Urologic infections and inflammations 1000+ MCQ with answer for IBPS SO

1. 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

2. 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

3. 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

4. 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

5. 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

6. 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

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

8. 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

9. What is true concerning granulomatous inflammation of the prostate?
A. is a common cause of elevated PSA level
B. might follow BCG treatment
C. is sequelae of untreated type III-b prostatitis
D. shows homogenous enhancement following Gd-DTPA on prostate MRI
Answer : B

10. 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

11. 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

12. 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

13. 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

14. What is (are) the cause(s) of recurrent community acquired UTI in women?
A. uncontrolled DM
B. sexual activity with multiple partners
C. high vaginal receptivity to bacterial adherence
D. all of the above
Answer : D

15. What could cause scrotal sinus?
A. improperly drained hair follicle scrotal abscess
B. syphilitic orchitis
C. tuberculous epididymitis
D. all of the above
Answer : D

16. 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

17. 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

18. 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

19. 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

20. What is false concerning genitourinary TB?
A. is the commonest extra-pulmonay site of infection
B. bladder TB is secondary to renal TB, and usually begins at the ureteral orifices
C. in the kidneys, TB is typically bilateral, cortical, and adjacent to the glomeruli; they may remain dormant for ages
D. epididymal TB might occur by hematogenous or direct spread from the urinary tract
Answer : A

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

22. 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

23. 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

24. 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

25. 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

26. What is false concerning sepsis syndrome?
A. poor tissue perfusion manifests as hyperlactemia and decreased capillary refill
B. acute oliguria indicates an organ dysfunction and circulatory collapse
C. septic shock is an extreme form of sepsis when hypotension persists despite adequate fluid resuscitation
D. hypotension is a sign of hyperdynamic circulation at an early septic shock
Answer : D

27. 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

28. When comparing nosocomial to community-acquired UTI, the latter is:
A. 45% are caused by E. coli
B. related to an indwelling urinary catheter in approximately 40% of cases
C. responds fairly to oral antibiotics
D. tends to report higher antibiotic resistance
Answer : C

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

30. 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

31. 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

32. 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

33. 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

34. 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

35. What is false concerning emphysematous cystitis?
A. the hallmark in the diagnosis is the cystoscopic findings
B. risk factors include transplant recipients
C. CT shows intramural and/or intraluminal gas in the bladder
D. requires surgical debridement and probably cystectomy
Answer : A

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

37. 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. classcally, treatment should be culture-specific
Answer : D

38. 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

39. 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

40. 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

41. 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

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

43. 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

44. 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

45. 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

46. 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

47. 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

48. 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

49. 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

50. 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