Urologic infections and inflammations MCQ Solved Paper for NMAT

1. 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

2. 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

3. What is the likelihood of contracting gonorrheal disease following a single intercourse with an infected woman?
A. 1.7%
B. 7%
C. 17%
D. 71%
Answer : C

4. 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

5. 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

6. What are the most indicative symptoms of chronic pyelonephritis?
A. fever and chills
B. suprapubic pain and pyuria
C. flank pain and tenderness
D. none of the above
Answer : D

7. 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

8. 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

9. 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

10. 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

11. 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

12. What is true concerning BPS/IC?
A. the onset of symptoms is insidious
B. the lesion has no proven relation to bladder cancer
C. if left untreated, the bladder will turn small, contracted, with submucosal calcifications
D. a single positive urine culture refutes the diagnosis
Answer : B

13. 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

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

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. 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

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

18. 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

19. 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

20. 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

21. 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

22. 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

23. 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

24. 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

25. Which of the following conditions does NOT cause bacterial persistence?
A. perivesical abscess with fistula to bladder
B. acute tubular necrosis
C. renal papillary necrosis
D. xanthogranulomatous pyelonephritis
Answer : C

26. 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

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 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

29. 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

30. 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

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

32. 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

33. Patients with bladder pain syndrome have:
A. a history of repeated urologic and/or gynecologic procedures
B. 10 fold higher incidence of childhood voiding problems
C. 4 fold higher incidence of anxiety-depression syndrome
D. 6 fold higher incidence of psychosomatic disorders
Answer : B

34. 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

35. 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

36. 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

37. 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