Urology Flashcards
(108 cards)
1
Q
One of the aetiologies listed below predisposes to testicular tumors:
A) testicular trauma
B) testicular torsion
C) undescended testes
D) BRCA2 mutation
A
C) undescended testes
2
Q
Mark the pathology which usually leads to scrotal pain on palpation:
A) testicular tumor
B) epididymitis
C) hydrocele
D) varicocele
A
B) epididymitis
3
Q
Prostate cancer is palpated as:
A) enlarged, consistency similar to smooth muscle
B) hard
C) tender, enlarged
D) non-tender, enlarged
A
B) hard
4
Q
Characteristic finding of female spontaneous urine:
A) higher pH
B) contains many epithelial cells
C) always contains a few red blood cells
D) always contains some pus
A
B) contains many epithelial cells
5
Q
Testicular torsion:
A) always bilateral
B) presents with sudden pain, which usually wakes the patient from his sleep
C) present with high fever immediately
D) more frequent on the right side
A
B) presents with sudden pain, which usually wakes the patient from his sleep
6
Q
Typical for renal colic, except:
A) flank tenderness
B) nausea, vomiting
C) labial or scrotal pain
D) tenderness on palpation of McBurney’s point
A
D) tenderness on palpation of McBurney’s point
7
Q
The conversion of testosterone to dihydrotestosterone is catalysed by the following enzyme which is also targeted as part of BPH treatment:
A) 5-α-reductase
B) 7-β-cytosterine
C) aromatase
D) acidic phosphatase
A
A) 5-α-reductase
8
Q
In the aetiology of prostate cancer the following plays a role:
A) age
B) genetic factors
C) hormonal factors
D) all of the above
A
D) all of the above
9
Q
The main risk factor for urothelial cancer is:
A) smoking
B) alcohol
C) benzidine
D) petrol
A
A) smoking
10
Q
The main symptom of stress urinary incontinence:
A) frequent urinary urge
B) nocturnal urinary dribbling
C) involuntary voiding following psychological stress
D) urinary dribbling following an increase in abdominal pressure (e.g. during exercise, coughing, sneezing etc.)
E) vaginal burning
A
D) urinary dribbling following an increase in abdominal pressure (e.g. during exercise, coughing, sneezing etc.)
11
Q
Tasks following the palpation of a nodule in the testis:
A) observation, then a control check-up
B) send the patient to a urologist
C) antibiotics, then control check-up
D) do a diagnostic work-up for chronic prostatitis
A
B) send the patient to a urologist
12
Q
Difficulty of voiding can be caused by:
1) prostate enlargement due to benign prostatic hyperplasia (BPH)
2) prostate cancer
3) acute prostatitis
4) phimosis
A) Answers 1, 2 and 3 are correct
B) Answers 1 and 3 are correct
C) Answers 2 and 4 are correct
D) Only answer 4 is correct
E) All of the answers are correct
A
E) All of the answers are correct
1) prostate enlargement due to benign prostatic hyperplasia (BPH)
2) prostate cancer
3) acute prostatitis
4) phimosis
13
Q
The cause of complete urinary retention can be:
1) bladder tumor
2) acute prostatitis
3) urethral narrowing
4) hypo- or acontractility of the detrusor
A) Answers 1, 2 and 3 are correct
B) Answers 1 and 3 are correct
C) Answers 2 and 4 are correct
D) Only answer 4 is correct
E) All of the answers are correct
A
E) All of the answers are correct
1) bladder tumor
2) acute prostatitis
3) urethral narrowing
4) hypo- or acontractility of the detrusorrr
14
Q
Inflammations accompanied by fever:
1) acute pyelonephritis
2) acute prostatitis
3) acute epididymitis
4) acute cystitis
A) Answers 1, 2 and 3 are correct
B) Answers 1 and 3 are correct
C) Answers 2 and 4 are correct
D) Only answer 4 is correct
E) All of the answers are correct
A
A) Answers 1, 2 and 3 are correct
1) acute pyelonephritis
2) acute prostatitis
3) acute epididymitis
15
Q
In the primary diagnosis of prostate cancer includes:
1) PSA
2) DRE (digital rectal examination)
3) prostate biopsy
4) abdominal ultrasound
A) Answers 1, 2 and 3 are correct
B) Answers 1 and 3 are correct
C) Answers 2 and 4 are correct
D) Only answer 4 is correct
E) All of the answers are correct
A
A) Answers 1, 2 and 3 are correct
1) PSA
2) DRE (digital rectal examination)
3) prostate biopsy
16
Q
Which hormons are essential to measure as part of andrological examinations?
