A 75-year-old man comes to the Medical Team after routine blood tests showed an acute kidney injury. He has a history of systemic lupus erythematosus (SLE) and is currently taking steroids. The renal team suspects acute interstitial nephritis (AIN). He has not been sick recently and is not taking any new medications.
What is the most appropriate investigation to perform for this patient’s diagnosis?
A 65-year-old woman presents to her General Practitioner complaining of general malaise, lethargy and ankle swelling. She was commenced on omeprazole eight weeks ago to treat indigestion. Urea, electrolytes and eGFR demonstrate that her renal function has declined significantly. She is referred to the renal team and a diagnosis of acute interstitial nephritis (AIN) is suspected.
What would be the next most useful investigation in order to confirm the diagnosis in this patient?
Male infertility is most commonly associated with which of the following?
A 63-year-old woman who is undergoing treatment for bladder cancer presents to the Emergency Department because she has noticed that the urine in her catheter is blood-stained.
On examination, the urine is pink in colour. Her observations are normal.
What would be the next most appropriate step in this patient’s management?
Select the SINGLE most likely option.
A 43-year-old lady with hypertension managed on ramipril undergoes annual review.
Her bloods are shown below:
Last year This year Reference range
Sodium (Na+) 134 133 135-145 mEq/l
Potassium (K+) 3.7 4.1 3.5-5.0 mEq/l
Creatinine (Cr) 84 96 44-97 μmol/l
Estimated glomerular filtration rate (eGFR) >90 79 >90 ml/min/1.73 m2
Based on these results, what should be the next step?
A 58-year-old man has been treated for many years with amlodipine for hypertension. Now this is not adequately controlling his blood pressure, and angiotensin-converting enzyme (ACE) inhibitor treatment is planned. On routine baseline blood tests, prior to commencing treatment, the estimated glomerular filtration rate (eGFR) is 49 ml/min/1.73 m2 (reference range >90 ml/min/1.73 m2).
Which of the following is the most appropriate next step in his management?
What is one of the most important functions of the proximal convoluted tubule (PCT)?
A 6-year-old girl presents to the Emergency Department with bloody diarrhoea, vomiting and fever. Her siblings and parents have also had similar symptoms after attending a birthday party at a local park. Her stool sample is positive for E. Coli and the Paediatric Team are concerned that she has haemolytic uraemic syndrome (HUS) secondary to this infection.
Which of the following results are most likely to be found if this patient is suffering from HUS?
A 10-year-old child with a history of infective diarrhoea presents with fever, hypertension, haematuria and bloody stools two weeks later. What could be a potential diagnosis?
What is the factor that is most likely to stimulate renin?