Urinary Findings and Diagnoses Quiz
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Questions and Answers

Which research method is the most crucial for assessing the urinary findings?

  • Cystoscopy, ultrasound of the kidneys (correct)
  • Cystography, ultrasound of the kidneys
  • Tank urine culture, kidney ultrasound
  • Kidney biopsy

What is the most appropriate preliminary diagnosis for a young girl experiencing frequent urination and pain when urinating?

  • Cystitis (correct)
  • Nephritic syndrome
  • Complicated urinary tract infection
  • Acute pyelonephritis

Based on the symptoms and lab results, which diagnosis is most likely for the 30-year-old woman with edema and dark-colored urine?

  • Nephrotic syndrome
  • Chronic kidney disease
  • Acute nephritic syndrome (correct)
  • Tubulointerstitial nephritis

Considering the symptoms and laboratory findings, what is the most probable diagnosis for the 18-year-old girl with fever and malaise?

<p>Acute pyelonephritis (C)</p> Signup and view all the answers

For the 27-year-old woman presenting with back pain and fever, which diagnosis should be suspected?

<p>Acute pyelonephritis (A)</p> Signup and view all the answers

What is a critical lab finding suggesting acute nephritic syndrome in the 30-year-old woman?

<p>High blood pressure (D)</p> Signup and view all the answers

Which finding in the 20-year-old girl's urine analysis most strongly suggests a urinary tract infection?

<p>Significant leukocytes (B)</p> Signup and view all the answers

What symptom combined with lab findings makes the most compelling case for an upper urinary tract infection?

<p>Elevated temperature (D)</p> Signup and view all the answers

Which group of drugs is most suitable for a patient experiencing an acute asthma attack unresponsive to salbutamol?

<p>Inhaled glucocorticosteroids (D)</p> Signup and view all the answers

What is the most suitable method of drug administration for a patient experiencing an asthma attack?

<p>Inhalation (C)</p> Signup and view all the answers

Which class of medication is most appropriate for basic therapy in a patient newly diagnosed with bronchial asthma?

<p>Inhaled glucocorticosteroids (A)</p> Signup and view all the answers

For a patient diagnosed with Chronic Obstructive Pulmonary Disease (COPD), which group of drugs is most appropriate?

<p>Bronchodilators (D)</p> Signup and view all the answers

What is the best management strategy for a COPD patient with a FEV1 of 80% and a Tiffno index of 69%?

<p>Avoid smoking (C)</p> Signup and view all the answers

Which treatment option is least appropriate for managing acute shortness of breath and wheezing in a smoker?

<p>Antibacterial drugs (D)</p> Signup and view all the answers

What is the most acceptable drug class for a patient whose asthma attacks occur predominantly during spring?

<p>Inhaled glucocorticosteroids (B)</p> Signup and view all the answers

Which method is the most reliable for conducting a differential diagnosis of Chronic Kidney Disease (CKD) and Acute Kidney Injury (AKI)?

<p>Diuresis measurement (D)</p> Signup and view all the answers

Which option is the least effective for managing cough with mucous sputum in a COPD patient?

<p>Intramuscular steroids (A)</p> Signup and view all the answers

Which diagnosis is most likely for a 20-year-old woman with painful urination and elevated leukocytes and erythrocytes in her urine analysis?

<p>Acute cystitis (C)</p> Signup and view all the answers

What is the most likely diagnosis for a 19-year-old guy with significant edema after an upper respiratory infection and presenting with low blood pressure?

<p>Nephrotic syndrome (D)</p> Signup and view all the answers

Which study is most effective for obtaining an accurate morphological diagnosis in cases of severe kidney conditions?

<p>Kidney biopsy (C)</p> Signup and view all the answers

In the context of kidney diagnosis, what does a daily proteinuria level of 3.8 g/s suggest?

<p>Nephrotic syndrome (C)</p> Signup and view all the answers

Which of the following is least likely to contribute to a diagnosis of Acute Kidney Injury in a clinical setting?

<p>Kidney biopsy (A)</p> Signup and view all the answers

What symptom is most characteristic of acute cystitis?

<p>Frequent painful urination (D)</p> Signup and view all the answers

What laboratory finding is often associated with nephrotic syndrome?

<p>Low serum albumin levels (C)</p> Signup and view all the answers

What is the most appropriate treatment tactic for a patient with emphysema and FEV1 = 65%?

