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Urologic infections and inflammations 1000+ MCQ with answer for RRB JE

Thursday 9th of March 2023

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1. 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
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 the average age of onset of BPS/IC patients?
A. 30
B. 40
C. 50
D. 60
Answer : B
4. 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
5. What is the preferred antibiotic for BPS/IC cases?
A. rifampicin
B. doxycycline
C. azithromycin
D. none of the above
Answer : D
6. 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
7. 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
8. What is false regarding cystitis cystica?
A. most cysts appear as filling defects on cystography
B. most often found in the trigone area
C. the cyst lumens contain esinophilic secretions that may have a few inflammatory cells
D. cystitis cystica and cystitis glandularis are reactive urothelial changes
Answer : A
9. What virus(s) could cause orchitis?
A. Coxsackie B
B. Epstein-Barr
C. varicella
D. all of the above
Answer : D
10. 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
11. 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
12. Under which surgical wound classification, does diagnostic cystoscopy under sterile technique fit?
A. dirty - infected
B. contaminated
C. clean - contaminated
D. clean
Answer : C
13. 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
14. 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
15. 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
16. 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
17. 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
18. 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
19. 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
20. What are the most commonly affectd organs by genitourinary schistosomiasis?
A. kidneys and adrenals
B. bladder and ureters
C. prostate and vasa
D. testes and epididymi
Answer : B
21. 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
22. 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
23. 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
24. 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
25. What is the most virulent factor for bacterial adherence?
A. P blood group
B. fimbria
C. pili
D. hemolysin
Answer : C
26. 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
27. 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
28. 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
29. What is NOT a complication of mumps orchitis?
A. infertility
B. hypogonadotropic hypogonadism
C. non seminomatous germ cell tumor
D. chronic orchalgia
Answer : C
30. 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
31. 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
32. What is the least important measure in indwelling catheter care?
A. cleansing the urethral meatus with aseptic agent
B. careful aseptic insertion of the catheter
C. maintenance of a closed drainage system
D. maintaining a dependant drainage system
Answer : A
33. 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
34. 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
35. No need for radiologic studies for recurrent UTI in:
A. children
B. the elderly
C. men
D. women
Answer : D
36. 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
37. What group of patients should be treated 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
38. 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
39. 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
40. 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
41. 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
42. 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
43. Epididymal cysts are common in the following conditions,
EXCEPT:

A. von Hippel-Lindau disease
B. tuberous sclerosis
C. cystic fibrosis
D. autosomal dominant polycystic kidney disease
Answer : B
44. 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
45. What is the ideal antibiotic class for self-start therapy on treating recurrent cystitis in a 32 yrs. married woman?
A. aminopenicillins
B. fluoroquinolones
C. aminoglycosides
D. nitrofurantoins
Answer : B
46. 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
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. 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
49. Using low-dose prophylactic or suppressive antimicrobials might be an option in treating the following type of prostatitis:
A. acute bacterial prostatitis presenting with abscess formation
B. recurrent or refractory chronic bacterial prostatitis
C. asymptomatic prostatitis with pyuria resistant to common antimicrobials
D. curiously, chronic inflammatory prostatitis could respond to low-dose suppressive antibiotic
Answer : B
50. 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

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