Pathology EMQ template.

Name: Huda Salmasi

Candidate number:

Theme: Renal failure

OPTION LIST

A	Acute interstitial nephritis	I	Ureteric stones
B	Chronic kidney disease	J	Urethral stones
C	Hyperkalemia	K
D	Hypokalemia	L
E	IgA nephropathy	M
F	Nephrotic syndrome	N
G	Renal acidosis	O
H	Thin membrane nephropathy	P

For each scenario below, choose the most appropriate answer from the list above. Each option may be used once, more than once or not at all.

1. A 62-year old man presents with lethargy and tiredness. He tells you that he is ‘on painkillers for back pain after a fall at work 6 weeks ago’. On examination he is pale. Blood tests reveal urea 39.2 mmol/L (normal 1.7-8.3) and creatinine 1158 μmol/L (normal 62-106). His records show that he had a creatinine of 90 μmol/L 3 months ago.

2. A 40-year old man presents acutely unwell with back pain that radiates to his groin, and nausea and vomiting. He tells you he has seen blood in his urine. On examination he is febrile.

3. A poorly controlled 48-year old diabetic lady presents with a swollen face and ankles. Blood tests show albumin <30g/L (normal 40g/L), ↑ cholesterol and normal creatinine. 24 hour urine collection reveals protein >3g.

4. A 25 year old man tells you he had dark brown urine after a sore throat and has since had microscopic haematuria. Renal biopsy reveals proliferation of the mesangium.

5. One of the complications of chronic kidney disease which has ECG features of peaked T waves, loss of the P wave and broad QRS complex.

ANSWERS

1. A

2. I

3. F

4. E

5. C