<p>Ipratropium bromide (D)</p> Signup and view all the answers

Given the symptoms and sputum analysis of a 50-year-old man, which drug is most appropriate for treatment?

<p>Ampicillin (C)</p> Signup and view all the answers

What further antibacterial tactic is most appropriate for a patient with pneumonia who is not responding to amoxicillin?

<p>Replace amoxicillin with azithromycin (D)</p> Signup and view all the answers

Based on the symptoms presented, what is the most reasonable diagnosis for the patient exhibiting signs of acrocyanosis and right ventricular hypertrophy?

<p>Idiopathic pulmonary fibrosis (A)</p> Signup and view all the answers

For an 18-year-old man with excessive thirst and frequent urination but a normal glucose level, what is the most appropriate treatment?

<p>Desmopressin (D)</p> Signup and view all the answers

In a patient experiencing weight gain and menstrual irregularities, which treatment strategy may be considered?

<p>Bromocriptine (D)</p> Signup and view all the answers

For a patient diagnosed with pneumonia while currently on amoxicillin, what is the likely next step in treatment?

<p>Replace amoxicillin with cephalexin (D)</p> Signup and view all the answers

Which of the following options is least likely to be appropriate for treating a patient with emphysema?

<p>Spiramycin (C)</p> Signup and view all the answers

What changes are most likely characterized by primary chronic insufficiency of the adrenal cortex?

<p>diffuse hyperpigmentation of the skin and mucous membranes (C)</p> Signup and view all the answers

What is the main pathological condition in type 1 diabetes?

<p>absolute deficiency of insulin secretion by beta cells (A)</p> Signup and view all the answers

Which hormones are most likely to be produced in excess in pheochromocytoma?

<p>catecholamines (B)</p> Signup and view all the answers

What group of medications would be MOST appropriate for preoperative preparation in a patient with adrenal hyperplasia and hypokalemia?

<p>aldosterone antagonists (D)</p> Signup and view all the answers

Which part of the endocrine system is most likely affected by Conn's syndrome?

<p>glomular zone of the adrenal glands (C)</p> Signup and view all the answers

At what level of glucose in the venous blood on an empty stomach is the most likely diagnosis of diabetes mellitus?

<p>≥6.5 mmol/l (C)</p> Signup and view all the answers

What is the MOST appropriate treatment strategy for a patient showing symptoms of adrenal insufficiency, including low cortisol levels?

<p>Glucocorticoids, mineralocorticoids (D)</p> Signup and view all the answers

For a patient experiencing episodes of elevated blood pressure, flushing, and palpitations due to high metanephrines, which medication group would be MOST appropriate for preoperative preparation?

<p>alpha-adrenoblockers (D)</p> Signup and view all the answers

What symptom is commonly associated with Cushing's syndrome as indicated by the patient's presentation of moon-shaped face and red stretch marks?

<p>Hypertension (B)</p> Signup and view all the answers

In the context of primary adrenal insufficiency, what would be an expected finding on a complete blood count?

<p>Decreased hemoglobin levels (C)</p> Signup and view all the answers

Which physical sign is commonly observed in patients with primary hyperaldosteronism?

<p>Hypokalemia (B)</p> Signup and view all the answers

Which of these laboratory findings aligns with a diagnosis of pheochromocytoma?

<p>Elevated metanephrines in urine (D)</p> Signup and view all the answers

What is a significant complication associated with untreated Cushing's syndrome?

<p>Increased risk of cardiovascular disease (B)</p> Signup and view all the answers

Flashcards

Cystitis

Inflammation of the bladder, often caused by bacteria, characterized by frequent urination, pain during urination, and potential leukocytes and erythrocytes in the urine.

Acute Pyelonephritis

A kidney infection, typically caused by bacteria, presenting with fever, back pain, and potential leukocytes and bacteria in the urine.

Nephrotic Syndrome

A serious kidney condition with damage to the filtering units (glomeruli) causing proteinuria and edema.

Tubulointerstitial Nephritis

A condition involving inflammation of the kidney tubules, often associated with drug allergies, causing renal dysfunction.

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Acute Pyelonephritis

A kidney infection characterized by fever, back pain, and potential leukocytes and bacteria in the urine.

