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

1. What condition(s) could occur in schistosomal ureter?
A. beading of the lower ureteral segment
B. ureteral fibrosis and calcifications of the distal ureter
C. stricture at the uretero-vesical junction
D. all of the above
Answer : D

2. Which of the following factors increases the risk of UTI due to facilitation of microbial ascent?
A. sexual activity
B. the use of spermicide
C. estrogen depletion
D. fecal incontinence
Answer : D

3. 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

4. The virulence of uropathogenic E.coli depends on all the following,
EXCEPT:
A. P blood-group antigen
B. P fimbriae in descending infections
C. emolysins
D. Dr family of adhesins in ascending infections
Answer : B

5. What is true concerning HIV infection?
A. HIV is a retrovirus that infects B-cells and dendritic cells
B. circumcised men are at lower risk for HIV infection
C. HPV infection increases the risk for cancers in HIV patients by 6.3 times
D. plasma HIV RNA load is a predictor of disease remission
Answer : B

6. A 44 yrs. male presents with recurrent left pyelonephritis and Proteus infection. His kidney is dilated and contains a stone. A renal biopsy showed foamy macrophages with neutrophils and cellular debris. What is the treatment?
A. PCNL after treating the infection
B. cystoscopy and placing a retrograde ureteral stent followed by ESWL
C. perc. nephrostomy and placing antegrade ureteral stent
D. nephrectomy
Answer : D

7. What is false concerning renal hydatid cysts?
A. might rupture into the collecting system causing (hydatiduria)and renal colic
B. are formed by the eggs of the tapeworm Echinococcus granulosus
C. most cysts are asymptomatic but might manifest as flank mass, dull pain, or hematuria
D. the most reliable diagnostic test uses partially purified hydatid arc 5 antigens in a double-diffusion test
Answer : B

8. 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

9. What is the most important pharmacokinetic property of a drug to cure UTI?
A. mode of administration
B. level in the serum
C. level in the urine
D. dosage
Answer : C

10. Irritative LUTS and dyspareunia in postmenopausal women are most likely to be due to:
A. giggle incontinence
B. estrogen deficiency
C. cystitis glandularis
D. cystitis cystica
Answer : B

11. What type of cells is implicated most in the pathogenesis of BPS/IC?
A. histocytes
B. T lymphocytes
C. mast cells
D. B lymphocytes
Answer : C

12. 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

13. Under which surgical wound classification, does diagnostic cystoscopy under sterile technique fit?
A. dirty - infected
B. contaminated
C. clean - contaminated
D. clean
Answer : C

14. What is false concerning UTI in long-term care facilities?
A. in catheterized individuals, entry of bacteria into the bladder is facilitated by the bacterial glycocalyx biofilm
B. infection cannot be reliably distinguished from bacteriuria by lab tests
C. co-trimoxazole is the preferred antibiotic for empiric therapy
D. symptomatic UTI may be a diagnosis of exclusion
Answer : C

15. What is the best statement that describes the action of antiproliferative factor?
A. inhibits bladder epithelial cell proliferation
B. inhibits the bladder proliferative growth factors
C. stimulates the proliferation inhibitory factors
D. none of the above
Answer : A

16. 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

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

18. What is false concerning urinary catheter-associated UTI (CAUTI)?
A. once a catheter is placed, the daily incidence of bacteriuria is 3-10%
B. on long-erm catheterization, over 90% of patients develop bacteriuria
C. the practice of using urinary catheters to control incontinence in bedridden patients should be discouraged
D. urine bags should be placed on the floor to enhance gravity drainage
Answer : D

19. 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

20. What is false in the treatment and prevention of STDs?
A. antibiotic therapy is recommended for affected individuals with documented trichomonal infection and sexual partners even if asymptomatic
B. empirical treatment for gonococcal urethritis should cover chlamydia trachomatis
C. consistent and proper usage of condoms is estimated to prevent HIV transmission by approximately 80 to 95%
D. vaccinations are available for the prevention of human papillomavirus, N. gonorrhea, chlamydia trachomatis
Answer : D

21. What is true concerning the treatment of catheter associated bacteriuria?
A. should be flushed frequently, but no antibiotic is advised
B. should be treated if febrile UTI has developed
C. should be treated only if urine culture is positive
D. should be treated once the catheter is removed
Answer : B

22. What is true regarding contrast CT imaging for a renal abscess?
A. abscess appears as a low attenuation cystic cavity containing gas
B. renal parenchyma around the abscess cavity may show hypo enhancement in nephrogram phase
C. associated fascial and septal thickening are seen with obliteration of perinephric fat
D. all of the above
Answer : D

