Urologic infections and inflammations 1000+ MCQ with answer for ESIC

1. All of the following etiologies for interstitial cystitis have been theorized, EXCEPT:
A. allergic, type I hypersensitivity response
B. pelvic floor dysfunction
C. up-regulation of histaminergic and muscarinic neuro-receptors
D. neural hypersensitivity
Answer : A

2. Histologically, the pathognomonic finding of Fournier gangrene include:
A. necrosis of the superficial and deep fascial planes
B. fibrinoid thrombosis of the nutrient arterioles
C. polymorphonuclear cell infiltration
D. all of the above
Answer : D

3. 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

4. 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

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

6. What is NOT a poor clinical practice on caring for urethral catheters?
A. taking urine samples by draining the urine bag
B. daily cleansing the external meatus
C. placing the urine bag on the floor
D. changing the urine bag once it is full
Answer : B

7. What type of human Herpes virus is implicated in all forms of Kaposi sarcoma?
A. 2
B. 6
C. 7
D. 8
Answer : D

8. 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

9. 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

10. 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

11. 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

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

13. 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

14. 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

15. What are the sequelae of recurrent uncomplicated UTI in young women?
A. minimal
B. chronic persistent infections
C. chronic relapsing infections
D. bouts of chronic pyelonephritis
Answer : A

16. 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

17. 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

18. 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

19. 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

20. 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

21. 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

22. 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

23. 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

24. 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

25. What is false concerning foreign body cystitis?
A. most commonly due to indwelling catheters
B. the areas of inflammation are usually confined to the lateral walls or the dome of the bladder
C. radiographic changes are nonspecific or present as bullous edema
D. indwelling catheters are associated with squamous cell carcinoma of the bladder
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. 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

28. 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

29. 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

30. 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

31. 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

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

33. What is true concerning the definition of UTI in women, based on culture results from a suprapubic aspirate of urine?
A. any amount of uropathogen grown in culture indicates UTI
B. for cystitis, more than 1000 CFU/mL indicates UTI
C. for pyelonephritis, more than 10,000 CFU/mL indicates UTI
D. for asymptomatic bacteriuria, more than 100,000 CFU/mL indicates UTI
Answer : A

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

35. 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

36. 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

37. 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

38. 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

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

40. 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

41. 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

42. What is false concerning Chlamydia trachomatis urethritis in males:
A. produces yellow whitish, scanty, frothy urethral discharge
B. shows gram (+), extracellular diplococcic
C. infection could be contracted from the spouses eyes
D. responds fairly to azithromycin
Answer : B

43. 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

44. 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

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

46. 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

47. 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

48. Which of the following is NOT a first-choice antimicrobial agent for uncomplicated acute cystitis in women?
A. nitrofurantoin monohydrate/macrocrystals
B. trimethoprim-sulfamethoxazole
C. ampicillin
D. fosfomycin
Answer : C

49. 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

50. 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