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Acute Nephritic Syndrome

A syndrome characterized by inflammation of the glomeruli, causing proteinuria, hematuria, and high blood pressure.

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Chronic Kidney Disease

A chronic kidney disease, characterized by progressive decline in kidney function, often causing proteinuria, edema, and high blood pressure.

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Urethritis

A condition involving inflammation of the urethra, often caused by sexually transmitted infections, characterized by burning during urination and potential discharge.

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What is Pheochromocytoma?

A condition characterized by excessive production of catecholamines (epinephrine and norepinephrine) by a tumor in the adrenal medulla.

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What is Conn's Syndrome?

A disorder characterized by hypersecretion of aldosterone from the adrenal glands, leading to low potassium levels and high blood pressure.

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What is Type 1 Diabetes?

A condition where the body doesn't produce enough insulin, leading to high blood sugar levels.

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Diuresis

A condition characterized by excessive urine production, typically exceeding 600 ml per day.

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Ultrasound of the kidneys with Dopplerography of blood vessels

A medical procedure that involves the use of ultrasound waves to create images of the kidneys and their blood vessels. It helps assess the size, shape, and function of the kidneys.

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Acute Cystitis

An inflammation of the bladder, often accompanied by painful urination and an increased number of leukocytes and erythrocytes in the urine.

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Kidney biopsy

A medical procedure where a small sample of kidney tissue is removed and examined under a microscope, providing a detailed diagnosis of kidney diseases.

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Urine analysis

A test that measures the presence and amount of various substances in the urine, including protein, leukocytes, and erythrocytes.

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Pheochromocytoma

A condition characterized by high blood pressure, often accompanied by flushing, fear, palpitations, weakness, sweating, and increased urination. Metanephrines in the urine are significantly elevated.

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Cushing's Syndrome

A condition marked by excessive cortisol production, often presenting with weight gain, moon face, red stretch marks, hypertension, and increased thirst and urination.

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Aldosterone Antagonists

A group of medications that block the action of aldosterone, a hormone that regulates sodium and potassium levels.

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ACE Inhibitors

A group of medications that block the conversion of angiotensin I to angiotensin II, which is a potent vasoconstrictor.

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Mineralocorticoids

A group of medications that block the effects of aldosterone, a hormone that regulates sodium and potassium levels.

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Alpha-Adrenoblockers

A group of medications that block the action of alpha-adrenergic receptors, leading to vasodilation and a decrease in blood pressure.

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Calcium Channel Blockers

A group of medications that block the entry of calcium into cells, resulting in vasodilation and a decrease in blood pressure.

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Angiotensin Receptor Blockers

A group of medications that block the effects of angiotensin II by binding to its receptors, leading to vasodilation and a decrease in blood pressure.

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Bronchial Asthma

A type of respiratory disorder marked by inflammation and narrowing of the airways, leading to coughing, wheezing, and shortness of breath. It's often triggered by allergens, irritants, or viral infections.

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Bronchodilators

A class of medications that help to relax the muscles in the airways, widening them and making it easier to breathe. They are commonly used to treat asthma and COPD.

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Inhaled Glucocorticosteroids

A type of medication that works by suppressing the immune system's inflammatory response in the lungs. They are often used to prevent asthma attacks and manage chronic obstructive pulmonary disease (COPD).

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Short-acting Bronchodilators

These are short-acting medications that are used to quickly relieve the symptoms of asthma or COPD. They work by relaxing the muscles in the airways, making it easier to breathe.

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COPD Stage A Management

The most appropriate management for a patient diagnosed with Chronic Obstructive Pulmonary Disease (COPD) stage A. Avoiding smoking is essential to manage the disease progress, along with other prescribed medications.

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FEV1

A measure of lung function that assesses the volume of air a person can exhale forcefully in one second, divided by the total amount of air they can exhale. It helps to diagnose and monitor respiratory conditions like COPD.

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Tiffeneau Index

A measure of lung function in which FEV1 is divided by the total volume of air that can be exhaled (Forced Vital Capacity). It is used to assess the severity of airway obstruction in conditions like COPD.

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Chronic Obstructive Pulmonary Disease (COPD)

A chronic respiratory disease characterized by airflow limitation and breathlessness, often caused by smoking and air pollution. It's marked by progressive limitations in lung function.

