A 65-year-old man comes to the clinic with a history of mild anaemia. The physician orders several urine tests. The results are as follows:
– Negative for haemoglobin, urobilinogen, and bilirubin
– Positive for protein
– Negative for glucose, nitrites, and leucocytes
– Positive for ketones
– +++ for Bence Jones
What could be the possible reason for these results?
As an Emergency department doctor, a 50-year-old man presents with intense left flank pain that extends to his groin. He reports that the pain began yesterday. Upon conducting a urinalysis, the following results were obtained:
– Haemoglobin +++
– Urobilinogen Negative
– Bilirubin Negative
– Protein Negative
– Glucose Negative
– Nitrites Negative
– Leucocytes Negative
– Ketones +
What could be the possible cause of these findings?
A 15-year-old girl comes to the clinic complaining of myalgia and brown-coloured urine. She has been diagnosed with rhabdomyolysis for the fourth time, and the cause is still unknown.
What investigation should be considered at this point?
A 50-year-old man is struggling with hypertension that is not responding to his current medications. His GP added ramipril to his amlodipine and doxazosin two months ago, but his blood pressure remains high at 162/75 mmHg. The GP decides to increase the ramipril dose to 1.25 mg once daily. However, the patient already has mild renal impairment due to his hypertension, so the GP follows NICE guidance and orders further renal function testing in two weeks. Unfortunately, the patient’s creatinine level has increased from 150 to 210 μmol/L. What should the GP’s next course of action be?
A 40-year-old male visits his doctor two days after finishing a marathon. He expresses worry about the reddish-brown hue of his urine and his overall feeling of illness. What is the pigment responsible for the urine discoloration?
What is the name of the newer induction drug that selectively targets B cells to quickly control ANCA associated vasculitides while sparing other lymphocytes?
What is the name of the drug used to quickly achieve disease control in ANCA associated vasculitides by inducing DNA crosslinkage and apoptosis of rapidly dividing cells during induction therapy?
A 30-year-old man with end stage renal failure due to IgA nephropathy underwent a kidney transplant from a deceased brainstem donor and experienced successful primary graft function. After being discharged eight days post-surgery, his creatinine levels stabilized at 85 umol/l with regular clinic visits. However, at seven weeks post-transplant, his creatinine levels increased to 190 umol/l despite being asymptomatic. As a result, he was admitted for further evaluation. What would be your initial course of action?
A 59-year-old man of Afro-Caribbean descent presented with bipedal oedema. He was a retired teacher with occasional international travel. On examination, his body weight was 40 kg with some oral ulcers.
Tests revealed:
Investigation Result Normal value
Haemoglobin 112g/l 135–175 g/l
White cell count (WCC) 5 × 109/l 4–11 × 109/l
Neutrophils 1.2 × 109/l 2.5–7.58 × 109/l
Lymphocytes 1.4 × 109/l 1.5–3.5 × 109/l
Eosinophils 0.8 × 109/l 0.1–0.4 × 109/l
Urine Protein 2+
Cholesterol 4.5 <5.2 mmol/l
Which of the following tests is next indicated for this patient?
In the treatment of autoimmunity and prevention of rejection after solid organ transplantation, various immunosuppressant drugs are used. Despite their effectiveness, these drugs have unwanted side effects that increase the risk of infection and malignancy. However, specific side effects are associated with each drug due to their unique mechanism of action. What is the immunosuppressant drug that is commonly linked to hirsutism and gingival hypertrophy in patients? Also, is there any age group that is more susceptible to these side effects?