Urologic infections and inflammations MCQ Solved Paper for RRB Group D

1. 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

2. What is true regarding Xanthogranulomatous Pyelonephritis?
A. CT shows the characteristic bear paw sign
B. it is an infected, obstructed, poorly functioning kidney containing stones
C. nephrectomy is the treatment
D. all of the above
Answer : D

3. 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

4. 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

5. What is the preferred antimicrobial prophylaxis for transrectal prostate biopsy?
A. aminoglycoside
B. fluoroquinolone
C. 2nd generation cephalosporin
D. doxycycline
Answer : B

6. What is the most significant complication of papillary necrosis?
A. ureteral obstruction
B. proteinuria
C. stone formation
D. renal scarring
Answer : A

7. 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

8. What is the most important pharmacokinetic property of a drug to cure UTI?
A. mode of administration
B. level in the serum
C. level in the urine
D. dosage
Answer : C

9. 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

10. 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

11. 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

12. 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

13. 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

14. 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

15. 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

16. 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

17. 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

18. What is true regarding honeymoon cystitis?
A. is a self-limiting infection where antibiotics are not required
B. is exclusively for UTI experienced by a girl after sexual intercourse on her wedding night
C. post-coital voiding has no value in the occurrence of the infection
D. self-initiated medication helps control the infection
Answer : D

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

20. 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

21. 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

22. 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

23. 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

24. 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

25. 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

26. 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

27. 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

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

29. Which of the following is NOT a treatment option for BPS/IC?
A. substitution cystoplasty and continent diversion
B. fulguration of a Hunner`s ulcer or hydrodistention
C. intravesical installation of silver nitrate or dimethyl sulfoxide
D. low dose external beam irradiation
Answer : D

30. 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

31. 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

32. What is true concerning HIV infection?
A. HIV is a retrovirus that infects B-cells and dendritic cells
B. circumcised men are at lower risk for HIV infection
C. HPV infection increases the risk for cancers in HIV patients by 6.3 times
D. plasma HIV RNA load is a predictor of disease remission
Answer : B

33. 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

34. 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

35. 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

36. 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 marophages 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

37. 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

38. 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

39. 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

40. 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

41. 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

42. 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

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

44. 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

45. 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

46. 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

47. 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

48. 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

49. What is false concerning peri-renal abscess?
A. could result from intra-renal abscess of ascending infection
B. urine culture might be negative
C. plain KUB X-ray has no value in the diagnosis
D. surgical drainage is the proper treatment
Answer : C

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