MLA Domain 5 · Presentation

Oliguria/ anuria

5 conditions in Finalist present this way. Work down the list and ask what would separate each one from the next — that discriminator is the exam question.

classic presentation · 1

Glomerulonephritis

Rapidly progressive GN — rising creatinine + active sediment ± haemoptysis (pulmonary-renal syndrome) → urgent immunolog

recognised feature · 4

Major haemorrhage

Young patients maintain BP until late then decompensate suddenly; concealed bleeding (retroperitoneal, GI, intra-abdomin

Sepsis & septic shock

Lactate >2, systolic BP <90 / MAP <65, reduced GCS, mottling, anuria → escalate to critical care

Shock

Cardiogenic or obstructive shock (raised JVP) — aggressive fluids can worsen it → treat the obstruction/pump cause

Shock — types & approach

Obstructive causes (tension pneumothorax, tamponade, massive PE) need immediate mechanical relief, not just fluids