Renal, Urology and Electrolytes

A 72-year-old woman with newly diagnosed multiple myeloma presents with confusion, constipation and weakness. Her serum calcium is 4.18 mmol/L (2.10–2.60), crea…

A 68-year-old man with a recent transurethral resection of a bladder tumour presents with worsening suprapubic pain and inability to pass urine. He has passed b…

A 63-year-old man with metastatic squamous cell carcinoma has persistent thirst, vomiting and confusion. After intravenous saline, his serum calcium concentrati…

A 72-year-old man with diabetic kidney disease takes perindopril and spironolactone. He has a serum potassium concentration of 6.2 mmol/L (3.5–5.2), chloride 11…

A 29-year-old man presents after completing an unusually strenuous cross-country event with severe thigh pain and dark urine. His creatinine concentration is 28…

A 54-year-old woman is treated for symptomatic hyponatraemia that has probably been present for several days. Her initial serum sodium concentration was 108 mmo…

A 68-year-old man with chronic kidney disease is admitted with pneumonia and has received intravenous fluids, calcium gluconate and insulin with glucose for a s…

A 62-year-old woman who takes sertraline for depression is brought to the emergency department after a witnessed generalised tonic-clonic seizure at home. She i…

A 23-year-old man presents because his urine has turned dark brown, which he noticed this morning. Two days ago he developed a sore throat and runny nose, which…

A 76-year-old woman taking perindopril for hypertension and regular ibuprofen for knee osteoarthritis presents after three days of vomiting and watery diarrhoea…

A 45-year-old woman has a 7-mm calculus in the distal ureter on non-contrast CT. Her pain is controlled with oral analgesia, creatinine is normal, and she is af…

A 38-year-old woman has recurrent episodes of visible haematuria, but her renal function is normal and urine protein excretion is minimal. The episodes begin wi…

A 70-year-old man with diabetic kidney disease takes ramipril and spironolactone. Routine testing shows potassium 6.4 mmol/L, confirmed on a non-haemolysed samp…

A 42-year-old man presents with haemoptysis, fatigue and rapidly worsening renal function. Creatinine is 486 micromol/L, urine microscopy shows dysmorphic red c…

A 67-year-old woman develops oliguria and a creatinine rise from 84 to 310 micromol/L after several days of septic shock. Urinalysis shows 2+ blood but no signi…

A 35-year-old man reports drinking approximately 6 L of water daily because of anxiety about dehydration. He is alert, euvolaemic and not taking diuretics or an…

A 29-year-old man presents with facial puffiness, dark urine and ankle swelling. He had an impetigo-like skin infection 18 days ago, and his blood pressure is 1…

A 68-year-old man presents with fever, rigors, dysuria and perineal pain. He has been unable to pass urine for 10 hours, and examination shows a markedly tender…

A 36-year-old woman with systemic lupus erythematosus has increasing ankle swelling and foamy urine. Her urine protein-to-creatinine ratio is 180 mg/mmol (refer…