Urologic infections and inflammations MCQ Solved Paper for SSC CHSL

1. 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

2. 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

3. 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

4. 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

5. 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

6. 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

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

8. What type of bladder cells secretes antiproliferative factor?
A. bladder epithelial cells
B. type C nerve endings in the bladder
C. type A delta nerve endings in the bladder
D. the innermost longitudinal fibres of detrusor muscle
Answer : A

9. 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

10. What is false concerning post UTI renal scarring in pediatrics?
A. the incidence of scarring following a single episode of febrile UTI is 4.5%
B. intra-renal reflux is common in convex papillae
C. scarring and chronic pyelonephritis lead to hypertension in 10-20%
D. scarring is best detected and followed up by DMSA
Answer : B

11. 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

12. 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

13. 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

14. 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

15. What is false concerning radiation cystitis?
A. the average time from the beginning of radiation therapy to initial symptoms could be 2 4 weeks
B. treatment with stationary radiation, portals carry a higher risk of morbidity than treatment with rotating portals do
C. it occurs in about 10% of patients treated with definitive irradiation therapy for prostate cancer after 10 years
D. most cases are mildly affected and require no specific therapy
Answer : A

16. 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

17. 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

18. 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 strans 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

19. 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

20. What is the most commonly affected organ by genitourinary Brucellosis?
A. kidneys
B. bladder
C. prostate
D. epididymis
Answer : D

21. 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

22. 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

23. What is false concerning UTI in long-term care facilities?
A. in catheterized individuals, entry of bacteria into the bladder is facilitated by the bacterial glycocalyx biofilm
B. infection cannot be reliably distinguished from bacteriuria by lab tests
C. co-trimoxazole is the preferred antibiotic for empiric therapy
D. symptomatic UTI may be a diagnosis of exclusion
Answer : C

24. 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

25. What kind of non-infectious cystitis, do patients with systemic lupus erythematosus (SLE), likely to develop?
A. cystitis glandularis
B. cystitis cystica
C. esinophilic cystitis
D. cystitis follicularis
Answer : C

26. 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

27. 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

28. What is false concerning genitourinary TB?
A. is the commonest extra-pulmonary 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

29. 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

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

31. 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

32. 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

33. 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

34. What is false regarding Herpes simplex (HSV) infection?
A. characterized by neurovirulence
B. the incubation period of primary genital herpes is 2 3 weeks
C. HSV can be isolated in the urine
D. HSV-1 infection causes urethritis more often than HSV-2 does
Answer : B

35. 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

36. 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

37. 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

38. 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

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

40. 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

41. 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

42. 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

43. What is false regarding the etiology and treatment of orchialgia syndrome?
A. small indirect inguinal hernia may irritate the genital branch of genitofemoral nerve causing orchialgia
B. might respond to a selective nerve block
C. the recommended treatment is orchiectomy with implantation of a testicular prosthesis
D. psychotherapy and stress management might alleviate the pain
Answer : C

44. 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

45. What is false regarding malakoplakia?
A. is an uncommon granulomatous disease that affect the skin and/or urinary bladder
B. it might be due to a disturbed function of B lymphocytes
C. characterized by the presence of basophilic inclusion structure (Michaelis-Gutmann body)
D. it might be due to a defective phagolysosomal activity of monocytes or macrophages
Answer : B

46. HIV infection increases the incidence of the following cancers, EXCEPT:
A. Kaposi sarcoma,
B. Hodgkin lymphoma
C. non-Hodgkin lymphoma
D. cervical cancer
Answer : B

47. 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

48. 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

49. 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

50. 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