1000+ Urologic infections and inflammations Multiple Choice Question Answer [Solved]

1. What could cause unresolved bacteriuria?
A. drug resistance
B. non-compliance
C. the presence of persistent pathology
D. all of the above
Answer : D

2. What are the diagnostic findings on cystometrogram for BPS/IC?
A. discomfort on placing urethral catheter and pain on bladder filling
B. difficulty in zeroing the pressure and diminished response to first cough
C. low filling pressure but high voiding pressure
D. uninhibited bladder contractions with a relative bladder hypotonia
Answer : A

3. What is false concerning acute pyelonephritis?
A. CBC reveals leucocytosis with predominance of neutrophils
B. contrast CT reveals one or more focal wedge-like swollen regions of the kidney parenchyma, sparing the cortex, and demonstrating reduced enhancement rim sign
C. in children, recurrent acute pyelonephritis might lead to renal scarring
D. in pregnancy, recurrent acute pyelonephritis might lead to preterm labor
Answer : B

4. What are the commonest organisms causing acute epididymitis in males younger than 35 yrs.?
A. N. gonorrhea and C. trachomatis
B. E. coli and Pseudomonas species
C. Mycoplasma genitalium and Ureaplasma species
D. Trichomonas vaginalis and Gardnerella vaginalis
Answer : A

5. Which of the following conditions is NOT associated with interstitial cystitis?
A. inflammatory bowel disease
B. rheumatoid arthritis
C. systemic lupus erythematosus
D. fibromyalgia
Answer : B

6. What are the target immune cells for HIV?
A. phagocytes
B. CD4 T cells
C. B lymphocytes
D. natural killer cells
Answer : B

7. How should a proper routine urine specimen be collected?
A. early morning sample, after cleansing the perineum and meatus
B. by urethral catheterization under strict aseptic technique
C. a clean catch of midstream voided urine
D. by suprapubic aspiration, as urine is sterile
Answer : C

8. What is the preferred antibiotic for BPS/IC cases?
A. rifampicin
B. doxycycline
C. azithromycin
D. none of the above
Answer : D

9. What is true regarding genitourinary TB?
A. commonly, TB enters the urinary tract via intravesical instillation of attenuated live BCG to treat bladder cancer
B. CT urography may show infundibular stricture with or without hydrocalicosis
C. renal ultrasonography reveals calyceal erosions moth-eaten calyx
D. TB of the vas appears, clinically, as a thin hard strictured tube
Answer : B

10. Patients with bladder pain syndrome have:
A. a history of repeated urologic and/or gynecologic procedures
B. 10 fold higher incidence of childhood voiding problems
C. 4 fold higher incidence of anxiety-depression syndrome
D. 6 fold higher incidence of psychosomatic disorders
Answer : B

11. What is false concerning antiretroviral medications?
A. multiple antiretroviral drugs can be combined into a single pill
B. might cause radiolucent renal stones
C. can lead to a significant rise in the serum level of PDE5 inhibitors, if taken simultaneously
D. have the advantage of structured treatment interruptions (drug holidays)
Answer : D

12. What are the most indicative symptoms of chronic pyelonephritis?
A. fever and chills
B. suprapubic pain and pyuria
C. flank pain and tenderness
D. none of the above
Answer : D

13. What is the earliest clinical finding of urosepsis?
A. elevated body temperature
B. dropped blood pressure
C. elevated heart rate
D. reduced urine output
Answer : C

14. What is the proper term to describe high bacterial count in urine without pus?
A. asymptomatic bacteriuria
B. sterile pyouria
C. bacterial colonization
D. unresolved bacteriuria
Answer : C

15. What host`s factors do NOT increase the risk of developing infections?
A. advanced age
B. anatomical anomalies
C. poor drug compliance
D. smoking
Answer : C

16. What is true regarding Xanthogranulomatous Pyelonephritis?
A. CT shows the characteristic bear paw sign
B. it is an infected, obstructed, poorly functioning kidney containing stones
C. nephrectomy is the treatment
D. all of the above
Answer : D

17. What is false regarding the etiology and treatment of orchialgia syndrome?
A. small indirect inguinal hernia may irritate the genital branch of genitofemoral nerve causing orchialgia
B. might respond to a selective nerve block
C. the recommended treatment is orchiectomy with implantation of a testicular prosthesis
D. psychotherapy and stress management might alleviate the pain
Answer : C

