Notes

Vesico-Ureteral Reflux (VUR) all true except?
A. Ultrasound scan is safe and can be repeated frequently in patients with VUR.
B. Mostly diagnosed by Renal and Bladder Ultrasound scan.
C. Conservative treatment should include oral prophylactic antibiotic.
D. High Grade VUR with renal scars usually need surgical treatment
E. DMSA is the best image to diagnosis renal scars
ANSWER: B

Epididymitis, one is true?
A. The peak age between 12 -18.
B. Ultrasound scan of scrotum is diagnostic.
C. The scrotal contents are within normal size.
D. Iliac fossa pain is a common presenting symptom.
E. Usually associated with low grade fever.
ANSWER: B

regarding BPH,all are true except:
A. the clinical presentation usually starts after the age of 40 year
B. may presents with storage symptoms
C. B3 agonist maybe used to treat voiding symptoms
D. mainly arise from the transitional zone
E. TURP is the standard surgical treatment
ANSWER: C

All are indications for surgery in BPH patients except:
A. recurrent UTI and prostatitis
B. refractory urinary retention
C. pesrsistance of bothersome symptoms despite medical treament
D. large prostate
E. refractory gross hematuria
ANSWER: D

67 year old male patient,with good performance status,newly diagnosed with prostate cancer, his parameteres shows total PSA is 6,gleason 6,and T1a , the recommended management is:
A. watchful waiting
B. radical prostatectomy
C. radiotherapy
D. hormonal therapy
E. active survielance
ANSWER: E

Regarding prostate CA which is wrong:
A. mainly arise from peripheral zone
B. Androgen deprivation is used in treatment of metastatic prostate CA
C. screening is mainly done by digital rectal examination and PSA testing
D. is more common in white people
E. high serum alkaline phosphatase is associatd with poor overall survival in prostate cancer patients
ANSWER: D

regarding renal trauma , which is true:
A. the presence of gross hematuria indicates more seriuos kidney injury than microhematuria
B. blunt kidney trauma with renal laceration more than 1 cm without urinary exravasation needs immediate surgical exploration and repair
C. urinary CT with IV contrast is the standard imaging of choice for the diagnosis in unstable patient with suspected renal trauma
D. penetrating renal trauma via gunshot needs surgical exploration
E. abdominal imaging is not indicated in stable pediatric patient with microhematuria after abdominal trauma
ANSWER: D

regarding posterior urethral injury , which is wrong:
A. mostly associated with pelvic fracture
B. retrograde urethrogram is diagnostic
C. most commonly occurs with stradle type of injury to the pernieum
D. maybe associated with inability to void
E. when suspected folys catheter insertion is contraindicated
ANSWER: C

All of the following are urinary bladder storage symptoms except:
A. Urgency
B. Terminal dribbling
C. Nocturia
D. Enuresis
E. Frequency of Micturation
ANSWER: B

A pathology that causes Total Hematuria is usually located in?
A. Distal urethra.
B. Prostatic Urethra.
C. Urinary Bladder and above.
D. Bladder Neck.
E. Membranous urethra.
ANSWER: C

14 y old boy attend ER complaining of sudden left testicular pain with vomiting . On doppler U/S no blood flow identified,what is the best next step?
A. scrotal exploration
B. bed rest,analgesia, antibiotic
C. scrotal aspiaration
D. inguinal ligation
E. none of the above
ANSWER: A

Transurethral resection (TUR) syndrome is caused by:
A. absorption of fluid during procedures such as holmium laser enucleation of the prostate and bipolar TURP.
B. absorption of non sodium containing irrigating fluid like glycine 5% during monopolar TURP, leading to an acute dilutional hyponatremia.
C. irrigating fluid placed at a less than ideal height above the patient.
D. a serum sodium of greater than 130 mEq per liter.
E. intraoperative ureteral injury.
ANSWER: B

Acute urine retention is usually associated with all of the followings except
A. Acute suprapubic pain.
B. overdistended UB with bilateral hydronephrosis.
C. Sudden onset.
D. Relieved with insertion of foly’s catheter.
E. Normal kidney function.
ANSWER: B