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

1. Which treatment modality has NO proven efficacy in CP/CPPS?
A. selective nerve block
B. balloon dilation
C. botulinum A toxin injection
D. ESWL
Answer : B

2. 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

3. 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

4. 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

5. Which statement best defines reinfection?
A. a new episode of UTI caused by different species or occurring at long intervals
B. recurrent UTIs caused by the same organism in each instance, classically, at close intervals
C. recurrent UTIs due to failure of medical therapy to eradicate the infection
D. recurrent UTIs due to a persistent pathology that is obstinate to surgery
Answer : A

6. What is true concerning malakoplakia?
A. is a premalignant condition
B. it can be locally aggressive and invades surrounding structures causing bone erosions
C. kidneys are the most commonly affected organs
D. characterized by rounded intracellular inclusions (owls-eyes) in large esinophilic histocytes
Answer : B

7. 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

8. What is the bladder`s first-line defense against infections?
A. natural sloughing of bladder mucosa
B. voiding
C. urine osmolarity
D. urine pH
Answer : B

9. 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

10. What is the average age of onset of BPS/IC patients?
A. 30
B. 40
C. 50
D. 60
Answer : B

11. 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

12. 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

13. 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

14. What is false concerning post UTI renal scarring in pediatrics?
A. the incidence of scarring following a single episode of febrile UTI is 4.5%
B. intra-renal reflux is common in convex papillae
C. scarring and chronic pyelonephritis lead to hypertension in 10-20%
D. scarring is best detected and followed up by DMSA
Answer : B

15. What is the commonest cause of relapsing UTI in males?
A. chronic epididymitis
B. epididymo-orchitis
C. chronic bacterial prostatitis
D. venereal cysto-urethritis
Answer : C

16. Which of the following does NOT cause sterile pyouria?
A. inadequately treated UTI
B. renal papillary necrosis
C. acute emphysematous pyelonephritis
D. urinary tract tuberculosis
Answer : C

17. 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

18. What group of patients should be treate for UTI only when symptomatic?
A. patients with indwelling catheters
B. neurogenic bladder patients on CIC
C. pregnant women
D. children under 5 years
Answer : A

19. 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

20. 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

21. A 40 yrs. man presents with clinical acute pyelonephritis, on intravenous antibiotics for 4 days, CT shows a renal abscess. What is next in the treatment?
A. carry on the full antibiotic course, and then repeat CT
B. incision and drainage of the renal abscess with/without nephrectomy
C. the abscess size dictates management
D. perc. drainage of the renal abscess
Answer : C

22. 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

23. 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

24. What virus(s) could cause orchitis?
A. Coxsackie B
B. Epstein-Barr
C. varicella
D. all of the above
Answer : D

25. 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-term 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

26. 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

27. What is false concerning epididymitis?
A. should be distinguished from testicular torsion in the emergency setting
B. viral epididymitis is commoner in the elderly
C. chronic epididymitis might complicate BPH
D. chronic epididymitis might require epididymectomy
Answer : B

28. 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

29. 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

30. During the initial 3-month period of HIV infection, what would be the best diagnostic lab test?
A. viral load assay
B. western blot analysis
C. southern blot analysis
D. HIV-1/HIV-2 serology assay
Answer : A

31. What is false concerning Brucellosis epididymitis?
A. commonly presents with scrotal pain, swelling, fever, and leucocytosis
B. epididymo-orchitis is the most frequent genitourinary complication of brucellosis
C. epididymo-orchitis occurs in 10-15% of male patients with brucellosis
D. treatment includes doxycycline and rifampicin for 6-8 weeks
Answer : A

32. Why could pyuria be sterile?
A. because standard laboratory culture specifications might not be favorable for growth of atypical organisms
B. because UTI could show fewer than 10 white cells/mm3 in urine
C. because laboratories may not report significant growth of a defined urinary pathogen
D. all of the above
Answer : D

33. What is false concerning Xanthogranulomatous Pyelonephritis?
A. is most commonly associated with Proteus or E. coli infection
B. is characterized by lipid-laden foamy macrophages
C. the overall prognosis is poor
D. it might involve adjacent structures or organs
Answer : C

34. What is true concerning scrotal abscesses?
A. could be a complication of chronic epididymitis and orchalgia
B. testicular torsion must be excluded
C. infected hair follicles and scrotal lacerations are predisposing factors
D. urethral discharge is not uncommon presentation
Answer : C

35. 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 selctive 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

36. What is true regarding acute pyelonephritis?
A. a cause of obstruction should be sought
B. PCN is placed to decompress the kidney and preserve renal function
C. blood-born staphylococci are commoner than ascending E.coli infections
D. blood and urine cultures must dictate the antibiotic choice from day 1
Answer : A

37. 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

38. 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

39. What is the most common serotype of HPV associated with squamous cell carcinoma of the penis?
A. 16
B. 18
C. 22
D. 12
Answer : A

40. 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

41. 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

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

43. What is false regarding viral cystitis?
A. in pediatrics, adenovirus types 11 and 21 could result in hemorrhagic cystitis
B. immunosuppressed children are especially susceptible to Cytomegalovirus and Adenoviruses 7, 21, and 35
C. in pediatrics, acute viral cystitis might present as acute retention of urine
D. classically, treatment should be culture-specific
Answer : D

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

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

46. 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

47. UPOINT system for phenotype categorization:
A. categorizes CP-CPPS, IC, and painful bladder syndrome based on 5 etiological principles
B. meant to classify CP-CPPS and IC patients into 6 domains
C. helps establish a reliable diagnosis of CP/CPPS or IC
D. the diagnostic scores of UPOINT depend on cystoscopy, TRUS, urine analysis and culture of uncommon microbes
Answer : B

48. What is the preferred antimicrobial prophylaxis for transrectal prostate biopsy?
A. aminoglycoside
B. fluoroquinolone
C. 2nd generation cephalosporin
D. doxycycline
Answer : B

49. 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

50. 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