GU-Surgery

Question 1

Gross hematuria in the absence of RBC casts indicates

Answer 1

non-glomerular disease

Question 2

red urine, smoker, flushed face, no RBC casts, hypertension and headache

Answer 2

Renal cell carcinoma

Question 3

Polycythemia and hypertension with RCC indicates

Answer 3

paraneoplastic syndrome

Question 4

1st line of tx for pt with urinary stones in the middle or distal ureter >10mm

Answer 4

ureterorenoscopy with stone removal

Question 5

1st line of tx for pt with urinary stones <10mm

Answer 5

Observation for spontaneous pass

Question 6

The most common cause of Urinary track obstruction in male newborns?

Answer 6

posterior urethral valves

Question 7

Urosepsis, palpable bladder, history of oligohydramniosis, in a male newborn. Dx? Tx?

Answer 7

• Posterior urethral valve

- Ablation of urethral valve

Question 8

1st line of treatment for BPH?

Answer 8

alpha-blockers (Terazosin, Tamsulosin, doxazosin)

Question 9

Adjunctive treatment for BPH

Answer 9

5 alpha reductase inhibitors (Finasteride therapy)

Question 10

name 4 features of kidney dysfunction

Answer 10

• Fatigue
• anemia
• Uremia
• elevated creatinine

Question 11

Pt in long-term use of NSAID and aspirin-caffeine causes analgesic nephropathy due to

Answer 11

inhibition of prostacyclin production - shrunken kidneys with irregular contours and capillary calcifications

Question 12

Initial hematuria, cleared by the end of the stream is

Answer 12

hematuria from urethral origin (or prostate)

Question 13

The tx of choice for castration-resistance prostate cancer with localized skeletal metastasis

Answer 13

External beam radiotherapy (EBRT)

Question 14

Indicated to rapidly decompress the renal collecting system to prevent permanent kidney injury from urinary tract obstruction

Answer 14

percutaneous nephrostomy

Question 15

indicated for emphysematous pyelonephritis and acute renal failure or septic shock

Answer 15

nephrectomy

Question 16

treatment for muscle-invasive bladder cancer without positive lymph nodes or distal metastasis

Answer 16

Radical cystectomy

Question 17

treatment for low grade non-muscle-invasive bladder cancer

Answer 17

Transurethral resection of tumor with intravesical chemotherapy (TURBT)

Question 18

Predisposing factors to acute urinary retention (AUR)(3)

Answer 18

BPH
Constipation
amitriptyline intake

Question 19

Acute kidney injury (AKI) that is post renal can be ruled out by

Answer 19

ultrasonography

Question 20

Best test to diagnose posterior urethral valves (PUV)

Answer 20

Voiding cystourethrogram

Question 21

respiratory distress, potter facies, limb anomalies, and oligohydramnios before birth is

Answer 21

potter sequence

Question 22

best step in a hemodynamically stable pt with suspected renal trauma

Answer 22

CT imaging with contrast

Question 23

Best imaging test for evaluating urethral injuries

Answer 23

Retrograde urethrogram

Question 24

US in young pt shows a solitary, round, sharply demarcated, hypo echoic lesion in there renal parenchyma with a strong posterior wall echo. Dx? NSIM?

Answer 24

• Simple renal cyst

- No treatment, reassurance

Question 25

HTN difficult to control hypokalemia Cr>30% after ACE inhibitor

Answer 25

Renal artery stenosis

Question 26

Flank pain following ingestion of diuresis-inducing beverages

Answer 26

Ureteropelvic junction obstruction (mild form in adult, sever in childhood)

Question 27

Previous UTI, slow abx therapy response, poor urine flow, flank or suprapubic mass, high Cr. U/S hydronephrosis, ureteric dilation or renal scarring in child 2-24months. Dx? Testing?

Answer 27

Vericoureteral reflux, Voiding cystourethrography

Question 28

19F, renal bruit and hypertension, Dx? NSIM?

Answer 28

Fibromuscular dysplasia causing renal artery stenosis , | ACE inhibitor & Percutaneous transluminal angioplasty with out stent placement

Question 29

Treatment for renal artery stenosis due to atherosclerotic disease

Answer 29

Precutaneous transluminal angioplasty with stent placement

Question 30

increased rate of pyelonephritis and retrograde flow of urine in vesicoureteral reflux risk to

Answer 30

renal scarring

Question 31

Lower abd pain, palpable lower abd mass due to distention of urinary bladder, hx of BPH, post-op

Answer 31

Bladder outlet obstruction

Question 32

headache, lightheadedness, tinnitus in young women with high bp and concurrent cervical and abd bruits, DX? Lab value

Answer 32

Fibromuscular dysplasia, elevated renin level

Question 33

the definitive treatment of hyperkalemia in Chronic renal failure patient

Answer 33

Hemodialysis

Question 34

The most common cause of bladder outflow obstruction and acute urinary retention

Answer 34

BPH

Question 35

abd mass felt in a child <2 yo irregular abd mass that often crosses the midline and associated with constitutional symptoms

Answer 35

Neuroblastoma

Question 36

Older than 2 yo non-tender abd mass that does not cross midline, smooth surface, mostly incidental finding, but may present with abd pain & hypertension

Answer 36

Wilms' tumor

Question 37

Preferred test to diagnose bladder rupture

Answer 37

Retrograde cystography

Question 38

Gross hematuria with pelvic fracture in trauma indicates

Answer 38

Traumatic bladder rupture

Question 39

Hematuria with pain and hematoma over the flank in trauma indicates. Dx? testing?

Answer 39

Renal injury, Intravenous pyelography

Question 40

First line of surgical procedure for stress incontinence after conservative therapy (pelvic floor muscle exercises/kegel)?

Answer 40

Urethral sling

Question 41

Gold standard surgical procedure for strep incontinence after conservative therapy who also have pelvic organ prolapse

Answer 41

Urethropexy

Question 42

Pt with urolithiasis a low urine pH is characteristic for

Answer 42

calcium oxalate, uric acid, or cystine stones

Question 43

Pt with nephrolithiasis, foley catheter got UTI, UA with alkaline urine pH. organism?

Answer 43

Proteus mirabilis

Question 44

Pt with foley catheter got UTI, normal urine pH, no nephrolithiasis, Organism?

Answer 44

E-Coli

Question 45

What should be performed in all febrile children with confirmed UTI between 2-24months ? Reason?

Answer 45

Renal and bladder ultrasound (RBUS), because it can detect anatomical abnormalities & vesicoureteral reflux

Question 46

What procedure can not be performed with active UTI

Answer 46

Voiding cystourethrography (VCUG)

Question 47

Pt >35yo or with risk factor for urothelial malignancy should undergo ______ to evaluate the lower urinary tract and ______ to evaluate the upper urinary tract

Answer 47

Cystoscopy | CT Urography

Question 48

Pt with blunt abd trauma with microscopic hematuria, stable. NSIM?

Answer 48

observation and follow up