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What is the most likely diagnosis: shortness of breath, dry cough, barrel chest, finger clubbing?

A respiratory condition characterized by shortness of breath, dry cough, barrel chest, and diminished lung function, suggesting an obstructive lung disease. It often presents with finger clubbing (progressively enlarged fingertips and nails) and accentuation of the second heart sound in the pulmonary artery, indicating pulmonary hypertension. Imaging often shows a reticular pattern in the lungs, primarily in the lower lobes.

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What characterizes Chronic Obstructive Pulmonary Disease?

Refers to a condition where the lungs are chronically inflamed and clogged with mucus, making it hard to breathe. It is typically characterized by a non-productive cough, dyspnea, dyspnea on exertion, wheezing, and chest tightness.

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What is the most appropriate treatment tactic for a dry cough, barrel chest, and finger clubbing?

The most appropriate treatment is to initiate bronchodilator therapy, which helps to relax the muscles in the airways and improve airflow.

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What is the most appropriate treatment tactic for a cough with green sputum, fever, and elevated neutrophil count?

Treatment focuses on the bacterial etiology of the pneumonia, aiming to eradicate the infection. Amoxicillin is an antibiotic commonly used for community-acquired pneumonia. However, the increasing temperature and persistent cough, even with amoxicillin therapy, suggest treatment failure and necessitate a change in the antibacterial approach.

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What is the most appropriate antibiotic to replace amoxicillin for persistent pneumonia?

Azithromycin is a suitable choice for a change in antibacterial strategy because it covers a broader range of bacteria, offering a possible solution for treating resistant infections. Other options can be considered depending on the specific bacteria identified.

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What is a likely diagnosis for frequent urination, thirst, and weight loss with normal blood glucose levels?

A condition characterized by increased thirst (polydipsia), frequent urination (polyuria), and weight loss, suggesting a possible hormonal imbalance associated with diabetes insipidus. The normal blood glucose level and absence of abnormal urine findings (except for low specific gravity) eliminate diabetes mellitus as a possibility.

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What is the most appropriate treatment for excessive thirst, frequent urination, and weight loss with normal blood glucose levels?

Desmopressin is used to treat diabetes insipidus by replacing the deficient hormone, vasopressin, responsible for regulating water balance. It effectively addresses the polydipsia and polyuria associated with this condition.

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What is a likely diagnosis for weight gain, visual disturbances, and menstrual irregularities?

A likely diagnosis is polycystic ovary syndrome (PCOS), a hormonal disorder that can lead to weight gain, visual disturbances (due to increased insulin resistance), menstrual irregularities, and other symptoms. Further investigation is necessary to confirm the diagnosis.

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Study Notes

Internal Medicine-2 Step-1

  • Urinary Tract Infections (UTIs): Recommended research methods in nephrology include the Nechiporenko test, Addis-Kakovsky sample, and urine sediment microscopy.

  • Community-Acquired UTI Pathogen: The most common cause is E. coli.

  • Hemorrhagic Cystitis Pathogen: Klebsiella is the most common causative agent.

  • Nephrotic Syndrome Cause: Loss of proteins in the urine is the most characteristic feature.

  • Renal Patient Clinical Examination: Cystography and Zimnitsky test are mandatory during long-term clinical examinations.

  • Chronic Kidney Disease Mechanism: Decreased functioning nephrons lead to hyperfiltration.

  • Acute Pyelonephritis: Symptoms include leukocyturia, elevated erythrocyte sedimentation rate (ESR), and bacteriuria.

  • Kidney Edema: Increased sodium retention in the body is a likely cause.

  • Nephrotic syndrome symptoms: Edema, hematuria, cylindruria, hypocholesterolemia, increased sedimentation rate.

  • Nitrogen excretion marker: Creatinine is an accurate indicator.

  • Chronic Kidney Disease Causes: Glomerulonephritis and arterial hypertension are the most frequent.

  • Nephroprotective Therapy in CKD: Angiotensin-converting enzyme (ACE) inhibitors are the gold standard.

  • Acute Kidney Injury Complications: The most likely complication is electrolyte imbalance.

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Test your knowledge on the crucial research methods and preliminary diagnoses related to urinary findings. This quiz covers various patient scenarios, lab results, and symptoms to assist in identifying accurate diagnoses. Challenge your understanding of renal and urinary tract conditions.

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