Urologic infections and inflammations MCQ Solved Paper for RRB NTPC

1. 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

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 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

4. 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

5. 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

6. 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

7. 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

8. What antimicrobial agent treats UTI and does NOT alter the gut flora?
A. trimethoprim- sulfamethoxazole
B. fluoroquinolones
C. aminoglycosides
D. nitrofurantoins
Answer : D

9. What is false concerning cystitis glandularis?
A. rarely, the urothelial cell nests show a central lumen lined by glandular epithelium
B. In some cases, it may form polypoid masses that mimic urothelial neoplasms
C. It might appear as multinodular exophytic mass seen on cystoscopy
D. cystitis cystica and cystitis glandularis frequently coexist in the same specimen
Answer : A

10. 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

11. Which statement best defines reinfection?
A. a new episode of UTI caused by different species or occurring at long intervals
B. recurrent UTIs caused by the same organism in each instance, classically, at close intervals
C. recurrent UTIs due to failure of medical therapy to eradicate the infection
D. recurrent UTIs due to a persistent pathology that is obstinate to surgery
Answer : A

12. 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

13. 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

14. 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

15. 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

16. 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

17. 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

18. 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

19. 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

20. What is NOT a complication of mumps orchitis?
A. infertility
B. hypogonadotropic hypogonadism
C. non seminomatous germ cell tumor
D. chronic orchalgia
Answer : C

21. 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

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

23. 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

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

25. 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

26. 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

27. 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

28. 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

29. 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

30. 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

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

32. 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

33. 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

34. 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

35. 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

36. 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

37. 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 receptivityto bacterial adherence
D. all of the above
Answer : D

38. 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

39. 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

40. 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

41. 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

42. What is the most virulent factor for bacterial adherence?
A. P blood group
B. fimbria
C. pili
D. hemolysin
Answer : C

43. What is false regarding prostatic abscesses?
A. clinically, cannot be differentiated from acute bacterial prostatitis
B. medical management is often unsuccessful
C. it harbors prostate cancer in approximately 4.3% of cases
D. management include suprapubic urinary diversion
Answer : C

44. 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

45. What is true concerning ovarian vein syndrome?
A. manifests as recurrent renal colics due to ureteral obstruction
B. treatment is surgical mobilization of ureter and ligation of the vein
C. commonly, occurs at the left side
D. the pain worsens on sitting upright and during pregnancy
Answer : B

46. 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

47. 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

48. 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

49. 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

50. 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