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

1. 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

2. 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

3. What is the laboratory differentiation between type III-a and type III-b prostatitis?
A. the cytological examination of the urine and/or EPS
B. transrectal ultrasonographic examination
C. the presence of ?10 WBCs/HPF in the urine with negative culture in type III-b
D. the positive urine culture, and negative EPS support type III-a
Answer : A

4. What is false concerning HIV infection?
A. AIDS patients in active infection show low CD4 + T-cell count
B. the diagnosis is confirmed by positive anti-HIV-1, anti-HIV-2 antibodies
C. patients receiving antiviral therapy could still be infectious
D. herpes simplex virus increases HIV replication in infected persons
Answer : B

5. What is false regarding prostatic abscesses?
A. clinically, cannot be differentiated from acute bacterial prostatitis
B. medical management is often unsuccessful
C. it harbors prostate cancer in approximately 4.3% of cases
D. management include suprapubic urinary diversion
Answer : C

6. 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

7. What kind of non-infectious cystitis, do patients with systemic lupus erythematosus (SLE), likely to develop?
A. cystitis glandularis
B. cystitis cystica
C. esinophilic cystitis
D. cystitis follicularis
Answer : C

8. 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

9. 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

10. 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

11. 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

12. What is false regarding pediatric renal parenchyma scarring?
A. chronic pyelonephritis and HTN lead to ESRD in 10% of the cases
B. neonatal symptoms of UTI are vague and non-specific, that delay the diagnosis and end in more scarring
C. despite adequate treatment, scarring continues after an attack of pyelonephritis as a chronic immune reaction against renal tubules
D. neonates have low intrarenal pelvic pressure, that predisposes to ascending infections
Answer : D

13. 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

14. 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

15. 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

16. 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

17. Screening for bacteriuria is mostly indicated for:
A. seniors house residents
B. ICU patients with indwelling urinary catheters
pregnant women
D. neurogenic bladder patients on CIC
Answer : C

18. Management of acute epididymo-orchitis in hospitalized patients includes all of the following, EXCEPT:
A. scrotal support and elevation
B. ice packs
C. non-steroidal anti-inflammatory agents
D. urethral catheterization
Answer : D

19. 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

20. 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

21. 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

22. 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

23. 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

24. What factor(s) increase(s) the risk of bacterial colonization in the prostate?
A. acute epididymitis
B. indwelling urethral catheters
C. transurethral surgery
D. all of the above
Answer : D

25. 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

26. What is false concerning corpora amylacea of the prostate?
A. are premalignant, and found in 1-6% of prostate biopsies
B. are small hyaline masses of unknown significance found in the prostate gland
C. they are degenerate cells or thickened secretions in the prostate ducts
D. might appear as prostate calcifications on X-ray KUB
Answer : A

27. 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

28. 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

29. 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

30. Which of the following does NOT cause unresolved bacteriuria?
A. giant staghorn stone
B. perivesical abscess with fistula to the bladder
C. bacterial resistance
D. self-inflicted infection
Answer : B

31. 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

32. 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

33. 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

34. 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

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

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

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

38. 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

39. 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

40. Which of the following factors increases the risk of UTI due to promotion of microbial colonization?
A. neurogenic bladder
B. the use of spermicide
C. urinary catheterization
D. fecal incontinence
Answer : B

41. 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

42. 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

43. 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

44. 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

45. What is the most virulent factor for bacterial adherence?
A. P blood group
B. fimbria
C. pili
D. hemolysin
Answer : C

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

47. What is false concerning the management of genitourinary TB?
A. prostatic TB is better drained per rectum before initiating the medications
B. renal TB may require nephroureterectomy
C. peripheral neuritis is a known side effect of isoniazid
D. moxifloxacin might result in tendon rupture
Answer : A

48. 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

49. The relative risk of prostate cancer in men with HIV compared to uninfected individuals is:
A. greater than 8 fold
B. greater than 6 fold
C. greater than 4 fold
D. comparable
Answer : D

50. What could NOT cause recurrent UTI in a 25 yrs. woman?
A. bladder neck suspension surgery
B. chronic constipation
C. poor genital hygiene
D. contraceptive diaphragm
Answer : A