Nephrotic syndrome causes excessive protein loss in urine, which increases the risk of blood clots like DVT and IVC obstruction.

Incorrect options-

• SLE can cause clots but usually doesn't cause DVT/IVC obstruction as a main symptom.
• Christmas disease is a bleeding disorder.
• Nephritic syndrome is related to inflammation not blood clots or IVC obstruction.

PKD is a genetic disorder that causes cysts in the kidneys, leading to abdominal pain, hematuria, high BP, and abnormalities in chromosome 16.

Incorrect options-

• Horseshoe kidney is a congenital issue where kidneys are fused, it doesn't cause hematuria or high BP.
• Glomerulonephritis is the inflammation of kidney that causes hematuria and high BP, but not linked to chromosome 16.
• Goodpasture's syndrome is an autoimmune disease affecting the kidneys and lungs, not associated with chromosome 16.

NDI occurs when kidneys don't respond to ADH, causing polyuria and polydipsia.

• Desmopressin acetate is a synthetic analog of ADH and can be used to distinguish central from nephrogenic DI.  Desmopressin won't change urine osmolarity because the kidneys are resistant to it.

Incorrect options-

• Central DI is a condition in which the body doesn't produce enough ADH, but desmopressin would help increase urine concentration.
• Renal faliure causes reduced urine output and elevated BUN and creatinine, not high osmolarity.
• AKI is similar to renal faliure, typically leads to decreased urine output and abnormal blood tests.

Lithium used for bipolar disorder, can cause nephrogenic diabetes insipidus, leading to excessive urination and thirst.

Adenosine may not be effective at all in patients taking theophylline.

Adult polycystic kidney disease is inherited in autosomal dominant pattern, meaning one altered gene from either parent is enough to cause the condition.

Uric acid stones are radiolucent meaning they dont show on X-rays, matching the IVP finiding of a non-radiopaque filling defect. On USG, they appear echogenic with a hyperacoustic shadow.

Renal CT scan provides detailed images of the kidneys surrounding structures, helping assess kidney size and function confirming renal artery stenosis.

Low C3 in post-strptococcal glomerulonephritis, the immune system is overactive, lowering C3 levels in the blood, which is a key indicator of the condition.

Epithelial cells in urine usually come from urethra, as its lined with these cells, and shedding them is normal.

Renal colic is intense, cramping pain from kidney stone moving through the urinary tract. The pain starts in the flank and radiates to the groin, and the UTI symptoms fit this diagnosis.

Incorrect options -

• Appendicitis pain is usually in the right lower abdomen, not left flank.
• Diverticulitis causes pain in left lower abdomen not flank.
• Urolithiasis refers to kidney stones, but renal colic describes the pain caused by moving stone.

In pre-renal faliure, the kidneys try to conserve sodium to help raise blood volume, leading to low sodium levels in the urine [less than 20mmol/l].

Renal angiography is the gold standard but done after CT/MRI as it is invasive.

All are complications of NSAIDs but upper GI bleeding is not a renal complication.

PKD is a genitic condition where cysts form in the kidneys, causing them to enlarge and press on the surrounding organse leading to abnormal masses and hematuria.

Acute glomerulonephritis is the inflammation of the kidney filters, and investigations typically include urinanalysis, ANA, and blood cultures to find infections. Cystoscopy is not used because it examines the bladder and urethra, not the glomeruli in the kidneys.

We suspect pyelonephritis. So, treatment includes admission, tests like urinanalysis,urine culture, blood culture. Antibiotic & re-hydration

Urine analysis checks for components like phosphate, specific gravity, and proteins which give clue about kidney function. However concentrating capacity, which measures how well the kidneys adjust urine concentration is not directly assessed in a routine urine test.

In ARF kidneys can't filter waste leading to issues like high phosphate, uremia and high potassium. However,acid phosphatase, an enzyme linked to tissue like prostate, isn't typically affected.

Enterococcus faecalis is commonly found in urinary tract, and bed ridden patients often have a higher risk of UTIs due to difficulty urinating, catheter use, and a weakened immune system.