18. Ureteral dilation in schistosomiasis could be due to:
A. vesicoureteral reflux
B. stenosis of the lower ureter
C. edematous ureteral wall causing deficient peristalsis
D. any of the above
Answer : D

19. What is false concerning esinophilic cystitis?
A. probably due to antibody/antigen reaction
B. has no diagnostic findings on cystoscopy
C. has no specific medical therapy
D. on histology, Von Brunn`s nests appear invaginating the urothelium into the lamina propria
Answer : D

20. What is false regarding cystitis cystica?
A. most cysts appear as filling defects on cystography
B. most often found in the trigone area
C. the cyst lumens contain esinophilic secretions that may have a few inflammatory cells
D. cystitis cystica and cystitis glandularis are reactive urothelial changes
Answer : A

21. What is true regarding urinary catheter-associated UTI (CAUTI)?
A. indwelling catheter insertion must be under sterile condition
B. systemic antibiotics help best in preventing bacteriuria
C. greater than 90% of nosocomial UTIs are related to urethral catheters
D. Intermittent catheterization carries the incidence of 1-3% of developing bacteriuria per insertion
Answer : D

22. What is false concerning the presentation of prostatitis syndrome?
A. type I could harbor prostate abscess
B. type II presents as intermittent urinary tract infections
C. type III-a presentation might include psychological complaints
D. between 10-15% of men with type IV, have pus cells in their semen but no symptoms
Answer : C

23. What is false concerning the cystoscopic findings of interstitial cystitis?
A. Hunner`s ulcers are multiple ulcerative patches surrounded by mucosal congestion on the dome or lateral walls
B. ulcers might get distorted after overdistention, because discrete areas of mucosal scarring rupture during the procedure
C. in non-ulcerative type, overdistention demonstrates glomerulations on the dome and lateral walls
D. overdistention results in mucosal tears and submucosal hemorrhage
Answer : B

24. What is false about urinary catheters?
A. condom catheters carry less risk of UTI if compared to urethral
B. suprapubic catheters carry less risk of UTI if compared to urethral
C. latex catheters carry less risk of UTI if compared to silicon
D. intermittent catheterization carry less risk of UTI if compared to indwelling catheters
Answer : C

25. HIV infection increases the incidence of the following cancers, EXCEPT:
A. Kaposi sarcoma,
B. Hodgkin lymphoma
C. non-Hodgkin lymphoma
D. cervical cancer
Answer : B

26. Asymptomatic bacteriuria should be treated in the following situations:
A. in the elderly
B. in long-term catheterized patient
C. in pregnancy
D. none of the above
Answer : C

27. What is the percentage of occurrence of Staphylococcus saprophyticus in symptomatic lower UTIs in young sexually active females?
A. 5%
B. 10%
C. 15%
D. 20%
Answer : B

28. What is false concerning radiation cystitis?
A. the average time from the beginning of radiation therapy to initial symptoms could be 2 4 weeks
B. treatment with stationary radiation, portals carry a higher risk of morbidity than treatment with rotating portals do
C. it occurs in about 10% of patients treated with definitive irradiation therapy for prostate cancer after 10 years
D. most cases are mildly affected and require no specific therapy
Answer : A

29. What is true concerning BPS/IC?
A. the onset of symptoms is insidious
B. the lesion has no proven relation to bladder cancer
C. if left untreated, the bladder will turn small, contracted, with submucosal calcifications
D. a single positive urine culture refutes the diagnosis
Answer : B

30. What is false regarding malakoplakia?
A. is an uncommon granulomatous disease that affect the skin and/or urinary bladder
B. it might be due to a disturbed function of B lymphocytes
C. characterized by the presence of basophilic inclusion structure (Michaelis-Gutmann body)
D. it might be due to a defective phagolysosomal activity of monocytes or macrophages
Answer : B

31. What is the most commonly affected organ by genitourinary Brucellosis?
A. kidneys
B. bladder
C. prostate
D. epididymis
Answer : D

32. What condition causes sterile pyuria?
A. urethral infection with trichomonas vaginalis
B. bladder infection with adenovirus
C. Kawasakis disease
D. all of the above
Answer : D

33. What is false regarding Gonorrheal STD in women?
A. nucleic acid amplification tests are the preferred to diagnose Gonococcal and Chlamydial infections
B. shows dark yellow, purulent, thick urethral discharge
C. the most common site of the infection is the endocervix
D. the incubation period is 2 3 weeks
Answer : D

