An 82-year-old man is admitted under the medical take with acute chest pain. An MRI of the chest with contrast is requested. His blood tests show acute kidney injury (AKI).
Which of the following would mitigate the risk of worsening AKI when using contrast?
Among the ethnic groups listed, which one has the highest likelihood of developing prostate cancer?
Which of the following statements is true for prostate cancer?
What is true about calcium homeostasis?
A 25-year-old woman comes to her General Practitioner complaining of urinary frequency, dysuria, suprapubic pain and back pain. The symptoms have been getting worse over the past 48 hours. During examination, she is febrile and tachycardic. She has no history of urinary infections.
What is the most suitable investigation to arrange for this patient next?
Choose ONE option only.
A 72-year-old man is admitted after a fall and a period of time on the floor. He has a long history of chronic illness and immobility, with medications for hypertension, cardiac failure and chronic chest disease.
On examination, he is obese, with a blood pressure of 110/75 mmHg, a pulse of 100 beats per minute and a temperature of 38.5°C. Respiratory examination reveals evidence of right lower lobe consolidation. He has no signs of traumatic bone injury.
Investigations reveal the following:
Investigation Result Normal value
Chest X-ray Right lower lobe pneumonia
Haemoglobin (Hb) 131 g/l 135–175 g/l
White cell count (WCC) 15.4 × 109/l 4.0–11.0 × 109/l
Platelets (PLT) 312 × 109/l 150–400 × 109/l
Sodium (Na+) 142 mmol/l 135–145 mmol/l
Potassium (K+) 6.7 mmol/l 3.5–5.0 mmol/l
Urea 15.1 mmol/l 2.5–6.5 mmol/l
Creatinine (Cr) 312 μmol/l 50–120 µmol/l
Creatine kinase (CK) 1524 IU/l 23–175 IU/l
Catheter specimen of urine: Red/brown in colour.
+++ for blood.
No red cells on microscopy
Which of the following diagnoses fits best with this clinical picture?
Which factors affect water excretion in the kidneys?
A 72-year-old man visits his general practice with symptoms of difficulty initiating urine flow. He also has to wake on a number of occasions each night to visit the toilet to pass urine. His pelvic exam is normal and a urinalysis does not indicate infection.
Which of the following treatment options is likely to bring the most rapid symptom relief?
A 60-year-old man visits his doctor complaining of urinary hesitancy, urgency and terminal dribbling that have been bothering him for the past 4 months. During a digital rectal examination, the doctor finds an enlarged, soft prostate with a smooth surface that is not tender. The patient’s PSA reading is within the normal range. What is the most suitable treatment option?
A 72-year-old man presents to his General Practitioner who has been on peritoneal dialysis for ten years due to end-stage renal failure. He complains of chronic back and shoulder pain and is subsequently diagnosed with renal amyloidosis secondary to long-term dialysis. This is thought to be the explanation for the pain in his shoulder.
What would be the next most appropriate step in this patient’s management?