The kidney plays a key role in producing erythropoietin, a hormone that signals the bone marrow to make RBCs. In CRF, reduced erythropoietin leads to decreased RBC with normal MCV, and a low reticulocyte count shows poor RBC production.

Incorrect oprions-

• Liver disease usually cause macrocytic anemia.
• Sickle cell anemia involves abnormal shaped cells and often shows a high reticulocyte count.
• G6PD deficiency leads to hemolysis with high reticulocyte.

Staying hydrated helps the bacteria to pass out of the urinary tract, reducing the risk of infections.

Blood in urine with loin and scrotal pain suggests a problem in the kidney, like tumor, whick can bleed and press on nearby areas.

Incorrect options- 

• Prostatitis causes urinary symptoms but rarely hematuria or loin pain.
• Cystitis is the infection of bladder, it may cause blood in urine but not loin or scrotal pain.
• Testicular cancer affects the testicles, not kidneys, and wouldn't cause hematuria.

All these clinical feature are typically indicative of Wegener's granulomatosis. This condition is related to inflammation of blood vessels, often affecting the nose [saddle nose], lungs [SOB, hemoptysis], and kidneys [hematuria].

• Other options are related only to kidneys and don't present with saddle nose deformity.

When the bladder overfills and can't empty properly, it leaks without warning.

Incorrect options-

• Urge incontinence will exhibit a sudden uncontrollable need to urinate.
• Stress incontinence will have a history of leakage triggered by activities like coughing or sneezing.
• BPH is not related to the patients presentation.

Smoking introduces harmful chemicals into the bloodstream, which are filtered by the kidneys and stored in the bladder. Over time, these toxins damage bladder cells, raising risk of cancer.

Narrowed kidney arteries reduce blood flow, causing the kidneys to raise BP in an attempt to improve circulation.

Incorrect options-

• Adrenal hyperplasia, pheochromocytoma, cushing's disease are less common than renal artery stenosis.

The most common cause of chronic renal faliure is DM. High blood sugar damages the tiny blood vessels in the kidneys over time, leading to scarring and decreased kidney function.

Ciprofloxacin is highly effective against gram-negative bacteria and penetrates well into the prostate tissue making it the first-line treatment.

Renal calculi cause sharp flank pain that can radiate to the groin as they move through the urinary tract. Dysuria occurs as the stone irritates the tract, but no fever suggests there's no infection.

The baby likely has a hydrocele, where fluid surrounds the testicle, making the scrotum swollen and soft. It's harmless and usually resolves on its own.

It's effective and clears most uncomplicated UTIs within a short course.

Incorrect options-

• Ciprofloxacin for 5 days is usually given for uncomplicated UTIs or resistant cases.
• Clarithromycin for 5 days is used for respiratory infections, not UTI.
• Penicillin G for 6 days is not a standard choice in UTI.

Klebsiella is a gram-negative rod that commonly causes urinary tract and prostate infections. It can grow on agar yeast media, supporing its diagnosis in acute prostatitis.

 Incorrect options-

• Chlamydia is associated with chronic prostatitis or STIs.
• Legionella causes repiratory infections.
• Mycoplasma is rarely linked to acute prostatitis compared to klebsiella.

Immune system detects transplant as foreign→ Activates immune response →Inflammation and tissue damage →Symptoms like fever.

Schistosoma haematobium is a parasitic worm that can infect urinary tract and cause long term bladder inflammation, increasing the risk of bladder cancer.

Incorrect options-

• Chlamydia and N.gonorrhoeae are STIs and not related to bladder cancer.
• Sterp. aureus is a bacteria and causes various infections but is not associated with bladder cancer.

Blood in urine is the most common sign of RCC because the growing tumor can cause bleeding in the kidney.

An FBS of 6.8 is considered impaired fasting glucose, meaning the blood sugar is higher than normal but not high enough for a diabetes diagnosis. This explains the excessive thirst and frequent urination.

DKA causes metabolic acidosis, and the main treatment is correcting the acidosis, replacing fluids, and addressing electrolyte imbalances. 

• Insulin infusion lowers blood sugar and reduces ketone production.
• NS replaces fluid lost due to dehydration and balances electrolytes.

Cola colored urine and nephritic symptoms suggest kidney issue. This test looks for RBCs, WBCs, and castes in the urine, helping identify the cause.

