Pathology EMQ template.

Name: Jenifer Salmons

Candidate number: 00410490

Theme: Renal Function

OPTION LIST

A	Acute Tubular Necrosis	I	SLE
B	BPH	J	Wegener’s granulomatosis
C	Lower UTI	K
D	Polyarteritis nodosa	L
E	Prostate carcinoma	M
F	Pyelonephritis	N
G	RCC	O
H	Renal calculi	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 23 year old female presents to A&E with left sided loin pain, rigors and vomiting. Urine analysis reveals microscopic haematuria and white cell casts.

2. A 65 year old man presents to his GP complaining of poor urinary stream which has been gradually getting worse over the last few years. Blood tests reveal: urea – 12mmol/L, creatinine – 200umol/L.

3. A 26 year old female presents with abdominal pain and recent weight loss. On examination she is febrile and has a BP of 150/95. FBC reveals: WCC - 18x10⁹/L, ESR – 60mm/hr, CRP – 15mg/L. Urine analysis shows microscopic haematuria. pANCA antibodies are positive.

4. On the ward round, an 80 year old female patient seems confused. The nurse mentions she has had a reduced urine output over the past few days. She was recently started on a course of I.V. gentamicin for a severe infection, but before this was otherwise well. Urine analysis shows epithelial cell casts. Blood tests reveal she has a urea of 8mmol/L and a creatinine of 210mmol/L. She has a fractional Na excretion of 4.

5. A 58 year old obese man presents to his GP with persistent right sided loin pain and macroscopic haematuria. He says that lately, he has been feeling increasingly tired and weak. FBC reveals: Hb – 22g/dl.

ANSWERS

1. F

2. B

3. D

4. A

5. G