A 68-year-old man with a history of chronic obstructive pulmonary disease and overweight presents to his GP with severe hypertension. Upon investigation, he is diagnosed with renal artery stenosis. What is a risk factor for the development of renal artery stenosis in this patient?
A 70-year-old patient receiving haemodialysis three times a week through a tunnelled internal jugular line arrives at the dialysis unit feeling well.
However, 15 minutes after starting haemodialysis he develops a fever, his blood pressure drops rapidly and he becomes unwell. He is sweaty and appears confused.
He still passes small volumes of urine and has a history of diverticular disease.
What could be the possible reason for his symptoms?
A 20-year-old woman discovers she is pregnant and despite it being unplanned, she is excited to become a mother. During her initial check-up, her blood pressure is measured at 170/120 mmHg. She has a clean medical history, except for a childhood bout of Henoch-Schönlein purpura. Additionally, there is no relevant family history and she does not smoke. What could be the probable reason for her hypertension?
A 44-year-old man presents with nephrotic syndrome and is undergoing further investigations to determine the underlying cause.
Under what condition would corticosteroids be the most successful in reversing the nephrotic syndrome?
As a locum GP, you come across a 40-year-old woman who is experiencing chills, pelvic discomfort, and painful urination. This patient has no history of diabetes. What are the possible urinalysis results that you might expect in this scenario?
A) Haemoglobin: Negative, Urobilinogen: Negative, Bilirubin: Negative, Protein: +, Glucose: +++, Nitrites: Negative, Leucocytes: +, Ketones: Negative
B) Haemoglobin: Negative, Urobilinogen: Negative, Bilirubin: Negative, Protein: Negative, Glucose: +, Nitrites: +++, Leucocytes: ++, Ketones: +++
C) Haemoglobin: +++, Urobilinogen: Negative, Bilirubin: Negative, Protein: Negative, Glucose: Negative, Nitrites: +++, Leucocytes: +++, Ketones: Negative
D) Haemoglobin: Negative, Urobilinogen: Negative, Bilirubin: Negative, Protein: Negative, Glucose: Negative, Nitrites: ++++, Leucocytes: Negative, Ketones: +++
E) Haemoglobin: Negative, Urobilinogen: +, Bilirubin: +, Protein: Negative, Glucose: Negative, Nitrites: +++, Leucocytes: Negative, Ketones: Negative
It is important to note that the urinalysis results may vary depending on the individual patient’s condition and medical history. As a healthcare professional, it is crucial to conduct a thorough examination and analysis to determine the appropriate diagnosis and treatment plan for the patient.
A 65-year-old man is presenting to the low clearance clinic with chronic kidney disease of unknown origin. He is experiencing general malaise, fatigue, and shortness of breath. His GFR has remained stable at 15 with a baseline creatinine of 385 μmol/L (and urea of 21 mmol/L) for over a year. However, recent blood work shows abnormal levels of Na, K, urea, creatinine, bicarbonate, Ca, Phos, Hb, and MCV.
Which medication would be the most beneficial to alleviate his symptoms?
A 39-year-old man is discovered on the roadside after a single-vehicle car accident. The duration of his lying there is uncertain. Upon the arrival of paramedics, his GCS is 10, and his blood pressure is 92/66 mmHg with a pulse of 96 bpm. Upon arrival at the Emergency department, his blood test results reveal a urea level of 44 mmol/l (normal range: 2.5 – 7.5) and a creatinine level of 620 µmol/l (normal range: 60 – 110). A catheterization procedure produces 50 mls of brown-colored urine. What additional blood test should be requested to determine the cause of his kidney dysfunction?
A 67-year-old man with diabetes comes in for his annual check-up. He reports occasional cramping in his calf after walking about a mile on flat ground, but is otherwise feeling well. He admits to smoking five cigarettes a day. During the exam, his blood pressure is measured at 166/98 mmHg, with a pulse of 86 bpm and a BMI of 30.2. Neurological exam is normal and his fundi appear normal. However, examination of his peripheral circulation reveals absent feet pulses and weak popliteal pulses. He is started on antihypertensive therapy and his U+Es are measured over a two-week period, with the following results:
Baseline:
Sodium – 138 mmol/L
Potassium – 4.6 mmol/L
Urea – 11.1 mmol/L
Creatinine – 138 µmol/L
2 weeks later:
Sodium – 140 mmol/L
Potassium – 5.0 mmol/L
Urea – 19.5 mmol/L
Creatinine – 310 µmol/L
Which class of antihypertensives is most likely responsible for this change?
A patient who had her PD catheter inserted into her abdomen complains that the first bag of the morning is often difficult to instil, and she cannot remove any fluid after the four hour dwell. Later in the day, this is better, and she can usually remove the fluid from the morning and instil the next bag and remove it after the dwell. What is the most probable reason for this issue?
A 65-year-old woman presents to her GP with a complaint of general malaise. Upon conducting blood tests, the following results were obtained:
Adjusted calcium: 2.3 mmol/L (2.2-2.4)
Phosphate: 0.9 mmol/L (0.7-1.0)
PTH: 8.09 pmol/L (1.05-6.83)
Urea: 7.8 mmol/L (2.5-7.8)
Creatinine: 145 μmol/L (60-120)
25 OH Vit D: 48 nmol/L (optimal >75)
What is the most likely diagnosis?