Question Easy Answer: C) Cystitis
Question Easy Explanation: The symptoms and urine dipstick findings suggest a urinary tract infection (UTI) at the level of the bladder, which is commonly referred to as cystitis. Positive nitrites indicate the presence of bacteria, typically E. coli, and leukocyte esterase indicates white blood cells responding to infection. NICE guidelines suggest managing uncomplicated cystitis in adults with appropriate antibiotics.
Question Medium: A 65-year-old man with a history of hypertension and diabetes presents with swollen ankles and frothy urine. His blood tests reveal hypoalbuminemia and hyperlipidemia. What is the most likely diagnosis?
A) Acute kidney injury
B) Nephrotic syndrome
C) Nephritic syndrome
D) Renal artery stenosis
E) Polycystic kidney disease
Explanations & Answers:
Question Medium Answer: B) Nephrotic syndrome
Question Medium Explanation: The combination of swollen ankles, frothy urine, hypoalbuminemia, and hyperlipidemia is indicative of nephrotic syndrome. This condition involves significant proteinuria, often leading to peripheral oedema and alterations in lipid metabolism. NICE guidelines recommend management through addressing the underlying cause and medications like ACE inhibitors or ARBs to reduce proteinuria.
Question Hard: A 75-year-old male presents with difficulty in initiating urination and a weak urinary stream. Upon examination, his prostate is enlarged. His prostate-specific antigen (PSA) levels are elevated but within age-specific ranges. What is the first-line medical treatment? 💊
A) Dutasteride
B) Tamsulosin
C) Finasteride
D) Watchful waiting
E) Transurethral resection of the prostate (TURP)
Explanations & Answers:
Question Hard Answer: B) Tamsulosin
Question Hard Explanation: The symptoms described are suggestive of benign prostatic hyperplasia (BPH). In accordance with NICE guidelines, the first-line medical treatment for moderate to severe symptoms of BPH typically involves an alpha-blocker such as Tamsulosin to relax the smooth muscle in the prostate and bladder neck, improving urinary flow.
Medical fact of the day: Did you know that the left kidney is often slightly higher in position than the right kidney due to the presence of the liver on the right side? This is an important consideration during renal imaging and surgery.
Quote of the day: “The care you give may be only a moment in your day, but it can be a lifetime in someone else’s memory. Keep inspiring.” 🌟