15th July 2024

A 28-year-old woman with poorly controlled T1DM is referred by her GP to the acute medical unit

A 28-year-old woman with poorly controlled T1DM is referred by her GP to the acute medical unit. On arrival, she is alert, however complaining of flank pain on the right. She also complains of haematuria for the last 3 days. RR is 22, SpO2 93% on air, HR 133, BP 99/55, Temp 38.8 degrees Celsius. A venous gas shows a pH of 7.21, plasma glucose of 33 and lactate of 4.1. WCC is 23, Hb is 134, CRP is 290. Other blood tests include Na 134, K 6, Ur 22, Cr 400, eGFR 15. A urine dip is positive for blood (+++), protein (++), leucocytes (++) and nitrites (+++).

Which of the following investigations is most likely to reveal the underlying diagnosis for this presentation?

Select the SINGLE most appropriate option from the list below. Select ONE option only.