A 6-year-old girl is diagnosed with haemolytic uraemic syndrome (HUS), after a recent Salmonella infection. She is admitted to the hospital and blood tests demonstrate a platelet count of 85 × 109/l as well as a haemoglobin of 9 g/dl. She is maintaining good oral intake and her observations are normal.
What would be the next most appropriate step in this patient’s management?
A 68-year-old psychiatric patient is brought to the Emergency Room, complaining of excessive thirst. He is carrying multiple shopping bags and has spent a significant amount of money. Blood tests reveal a urea level of 20.5 mmol/l (reference range 2.5–7.1 mmol/l), a creatinine level of 190 μmol/l (reference range 53–106 μmol/l) and a sodium level of 144 mmol/l (reference range 135–145 mmol/l). Urinary osmolality is low.
What is the most likely diagnosis based on this clinical presentation?
A female patient with a history of renal cell carcinoma presents with enlarged legs bilaterally from the groin area downwards, along with dilated veins around the belly button. What is the underlying mechanism responsible for this?
A 45-year-old non-smoker with hypertension and diabetes has been diagnosed with bilateral renal artery stenosis. Blood tests reveal that he has normal renal function. He has undergone percutaneous angioplasty to both renal arteries, which was unsuccessful.
Which medication should this patient be started on?
A 40-year-old woman undergoing treatment for rheumatoid arthritis complains of nephrotic syndrome.
Which medication is the probable cause of this issue?
A 38-year-old man with a history of Wilson’s disease and mild osteoarthritis presents with features of nephrotic syndrome.
Which medication is the most likely cause for his condition?
A 52-year-old woman presents to her general practitioner (GP) with symptoms of a urinary tract infection. There is a history of multiple attendances and a previous neurology referral for migraine. She admits to taking multiple painkillers for her headaches. Blood pressure is 160/90 mmHg. Urinalysis reveals haematuria, and the GP commences her on a 2-week course of nitrofurantoin. She returns, still complaining of symptoms, at which point the presence of a normochromic normocytic anaemia is noted, along with a serum creatinine level of 230 μmol/l (reference range 44–97 μmol/l).
What diagnosis fits best with this clinical picture?
A 25-year-old man with a family history of autosomal-dominant polycystic kidneys has been diagnosed with polycystic kidneys on ultrasound. He is currently asymptomatic and has no other past medical history.
What is the most crucial factor to manage for improving his long-term prognosis?
A 6-year-old boy has been treated for a first urinary tract infection. There was no evidence of pyelonephritis. Urine culture demonstrated growth of Escherichia coli. He was given a course of trimethoprim and recovered well.
Which of the following is the most appropriate next step in his management?
Select the SINGLE most appropriate next step from the list below. Select ONE option only.
A 32-year-old woman presents to the Emergency Department with right flank pain radiating to her groin. A urine dipstick reveals the presence of blood. You suspect a possible ureteric stone.
What is the most suitable imaging modality to confirm the diagnosis?