34. In which segmented voided bladder (VB) specimen, the diagnosis of chronic prostatitis is confirmed?
A. VB1 and VB3
B. prostatic secretions and the VB3
C. prostatic secretions and the VB2
D. prostatic secretions and the VB1
Answer : B

35. What is false concerning chronic orchialgia syndrome?
A. it is a constant or intermittent pain of testes for more than 3 months
B. could be due to appendix testis torsion-detorsion
C. could be due to radiculitis resulting from a degenerative lesion in the thoraco-lumber vertebrae
D. could be a result of entrapment neuropathy of ilioinguinal or genitofemoral nerve
Answer : B

36. What is the mortality rate of emphysematous pyelonephritis?
A. 43%
B. 53%
C. 63%
D. 73%
Answer : A

37. What is false regarding Fournier`s gangrene?
A. is defined as a polymicrobial chronic infection of the perineal, perianal, or genital areas
B. as the disease progresses, branches from the inferior epigastric, deep circumflex iliac, and external pudendal arteries get thrombosed
C. presents as a dark skinned-scrotum, subcutaneous crepitation, and foul smell
D. surgical debridement often spares the testes
Answer : A

38. What type of scrotal ulcers is painless, punched out, with yellowish grey floor?
A. tuberculous ulcer
B. malignant ulcer
C. gummatous ulcers
D. traumatic ulcer
Answer : C

39. What is (are) the prominent clinical finding(s) in the diagnosis of acute pyelonephritis?
A. fever, chills, abdominal pain
B. costovertibral angle tenderness
C. hypogastric and loin pain
D. flank pain, dysuria
Answer : B

40. What antimicrobial agent treats UTI and does NOT alter the gut flora?
A. trimethoprim- sulfamethoxazole
B. fluoroquinolones
C. aminoglycosides
D. nitrofurantoins
Answer : D

41. What condition does NOT present as an acute loin pain with fever and marked flank tenderness?
A. ascending UTI causing acute lobar nephronia
B. acute pyelonephritis in a transplanted kidney
C. infected renal subcapsular hematoma
D. perinephric abscess causing septicemia
Answer : B

42. What is false concerning peri-renal abscess?
A. could result from intra-renal abscess of ascending infection
B. urine culture might be negative
C. plain KUB X-ray has no value in the diagnosis
D. surgical drainage is the proper treatment
Answer : C

43. A 60 yrs. man underwent TURP for, only, obstructive LUTS. Histology of prostate chips reveals prostatitis. What NIH type of prostatitis would it be?
A. type I
B. type II
C. type III
D. type IV
Answer : D

44. What kind of cystitis does NOT progress to malignancy?
A. foreign-body cystitis due to vesical calculi
B. Von Brunn`s nests of cystitis cystica and cystitis glandularis
C. schistosomiasis cystitis
D. inverted papilloma of the bladder
Answer : B

45. A 48 yrs. woman presents with recurrent cystitis. Cystoscopy showed a raised bladder lesion. Biopsies from the lesion reveals Von Hansemann histiocytes, and Michaelis-Gutmann bodies. What is the treatment?
A. sulfonamide for several months
B. TUR of the bladder lesion followed by proper staging
C. radical cystectomy and urinary diversion
D. intravesical installation of mitomycin without irradiation
Answer : A

46. What is essential on diagnosing bladder pain syndrome BPS/IC?
A. sterile pyuria on 3 consecutive cultures
B. the presence of glomerulations and/or Hunner`s ulcer on endoscopy
C. pain and discomfort related to the bladder
D. urgency and frequency with no documented infection
Answer : C

47. What is the commonest intra-scrotal pathology in AIDS patients?
A. beaded vas deferens
B. testicular micrilithiasis
C. testicular atrophy
D. epididymal granuloma
Answer : C

48. What condition is associated with renal papillary necrosis?
A. nephrotic syndrome
B. hypertension
C. sickle cell hemoglobinopathy
D. sarcoidosis
Answer : C

49. What is the most significant biological difference in women susceptibility to UTI?
A. adherence of bacteria to vaginal cells
B. vaginal dryness
C. O serogroup
D. vaginal pH
Answer : A

50. As per NIH classification of prostatitis, which type requires no treatment?
A. type I
B. type II
C. type III
D. type IV
Answer : D