كل يوم case 🫀🩻🩺

A 62 year old man presents with sudden anuria on a background history of several weeks of 'not passing much urine'. He denies dysuria or haematuria but admits to having a poor stream for many years. He is normotensive and otherwise looks well and has no systemic symptoms. What is the best initial diagnostic investigation? #medicine1 #surgery1

جاي جاي جاي مهم مهم مهم A 45-year-old man complains of breathlessness and feeling tired for the past week. He also remarks that he has not been passing as much urine as usual. On clinical examination he is not dehydrated. He has a serum creatinine of 500 μmol/L. Urine analysis reveals a urine osmolality of 650 mOsm/kg and a urine sodium of 15 mmol/L. You diagnose acute kidney injury (AKI). What is the least likely cause of his renal failure? a. Decreased cardiac output b. Severe liver failure c. Hypovolaemia d. Renal artery obstruction e. Acute tubular necrosis

A 43-year-old man with gout complains of severe intermittent loin pain and microscopic haematuria which has lasted for several hours. What is the initial most appropriate step in management? a. Fluid replacement b. Allopurinol c. Pain relief d. Shock wave lithotripsy e. Nephrolithotomy

A 68-year-old man with chronic renal failure is referred for peritoneal dialysis. What is the most likely complication of this form of dialysis? a. Cardiovascular disease b. Peritonitis c. Amyloidosis d. Shoulder pain e. Carpal tunnel syndrome

A 67-year-old diabetic patient complains of bone and muscle pain for the last 4 weeks. She remarks that she feels more tired than usual and is constantly itching. Routine blood investigations reveal an estimated glomerular filtration rate 28 mL/ min per 1.73m2 and a haemoglobin of 8.7g/dL. In addition, her vitamin D level is low. What is the most appropriate step in her management? a. Review of diabetic medication b. Reduction of protein intake c. Erythropoietin injections d. Referral for dialysis e. Vitamin D analogues

شويه رومتولجي واندو

A 65-year-old man complains of waking up in the night to pass urine for the past 3 weeks. He feels generally quite tired and complains of muscle weakness. Routine blood tests reveal a serum calcium of 1.76mmol/L, a serum phosphate of 3.4mmol/L, a low vitamin D level and a raised parathyroid hormone level. You diagnose renal osteodystrophy. Which of the following radiological signs is least likely? a. Bamboo spine b. Subperiosteal erosions c. Salt and pepper skull d. Brown tumours e. Pseudofractures

A 46 year old man with a 10-year history of type 2 diabetes presents with a 6-week history of bilateral leg swelling. He reports that he had been taking non-steroidal anti-inflammatory drugs (NSAIDs) for osteoarthritis regularly for the past 3 months. Investigations reveal: eGFR > 60 mL/min/ 1.73 m2; urinalysis: protein 4+, blood negative; protein : creatinine ratio 1680 mg/mmol; and a serum albumin of 14 g/L. Serum albumin and urinary albumin : creatinine ratios 4 months previously were 36 g/L and 25 mg/mmol, respectively. What is the most likely diagnosis? A. Amyloidosis B. Diabetic nephropathy C. IgA nephropathy D. Minimal change disease E. Tubulointerstitial nephritis

82 yr old woman Diabetic Hypertensive Ischaemic heart disease Presented with 3 days history of abdominal pain and constipation then ended with transient diarrhea. On examination: generalized abdominal guarding.... Dx?

المتبقي 15يوم

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الاسئله هاند ميند واغلبها من كلام الدكاتره والاشياء الي ركزو عليها فنصيحه لادوخون نفسكم بالمصادر والهوسه نعم ادربو شكد ما تكدرون بس لاتخلوها تاثر على دراستكم للملازم وتاخذ وقتكم كله

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