A painless penile ulcer with rolled edges suggests syphilis. Darkfield microsocpy is the fastest and most affordable way to detect Treponema pallidum, the bacteria causing syphilis.

The normal 24-hour urine protein level is ususlly less than 150 mg. Since the patient's value falls within the normal range, no treatment or further action is reuiqred

This is most likely a case of pyelonephritis which need urgent hospitalization. Hospitalization ensures close monitoring, IV antibiotics directly combat the infection, and fluids help with hydration and flushing the infection.

Urge incontinence is marked by a sudden, intense urge to urinate, followed by involuntary leakage. This fits the patient's symptoms of losing control after waking up with a full bladder.

Incorrect option-

• Urgency incontinence is another term for urge incontinence.
• Stress incontinence is cause by pressure on the bladder.
• Overflow incontinence is characterized by constant leakage due to full bladder.

A CT scan without contrast is gold standard for detecting kidney stones. It provides detailed images without the risk of contrast dye obscuring the stones.

For mild BPH, medications are the first-line treatment. They relax prostate and bladder muscles, improving urine flow and reducing symptoms without the need for invasive procedures.

The symptoms indicate an uncomplicated UTI. Ciprofloxacin, a fluroquinolone is effective against common UTI pathogens and is taken for a short duration, ensuring fast recovery.

With a UTI more than 14 days, the risk of pyelonephritis is significantly high, around 50%. The prolonged duration allows the infection to ascend to the kidneys.

Epididymo-orchitis is inflammation of epididymis and testicle, often caused by bacterial infections. A urethral stricture increases the risk by trapping bacteria, leading to infection and inflammation.

• Radiopaque: calcium oxalate, cystine, calcium phosphate, magnesium-ammonium-phosphate.
• Radiolucent: uric acid, blood clots, sloughed papillae.

An opaque filling defect on IVP suggests a solid mass like tumor. On ultrasound tumors often appear as dense structures with acoustic shadowing, consistent with a hard, solid mass.

Incorrect option-

• Blood clot can cause filling defect but lacks the dense shadowing typical of a tumor.
• Uric acid stones are radiolucent and wouldn't appear opaque on IVP.
• Sloughed renal papilla can cause a defect but doesn't produce findings consistent with a tumor.

Rapid correction of hyponatremia can lead to brain edema, where water rushes into brain cells, causing them to swell due to sudden shift of sodium levels.

• Disease of adults, most commonly affecting males aged 19-40 year.
• Erythematous edematous scrotum. 
• Cremasteric reflex will be present, like it is present normally, as genitofemoral nerve is intact.

In epididymitis inflammation can irritate urinary tract, causing microscopic RBCs to appear in the urine. This is a key diagnostic clue, especially alongside symptoms like scrotal pain and swelling.

The patients symptoms and lab results are suggestive of DKA. A urine dipstick is the best diagnostic tool here, as it detects ketones in urine, which are produced when the body breaks down fat due to lack of insulin.

The clinical features are suggestive of adrenal insufficiency. The next investigation should focus on assessing the adrenal glands ability to produce cortisol. This can be done by checking the ACTH levels which will be high if adrenal glands are not responding to ACTH, suggesting primary adrenal insufficiency, or low if the problem is at pituitary level, indicating secondary adrenal insufficiency.

PSGN is a renal condition that usually develops 1-3 weeks after a streptococcal infection. In this case the patient initially has a URTI, which could have been caused by a streptococcal infection.

Causes of End-stage renal disease include:

1) Kidney disease – obviously ESRD starts as an early kidney disease. 2) Diabetic nephropathy - 43.2% of kidney failure is due to diabetes 3) Chronic kidney failure -ESRD is by definition the last state of chronic kidney failure 4) Hypertension - 23% of cases 5) Glomerulonephritis - 12.3% of cases 6) Polycystic kidney disease - 2.9% of cases.

BPH Symptoms :

• Waking at night to urinate
• Sudden and strong urge to urinate.
• A frequent need to go, sometimes every 2 hours or less pushing or straining to begin aweak stream.
• Dribbling after finishing.
• Feeling the bladder has not completely emptied after finishing.
• Pain or burning while urinating.

