skip to main content

Anaemia of chronic kidney disease — MCCQE Part 1 MCQ

Instant feedback + full explanation. One question, done properly.

ModerateFatigueAnaemia of chronic kidney diseaseMCCQE Part 1

After appropriate evaluation excludes other causes, a patient has prolonged disabling fatigue, unrefreshing sleep, cognitive difficulty and reproducible symptom worsening 24 hours after modest physical or mental activity. What is the most appropriate management approach?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: B — Develop individualized energy management within current limits and treat symptoms collaboratively

The delayed, disproportionate worsening after activity is post-exertional malaise, a defining management consideration in ME/CFS. Care should validate the illness, address sleep, pain, orthostatic and other symptoms, and collaboratively establish an activity pattern within the person's fluctuating energy limits. Pacing uses planning, pre-emptive rest and adjustment after flares; it is not a promise of cure or permanent bed rest. Programmes that impose fixed incremental exercise regardless of symptoms should not be prescribed because they may trigger deterioration. Continue longitudinal review for new clinical features and support function, education, work or disability needs rather than treating normal routine tests as evidence that symptoms are unreal.

Reference: HealthLink BC and NICE ME/CFS guidance: https://www.healthlinkbc.ca/healthwise/myalgic-encephalomyelitischronic-fatigue-syndrome-managing-your-energy ; https://www.nice.org.uk/guidance/ng206/chapter/recommendations