-
Question 1
Correct
-
A 15-year-old boy presents with hypertension and acute renal failure after an episode of diarrhoea. What is the most likely diagnosis?
Your Answer: Haemolytic–uraemic syndrome
Explanation:The likely diagnosis in this case is Haemolytic Uremic Syndrome (HUS), which is generally seen in young children presenting with a triad of symptoms, namely: acute renal failure, microangiopathic haemolytic anaemia, and thrombocytopenia. The typical cause of HUS is ingestion of a strain of Escherichia coli causing diarrhoea in these cases as well.
-
This question is part of the following fields:
- Renal
-
-
Question 2
Incorrect
-
A 11-year-old boy is admitted to the hospital with diarrhoea and lethargy. There is a known local outbreak of E coli 0157:H7, and his initial bloods show evidence of acute renal failure. Given the likely diagnosis, which one of the following investigation results would be expected?
Your Answer: Increased prothrombin time
Correct Answer: Fragmented red blood cells
Explanation:The likely diagnosis in this case is Haemolytic Uremic Syndrome (HUS), which is generally seen in young children presenting with a triad of symptoms, namely: acute renal failure, microangiopathic haemolytic anaemia, and thrombocytopenia. The typical cause of HUS is ingestion of a strain of Escherichia coli. The laboratory results will usually include fragmented RBCs, decreased serum haptoglobin, reduced platelet count, nonspecific WBC changes, and normal coagulation tests (PTT included).
-
This question is part of the following fields:
- Renal
-
-
Question 3
Correct
-
A 7-year-old girl is given cephalexin to treat an infection and develops hives, with localised facial oedema. Which of the following conditions will cause localised oedema?
Your Answer: Angio-oedema
Explanation:Angio-oedema, is the rapid swelling of the skin, mucosa and submucosal tissues. The underlying mechanism typically involves histamine or bradykinin. The version related to histamine is to due an allergic reaction to agents such as insect bites, food, or medications. The version related to bradykinin may occur due to an inherited C1 esterase inhibitor deficiency, medications e.g. angiotensin converting enzyme inhibitors, or a lymphoproliferative disorder.
-
This question is part of the following fields:
- Renal
-
-
Question 4
Correct
-
A 10 year old boy presents with generalized swelling. This includes puffiness in the face and swollen ankles - these symptoms have been present for 4 days. The swelling began just a few days after he suffered from a mild cold with a runny nose. His only past medical history is that of eczema. His urine analysis showed the following: haematuria| proteinuria (10g/24h)| creat60umol/l| and albumin of 15g/l. From the list of options, what is the single most likely diagnosis for this patient?
Your Answer: IgA nephropathy
Explanation:A 10 year old child, with a history of URTI and haematuria, presents a picture consistent with a diagnosis of IgA nephropathy. This condition can present with proteinuria and generalized swelling. However, an important differentiating point from rapidly progressive GN is the duration. IgA nephropathy is usually <10 days (commonly 4-5 day history of infection).
-
This question is part of the following fields:
- Renal
-
-
Question 5
Correct
-
A 12 year old boy has a high HbA1c and is being checked by the diabetic specialist nurse. He has been skipping meals lately and his school teachers have noticed that he's been unhappy. Who do you suggest his parents take him to?
Your Answer: Clinical psychologist
Explanation:The boy is most probably a type 1 diabetic patient. Such a condition can affect the behaviour and psychological state of a young child reflected in their behaviour. The parents should seek the help of a clinical psychologist.
-
This question is part of the following fields:
- Renal
-
-
Question 6
Incorrect
-
A 16-year-old girl developed haemoptysis with acute kidney injury requiring dialysis. She suffered from recurrent epistaxis for the past 2 weeks. Renal biopsy showed crescentic glomerulonephritis. Which antibody would you expect to be positive?
Your Answer: Anticentromere
Correct Answer: Antiproteinase 3
Explanation:This patient has pulmonary renal syndrome which is most commonly due to an ANCA positive vasculitis. The history of recurrent epistaxis makes Wegener’s granulomatosis the most probable diagnosis. Wegener’s granulomatosis, microscopic polyangiitis, and idiopathic pauci-immune necrotizing crescentic glomerulonephritis (NCGN) are strongly associated with antineutrophil cytoplasmic autoantibodies (ANCAs) directed against either proteinase 3 (anti-PR3) or myeloperoxidase (anti-MPO).
-
This question is part of the following fields:
- Renal
-
-
Question 7
Correct
-
A 2-month-old infant was brought to the paediatrics ward by her mother with a complaint of excessive crying during urination. The urine culture of the infant revealed E.coli. Which of the following investigations should be done next?
Your Answer: US
Explanation:Urine culture confirms a diagnosis of a UTI. A kidney ultrasound will be the next best investigation because it will help us to visualise the bladder, kidneys, and ureters to rule out any congenital obstruction in the urinary tract that might be the actual cause of infection in this 2-month old girl.
-
This question is part of the following fields:
- Renal
-
-
Question 8
Correct
-
A 7-year-old female presented with complaints of haematuria and fatigue. She had a history of bloody diarrhoea starting 7 days previously. On investigation, her serum urea and creatinine were raised and proteinuria was present. Which of the following is the most suitable diagnosis for her?
Your Answer: Haemolytic-uremic syndrome (HUS)
Explanation:HUS syndrome occurs mostly in children after some days of bloody diarrhoea. Damaged red blood cells also damage the kidney filtering unit and lead to sudden renal failure.
-
This question is part of the following fields:
- Renal
-
-
Question 9
Incorrect
-
A 11-year-old boy has a history of tonsillitis followed by haematuria and hypertension about 10 days later. What would be the characteristic blood test finding in this condition?
Your Answer: Normal C3 level
Correct Answer: Depressed CH 50 level
Explanation:Because the medical history included tonsillitis followed by haematuria and hypertension, there is a strong suspicion of a case of post-streptococcal glomerulonephritis (PSGN). Patients with PSGN usually have serological findings showing depressed serum haemolytic component CH50 and serum concentrations of C3. Sometimes depressed C4 levels are also apparent, but not always, therefore, the answer to this question is: depressed CH50 level.
-
This question is part of the following fields:
- Renal
-
-
Question 10
Incorrect
-
A 4 year old girl is brought to the emergency due to fever and urinary urgency. The temperature is recorded to be 39C. Which of the following is the best investigation in this case?
Your Answer: Catheter catch of urine
Correct Answer: Clean catch of urine
Explanation:Urine culture and sensitivity is used to diagnose a urinary tract infection (UTI). A mid-stream clean catch urine sample is the most common type of sample collected. It is important to follow the clean catch process to have accurate results from an uncontaminated sample. Urine cultures can also check for infections of the bladder or kidney.
-
This question is part of the following fields:
- Renal
-
SESSION STATS - PERFORMANCE PER SPECIALTY