When the glomeruli are damaged, RBCs leak into the urine. These cells clump together inside the kidney tubules, forming casts shaped like the tubules. The precense of these casts is a strong sign of glomerular damage, making it a key diagnostic feature.

When a patient presents with acute urinary retention, the first priority is to relieve pressure in the bladder. This is done by inserting foley's catheter which drains the urine.

Treating the infection early significantly reduces the risk of PSGN.

• CT scan is highly sensitive for detecting kidney stones, even small ones, providing detailed 3D images of the urinary tract.
• X-ray after CT is useful for some stones like uric acid stones, which might not show on CT but are detectable on X-ray.

Laproscopy is the best option because it's minimally invasive. It involves small incisions and allows the surgeon to precisely remove the mass while minimizing tissue disruption.

The PSA test is not 100% accurate. High PSA levels can be caused by things like BPH or inflammation, not just cancer. Overdiagnosis and overtreatment of slow growing cancers are also risks. Therfore it's important to talk through these risks and benifits so the patient can take a well informed decision.

When a kidney stone moves through the urinary tract, it can irritate and damage the lining causing visible blood in urine.

Incorrect options-

• Cystitis is more common in women.
• Renal carcinoma is less common in young people.
• Prostatic carcinoma is common in older man and hematuria is not a typical presentation.

Urinary calculi are often idiopathic, 90% are radiopaque and 75% are calcium oxalate stones

The patients features and DRE findings are clearly indicating towards acute prostatitis.

This blood test measures PSA levels, a protein produced by prostate. Elevated PSA levels can be a sign of BPH, although its not specific to BPH. An elevated PSA can also indicate prostate cancer, but its commonly used to monitor prostate health.

The patient likely has BPH due to- 

• Dull loin pain from urine backup.
• Interurpted urination from prostate obstruction.
• Increased BUN/ creatinine indicating kidney impairment from urinary retention.
• Bilateral hydronephrosis caused by urinary obstruction.

It is the best investigation as it measures how well kidney filters waste.

Microalbuminuria generally precedes overt proteinuria by 5-10 years. Once proteinuria is detected, renal function gradually deteriorates over 10-15 years.

Parotitis is the inflammation of parotid gland caused by viral infection like mumps.

BPH causes urinary symptoms such as nocturia,diminished stream and sometimes hematuria but doesn't cause parototis.

Testicular torsion usually presents with severe pain, swelling, and is more common in young males, and requires surgical treatment to restore flow.

Stress can lead to ED. Relaxing techniques like deep breathing and meditation can lower stress, improving ED.

Premature ejaculation (PE) is the most common sexual dysfunction in men younger than 40 years.

RBC castes are formed when red blood cells get trapped in kidney tubules indicating direct damage and inflammation in the glomeruli. This makes them highly specific for active glomerulonephritis.

Incorrect options-

• HIgh creatinine indicates kidney dysfuction but is not specific to glomerulonephritis.
• WBC casts suggest infection but are more common in pyelonephritis.
• Proteinuria is not specific.

Pyelonephritis is a severe kidney infection that needs close monitioring. IV antibiotics act faster and  more effectively than oral ones, while IV fluids ensure proper hydration and support recovery.

Conditions like testicular torsion can cause severe abdominal pain. Early detection is vital to prevent damage to the testicle.

Incorrect options-

• Kidney related issue is less likely to cause sudden severe pain.
• Lumbar back pain is unrelated in this case.
• Rectal issues present with localized pain.

The cahracterstic feature ''bag of worm'' sensation is indicative of varicocele. It occurs due to dilated veins in the scrotum causing this unique texture.

In older man large prostate can block flow of urine, causing a full bladder and hydronephrosis.

A normal cystogram rules out bladder injury, but gross hematuria after trauma suggests possible damage to the kidneys or ureters. An IVP helps visualize the entire urinary tract to locate the bleeding source.

Left hypochondrial pain could involve kidney or urinary tract. Since the patient already underwent a cystoscopy, a urologist is best suited to evaluate and manage any urinary issues.

This parasitic infection can damage urinary tract, leading to stone formation and hematuria.

