Urologic infections and inflammations MCQ Solved Paper for SSC Stenographer

1. 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

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

3. 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

4. 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

5. 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

6. 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

7. 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

8. 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

9. 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

10. 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

11. 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

12. 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

13. 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

14. 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

15. 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

16. What is false about urinary catheters?
A. condom catheters carry less risk of UTI if compared to urethral
B. suprapubic catheters carry less risk of UTI if compared to urethral
C. latex catheters carry less risk of UTI if compared to silicon
D. intermittent catheterization carry less risk of UTI if compared to indwelling catheters
Answer : C

17. 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 re 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

18. 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

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

20. 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

21. 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

22. What type of cells is implicated most in the pathogenesis of BPS/IC?
A. histocytes
B. T lymphocytes
C. mast cells
D. B lymphocytes
Answer : C

23. What is the bladder`s first-line defense against infections?
A. natural sloughing of bladder mucosa
B. voiding
C. urine osmolarity
D. urine pH
Answer : B

24. 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

25. 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

26. 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

27. 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

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

29. What is NOT a poor clinical practice on caring for urethral catheters?
A. taking urine samples by draining the urine bag
B. daily cleansing the external meatus
C. placing the urine bag on the floor
D. changing the urine bag once it is full
Answer : B

30. 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

31. 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

32. What is the mortality rate of emphysematous pyelonephritis?
A. 43%
B. 53%
C. 63%
D. 73%
Answer : A

33. What is false regarding viral cystitis?
A. in pediatrics, adenovirus types 11 and 21 could result in hemorrhagic cystitis
B. immunosuppressed children are especially susceptible to Cytomegalovirus and Adenoviruses 7, 21, and 35
C. in pediatrics, acute viral cystitis might present as acute retention of urine
D. classically, treatment should be culture-specific
Answer : D

34. 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

35. What does NOT predispose to acute epididymitis is:
A. TUR ejaculatory duct
B. prolonged urethral catheterization
C. prostatic biopsy
D. vas ligation
Answer : C

36. What is true concerning the treatment of catheter associated bacteriuria?
A. should be flushed frequently, but no antibiotic is advised
B. should be treated if febrile UTI has developed
C. should be treated only if urine culture is positive
D. should be treated once the catheter is removed
Answer : B

37. 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

38. 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

39. 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

40. 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 macrophages 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

41. 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

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 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

44. 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

45. 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

46. What could cause unresolved bacteriuria?
A. drug resistance
B. non-compliance
C. the presence of persistent pathology
D. all of the above
Answer : D

47. 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

48. 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

49. 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

50. 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