KMU Past Paper Practice

A 42-year-old man develops fever, a generalized rash and rising serum creatinine one week after starting a new medicine. Urinalysis shows pyuria, but he has no dysuria or flank pain. Which renal biopsy finding would best support the suspected diagnosis?

A woman develops an unexplained rise in serum creatinine with pyuria after recent drug exposure. She has no rash and her peripheral eosinophil count is normal. Which interpretation is most appropriate?

A nephrectomy specimen from a patient with severe acute renal infection shows multiple small yellow-white areas scattered through the renal parenchyma. Which pathological process best accounts for this appearance?

A patient with a long history of recurrent renal infection undergoes renal biopsy. Which microscopic finding most strongly indicates that the tubulointerstitial injury has become chronic?

A 59-year-old woman has repeated episodes of lower urinary tract inflammation over several years. Cystoscopic biopsy is performed because symptoms persist between episodes. Which finding best fits chronic cystitis?

A woman with urinary frequency and dysuria has a dipstick test positive for leukocyte esterase. Which urinary abnormality is this test primarily detecting indirectly?

A healthy 25-year-old woman presents with her first episode of dysuria and urinary frequency. She is afebrile, has no flank pain and has no history suggesting obstruction or structural urinary disease. Which investigation principle is most appropriate?

A patient with upper urinary tract infection has high fever, repeated vomiting and significant systemic illness, making reliable oral treatment difficult. Culture shows susceptibility to an appropriate cephalosporin. Which treatment characteristic is most useful in this situation?

A patient receiving co-trimoxazole for a susceptible urinary infection develops increasing fatigue, easy bruising and reduced blood-cell counts. Which recognized adverse effect is the best explanation?

A woman treated with nitrofurantoin for recurrent lower urinary infection develops new cough and shortness of breath without evidence of worsening UTI. Which drug-related complication should be considered?

A man completes a course of amoxicillin–clavulanate for UTI. Several days later he develops jaundice and abnormal liver-function tests. Which adverse effect of the antimicrobial combination is most relevant?

A patient with severe acute cystitis undergoes bladder examination because of visible hematuria. Which gross mucosal change would be compatible with marked acute inflammation?

A 5-year-old child has experienced several febrile UTIs involving the upper urinary tract. The current episode responds to treatment. Why is prevention of further episodes particularly important?

Parents of a school-aged girl with previous uncomplicated UTIs ask how they can reduce the risk of future episodes. Which advice is most appropriate as part of routine prevention?

A pregnant woman develops bacteriuria despite having no known urinary abnormality before pregnancy. Which physiological change most directly contributes to the increased tendency toward ascending UTI during pregnancy?

A woman at 30 weeks of pregnancy is admitted with renal infection, high fever and systemic illness. Which concern best explains why pyelonephritis in pregnancy requires close clinical monitoring?

A patient with urinary symptoms has a positive nitrite dipstick result. Which bacterial property most directly produces this laboratory finding?

A woman presents with another episode of UTI. Six months earlier, her urine culture grew an organism resistant to one commonly used antimicrobial. Before selecting empirical therapy, which information is most useful?

A 72-year-old patient with acute pyelonephritis is febrile, dehydrated and passing less urine than usual. In addition to urine studies, which laboratory test is particularly useful for assessing possible renal functional impairment?

A patient receiving co-trimoxazole for UTI develops fever and a rapidly spreading generalized skin eruption after starting therapy. Which recognized drug complication should be considered first?