23. 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

24. What is true regarding chronic epididymitis symptomatology?
A. pain is dull aching in the scrotum, perineum, inner thighs, and lower abdomen
B. dysuria, frequency, and/or urgency
C. long-standing (> 6 weeks) history of scrotal pain, and tenderness
D. low grade fever, malaise, and urethral discharge
Answer : C

25. What are the most commonly affected organs by genitourinary schistosomiasis?
A. kidneys and adrenals
B. bladder and ureters
C. prostate and vasa
D. testes and epididymi
Answer : B

26. What type of bladder cells secretes antiproliferative factor?
A. bladder epithelial cells
B. type C nerve endings in the bladder
C. type A delta nerve endings in the bladder
D. the innermost longitudinal fibres of detrusor muscle
Answer : A

27. 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

28. 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

29. 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

30. What is true regarding nephrogenic adenoma of the bladder?
A. results from ectopic nephrogenic blastema cells in the detrusor muscle
B. might undergo malignant transformation in 15 40% of the cases
C. on cystoscopy, it appears as a bladder mucosal irregularity or large intramural mass
D. the preferred treatment is cystectomy and urinary diversion
Answer : C

31. 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

32. 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

33. What is false concerning acute glomerulonephritis?
A. manifested as a sudden onset of hematuria, proteinuria, oliguria, edema, hypertension, and RBC casts in the urine
B. post-streptococcus GN has an incubation period of 1-3 weeks with specific strains of group A beta-hemolytic streptococcus
C. the triad of sinusitis, pulmonary infiltrates, and nephritis, suggests Wegener granulomatosis
D. C3, C4, ESR and antistreptolysin O titer are increased
Answer : D

34. What is false regarding schistosomal cystitis?
A. an esinophilic immune reaction is generated in response to the eggs
B. chronic schistosomiasis can eventually result in small bladder and the development of cancers
C. schistosoma mansoni often causes urinary tract infections
D. could cause inflammatory polys and recurrent hematuria
Answer : C

36. 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

37. What is true concerning bacterial colonization in the bladder?
A. is always asymptomatic
B. it shows a serological immune antibody response
C. is a common cause of sterile pyuria
D. typically, at this stage, the body demonstrates bacteriuria
Answer : A

38. What is (are) the complication(s) of sexually transmitted infections?
A. pelvic inflammatory disease
B. lymphogranuloma venereum
C. infertility
D. all of the above
Answer : D

39. Which of the following has NO role in bacterial colonization in the prostate?
A. intra-prostatic ductal reflux
B. paraphimosis
C. specific blood groups
D. unprotected anal intercourse
Answer : B

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

41. What is false regarding biopsy-taking from interstitial cystitis bladder?
A. no pathognomonic histology for interstitial cystitis
B. basically, biopsies are performed to exclude carcinomas and other varieties of cystitis
C. diagnostic biopsies include the presence of discrete micro-ulcers and increased numbers of mast cells in the detrusor muscle or submucosa
D. none of the above
Answer : C

42. What is false concerning inverted papilloma of the bladder?
A. It is an endophytic tumor of the transitional urothelium
B. harbors p53 gene mutations
C. presents with hematuria, dysuria, and irritative voiding
D. the lesion requires transurethral resection
Answer : B

43. 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

44. No need for radiologic studies for recurrent UTI in:
A. children
B. the elderly
C. men
D. women
Answer : D

45. 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

46. What are the most commonly affected organs by genitourinary tuberculosis?
A. kidneys, prostate and epididymi
B. bladder, ureters and renal pelvis
C. vasa, scrotum and adrenals
D. testes, bladder neck and seminal vesicles
Answer : A

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

48. What is true regarding balanoposthitis?
A. is best diagnosed by ascending urethrography
B. occurs mostly in diabetic and immunosuppressed patients
C. could be due to maceration injury, irritant dermatitis, or Candida
D. commonly presents with deep inguinal lymphadenopathy
Answer : C

49. What is false regarding urethral syndrome in postmenopausal women?
A. pH of vaginal secretions increases after menopause
B. estrogen deficiency manifests as trophic urethritis and atrophic vaginitis
C. topical conjugated estrogen replacement carries a significant risk of breast and endometrial cancers
D. manifestations might include obstructive symptoms and non-infectious cystitis
Answer : C

50. What does NOT predispose to acute epididymitis is:
A. TUR ejaculatory duct
B. prolonged urethral catheterization
C. prostatic biopsy
D. vas ligation
Answer : C