renal and uro DPD

Question 1

35 yr old woman presents with ankle oedema. Echocardiogram: NAD. U+Es are normal. ALT, AST + ALP are normal. Albumin is 15 (low). What would the next investigation be?

Answer 1

Urinalysis

Oedema DDx = heart failure, liver disease and albuminuria. The former 2 options are disregarded so this could be nephrotic syndrome - oedema, hypoalbuminaemia, proteinuria. Urinalysis detects presence of proteins.

Question 2

40 year old man presents with loin pain. CRP is normal and urinalysis results show blood ++. What would the best investigation to request?

Answer 2

CT KUB

DDx for loin pain: pyelonephritis, renal colic

Question 3

A 24 year old female presents with severe right sided back and abdominal pain and a
fever. She has no other PMH or travel history.

Answer 3

Acute pyelonephritis (fever, loin/flank pain and tenderness) may present as back pain

DDx: cholecystitis, hepatitis (but no jaundice here or travel Hx), campylobacter (no diarrhoea here)

Question 4

Indications for dialysis

Answer 4

HyperK+
Fluid overload (pulmonary oedema)
Metabolic acidosis
Symptomatic uraemia (pericarditis or encephalopathy)
Drug OD

Question 5

Allopurinol used to treat

Answer 5

Gout and kidney stones

MOA: decreases uric acid levels

Question 6

PSA is raised in

Answer 6

prostate cancer
BPH
prostatis
catherisation
UTI

Question 7

Drugs overdose that require dialysis (BLAST mneumonic)

Answer 7

Barbituates
Lithium
Alcohol
Salicylates
Theophylline

Question 8

Inguinal hernias anatomy (and direct vs indirect)

Answer 8

Occurs above and medial to the pubic tubercle.

Direct: medial to inferior epigastric vessels and enters through a weak point in the fascia of the abdominal wall (Hesselbach’s triangle)
Indirect: through inguinal ring

Question 9

Femoral hernias anatomy

Answer 9

Occurs below and lateral to the pubic tubercle.

Often irreducible so easily strangulate

Question 10

Amyloidosis affects the kidneys and causes nephrotic syndrome and…

Answer 10

Membranous glomerulonephritis

peripheral oedema, hypoalbuminaemia and proteinuria will be signs of this

Question 11

Secondary amyloidosis (AA) causes problems in

Answer 11

Kidneys (nephrotic)
Liver (hepatomegaly)
Spleen (splenomegaly)

patient with secondary AA amyloidosis may have associated diseases of chronic inflammation (IBD and RhA).

Question 12

Which part of the prostate is enlarged in BPH?

Answer 12

Central zone

Question 13

A 25yr old man presents with a testicular swelling that has increased in size over the past few months. The swelling is fluctuant and underlying testis is impalpable. What is the likely diagnosis?

Answer 13

Hydrocoele
Fluid of it surrounds the body of the testis and underlying testis is impalpable. Primary hydrocoeles are idiopathic and secondary occur to trauma, tumour and infection.

Question 14

A 45yr old man presents with scrotal swelling and is worried that he is growing a 3rd testicle. O/E: smooth fluctuant swelling within the scrotum. Both L and R testes are palpable. What is the likely diagnosis?

Answer 14

Epididymal cyst

Separate from testis therefore testis is palpable