MLA Domain 5 · Presentation

Urinary symptoms

7 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

Genitourinary syndrome of menopause

Postmenopausal bleeding must not be attributed to atrophy until cancer is excluded

recognised feature · 2

Hydronephrosis & obstructive uropathy

Obstructed + infected system → emergency decompression + antibiotics

Pyelonephritis

OBSTRUCTED + infected kidney (pyonephrosis) — stone/obstruction with infection → EMERGENCY decompression (nephrostomy/st

differential of the above · 4

Contact dermatitis

Severe occupational/hand disease threatening work; airborne or widespread facial involvement

Lichen sclerosus

Persistent ulcer/lump or thickened area → biopsy to exclude vulval squamous cell carcinoma

Vulval cancer

Any persistent vulval lump/ulcer → biopsy (do not treat as infection indefinitely)

Vulvovaginal candidiasis

Recurrent (≥4/year) → check diabetes/immunosuppression; pregnancy (oral azoles avoided)