A full bladder that can't empty completely causes dribbling, urgency, a palpable bladder, and a sense of incomplete voiding.

Dysuria, anal pain, and a boggy mass on rectal exam are hallmark of prostate inflammation, often due to bacterial infection.

Seminoma are highly radiosensitive tumors, meaning they respond very well to radiation therapy, making it an effective treatment option.

Metformin can accumulate in blood if kidney function is impaired, leading to lactic acidosis, a potentially life threatening condition. Even with high creatinine clearance, the patient's kidney function may not be adequate for metformin, so it should be stopped.

Rapid fluid replacement with hypotonic solution like DS can dilute sodium levels in blood, leading to hyponatremia. This condition can cause confusion and headaches due to low sodium level.

Ct scans are highly accurate for detecting renal stones. Without contrast, it provides clear images of stones, size, location, and number, without the risk of contrast material interfering with results.

This condition involves inflammation of spaces between the kidney tubules. It can be caused by infections, medications, or autoimmune disease. The patient's persistent UTI symptoms despite treatment, along with mild bladder tenderness suggest kidney involvement beyond just bladder infection.

Colpotomy is a surgical procedure to investigate and treat a palpable mass causing persistent UTI symptoms, especially when medication fails

Renal tubular acidosis (RTA) is composed of a group of disorders characterized by an inability of the kidney to resorb bicarbonate/ secrete hydrogen ions, resulting in hyperchloremic, normal anion gap metabolic acidosis. Renal function (glomerular filtration rate [GFR]) must be normal or near normal.

Diabetes insipidus leads to excessive urine production, causing dehydration and hypernatremia, not hyponatremia.

Bilateral renal artery stenosis reduces blood flow to the kidneys, leading to kidney dysfunction with symptoms like edema, azotemia, and a decreased GFR.

The kidneys filter uric acid from the blood vessels and excrete it in the urine, making this the main way the body removes it.

A flat curve response is not a recognized side effect of thiazide diuretics. It's more of a term related to certain drug condition responses, but not specific to thiazides.

If lactic acid accumulates →metabolic acidosis, the body compensates to some extent by hyperventilation, via medullary chemoreceptor, leading to removal of CO2 in the lung.

The patient with moderate BPH is expreriencing incomplete voiding, a common symptom of BPH. If medications don't work, surgery is often recommended to relieve urinary obstruction and improve bladder emptying.

Incorrect options-

• Catheter might temporarily help but isn't a long-term fix.
• Increasing water intake might help in some cases but won't resolve with moderate BPH.
• Increased carbohydrate intake is irrelevant to BPH treatment.

Ureteral stricture, a narrowing of the ureters, block urine flow, leading to hydronephrosis. This condition can cause loin pain and elevate serum urea and creatinine levels, however, having bilateral ureteral stricture is extremely rare condition. Best option would be D- prostate cancer.

While arteriogram confirms renal artery stenosis in the left kidney, a biopsy is necessary to rule out other causes like chronic kidney infections or tumors. This will provide a definitive diagnosis and guide further treatment.

Serum creatinine is a byproduct of muscle metabolism, and kidneys filter it out. Elevated levels of serum creatinine are a reliable indicator of kidney dysfunction because the kidneys ability to clear creatinine decreases as their function declines.

Urge incontinence happens when bladder contracts involuntarily, leading to dribbling or involuntary leakage. This patient's frequent nighttime urgency and wetness upon waking suggest her bladder is contracting, producing a strong urge to urinate. 

This is a chronic condition causing bladder pain, urgency and frequent urination. The patient's symptoms have persisted despite use of various antibiotics, making a bacterial infection unlikely. The lack of improvement is therefore suggestive of interstitial cystitis.

PKD is a genetic disorder that causes multiple fluid-filled cysts to form in the kidneys, leading to kidney enlargement. The ultrasound showing enlarged kidneys with multiple cycts, along with patients trisomy of chromosome 16 strongly points in favor of this diagnosis.

After correcting dehydration with 3 liters of DS the patient likely developed hyponatremia, a condition where sodium levels in blood drop too low. DS is a hypotoic sloution which can dilute sodium, especially in elder patients. This can lead to confusion and headache.