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An 80 year old female presents to the emergency department with extreme weakness, disorientation, hypertensive and tachycardia. The lady had been suffering from Type 2 Diabetes mellitus for over 10 years. The following test results were obtained from the pathology department. Parameter Result Range Creatinine 168 umol/L 48-80 umol/L Urea 13.8 mmol/L 1.7-8.3 mmol/L Potassium 5.7 mmol/L 3.7-5.4 mmol/L HbA1c 51 mmol/Mol 19-40 mmol/Mol e-GFR (MDRD formula) 27ml/min/1.73sq.m >90 ml/min/1.73sq.m Ferritin 273.1 ug/L 4.6-204 ug/L Q1. What is the most likely diagnosis? (10% of the marks; word limit 100 words) Q2. Discuss each of the biochemical findings and outline the clinical significance? (30% of the marks; word limit 300 words) Q3. The lady had a 24hr urine sample of 1950 ml collected and had a plasma creatinine concentration of 168umol/L, and a urine creatinine 8.3mmol/L, calculate the creatinine clearance and comment on the result. (20% of the marks; word limit 250 words) Q4. Discuss how age, sex and diet affect the serum creatinine production rates? (20% of the marks; word limit 250 words) Q5. Discuss the advantages of cystatin C as a marker of renal function? (20% of the marks; word limit 250 words)

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Tellus molestie nunc non blandit massa enim nec dui. Tellus molestie nunc non blandit massa enim nec dui. Ac tortor vitae purus faucibus ornare suspendisse sed nisi. Pharetra et ultrices neque ornare aenean euismod. Pretium viverra suspendisse potenti nullam ac tortor vitae. Morbi quis commodo odio aenean sed. At consectetur lorem donec massa sapien faucibus et. Nisi quis eleifend quam adipiscing vitae proin sagittis nisl rhoncus. Duis at tellus at urna condimentum mattis pellentesque. Vivamus at augue eget arcu dictum varius duis at. Justo donec enim diam vulputate ut. Blandit libero volutpat sed cras ornare arcu. Ac felis donec et odio pellentesque diam volutpat commodo. Convallis a cras semper auctor neque. Tempus iaculis urna id volutpat lacus. Tortor consequat id porta nibh.

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The task is: A recent self-review has shown that the medical school lacks both exposure for students to primary care settings and sufficient early clinical skills training. In response to this, the Dean has received a proposal from the Medical Education Unit (MEU) to introduce a series of new attach ...

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