1) testosterone
2) FSH
3) LH
4) parathyroid hormone
A) Answers 1, 2 and 3 are correct
B) Answers 1 and 3 are correct
C) Answers 2 and 4 are correct
D) Only answer 4 is correct
E) All of the answers are correct
A
A) Answers 1, 2 and 3 are correct
1) testosterone
2) FSH
3) LH
17
Q
Ultrasonography of the testes can be used for the diagnosis of:
1) infertility
2) testicular tumor
3) azoospermia
4) orchidoepididymitis
A) Answers 1, 2 and 3 are correct
B) Answers 1 and 3 are correct
C) Answers 2 and 4 are correct
D) Only answer 4 is correct
E) All of the answers are correct
A
C) Answers 2 and 4 are correct
2) testicular tumor
4) orchidoepididymitis
18
Q
In case of non-muscle invasive bladder tumors recurrence can be prevented via bladder instillation of the following chemicals:
1) BCG
2) Bleomycin
3) Mitomycin C
4) Vincristin
A) Answers 1, 2 and 3 are correct
B) Answers 1 and 3 are correct
C) Answers 2 and 4 are correct
D) Only answer 4 is correct
E) All of the answers are correct
A
B) Answers 1 and 3 are correct
1) BCG
3) Mitomycin C
19
Q
Continent urine diversions include:
1) ureterocutaneostomy
2) bilateral percutaneous nephrostomy
3) ureteroileocutaneostomy (Bricker ileal conduit)
4) orthotopic bladder
A) Answers 1, 2 and 3 are correct
B) Answers 1 and 3 are correct
C) Answers 2 and 4 are correct
D) Only answer 4 is correct
E) All of the answers are correct
A
D) Only answer 4 is correct
4) orthotopic bladder
20
Q
Can be used to treat muscle-invasive bladder tumors as a part of curative or palliative managment:
1) Mitomycin, Epirubicin
2) radical cystectomy
3) local chemotherapy
4) resection of the bladder wall
A) Answers 1, 2 and 3 are correct
B) Answers 1 and 3 are correct
C) Answers 2 and 4 are correct
D) Only answer 4 is correct
E) All of the answers are correct
A
C) Answers 2 and 4 are correct
2) radical cystectomy
4) resection of the bladder wall
21
Q
Pyelonephritis in pregnancy:
1) usually left-sided
2) its treatment is the termination of the pregnancy
3) frequent in the first trimester
4) presents in pregnant women as fever and renal pelvis dilation visualised under ultrasonography
A) Answers 1, 2 and 3 are correct
B) Answers 1 and 3 are correct
C) Answers 2 and 4 are correct
D) Only answer 4 is correct
E) All of the answers are correct
A
D) Only answer 4 is correct
4) presents in pregnant women as fever and renal pelvis dilation visualised under ultrasonography
22
Q
Choose the procedure that is not transurethral:
1) internal urethrotomy
2) ESWL (Extracorporeal Shock Wave Lithotripsy)
3) inserting ureteral catheter with cystoscopy
4) epicystostomy
A) Answers 1, 2 and 3 are correct
B) Answers 1 and 3 are correct
C) Answers 2 and 4 are correct
D) Only answer 4 is correct
E) All of the answers are correct
A
C) Answers 2 and 4 are correct
2) ESWL (Extracorporeal Shock Wave Lithotripsy)
4) epicystostomy
23
Q
Which factors have negative effect on erectile function?
1) diabetes
2) high uric acid levels
3) beta blockers utilized in hypertension
4) antidiabetics
A) Answers 1, 2 and 3 are correct
B) Answers 1 and 3 are correct
C) Answers 2 and 4 are correct
D) Only answer 4 is correct
E) All of the answers are correct
A
B) Answers 1 and 3 are correct
1) diabetes
3) beta blockers utilized in hypertension
24
Q
Acute kidney failure laboratory values are:
1) hyperkalemia
2) increased serum creatinine levels
3) acidosis
4) decreased eGFR
A) Answers 1, 2 and 3 are correct
B) Answers 1 and 3 are correct
C) Answers 2 and 4 are correct
D) Only answer 4 is correct
E) All of the answers are correct
A
E) All of the answers are correct
1) hyperkalemia
2) increased serum creatinine levels
3) acidosis
4) decreased eGFR
25
Which are the markers of testicular tumor?
1) PSA (Prostate-Specific Antigen)
2) β-hCG
3) testosterone
4) AFP (Alpha-fetoprotein)
A) Answers 1, 2 and 3 are correct
B) Answers 1 and 3 are correct
C) Answers 2 and 4 are correct
D) Only answer 4 is correct
E) All of the answers are correct
C) Answers 2 and 4 are correct
2) β-hCG
4) AFP (Alpha-fetoprotein)
26
Which of the following drugs are used to improve urinary incontinence in females?
1) Doxycycline
2) Anticholinergics
3) Alpha-receptor blockers
4) Beta-3-adrenoreceptor agonists
A) Answers 1, 2 and 3 are correct
B) Answers 1 and 3 are correct
C) Answers 2 and 4 are correct
D) Only answer 4 is correct
E) All of the answers are correct
C) Answers 2 and 4 are correct
2) Anticholinergics
4) Beta-3-adrenoreceptor agonists
27
Cause(s) of erectile dysfunction:
1) antihypertensive drugs
2) induratio penis plastica
3) smoking
4) alcoholism
A) Answers 1, 2 and 3 are correct
B) Answers 1 and 3 are correct
C) Answers 2 and 4 are correct
D) Only answer 4 is correct
E) All of the answers are correct
E) All of the answers are correct
1) antihypertensive drugs
2) induratio penis plastica
3) smoking
4) alcoholism
28
Which of the following can be used to differentiate kidney cysts from tumors?
1) ultrasound
2) IVP (Intravenous pyelography)
3) CT
4) retrograde pyelography
5) MRI
A) 1st, 3rd and 5th answers are correct
B) 1st, 4th and 5th answers are correct
C) 2nd, 3rd and 4th answers are correct
D) 2nd, 4th and 5th answers are correct
E) All 5 answers are correct
A) 1st, 3rd and 5th answers are correct
1) ultrasound
3) CT
5) MRI
28
Symptoms of acute pyelonephritis:
1) kidney pain related to movement
2) affected kidney is sensitive to balloting
3) fever
4) pyuria
5) macroscopic haematuria
A) 1st, 3rd and 5th answers are correct
B) 1st, 4th and 5th answers are correct
C) 2nd, 3rd and 4th answers are correct
D) 2nd, 4th and 5th answers are correct
E) All 5 answers are correct
C) 2nd, 3rd and 4th answers are correct
2) affected kidney is sensitive to balloting
3) fever
4) pyuria
29
Causes of macroscopic hematuria can be:
1) renal adenocarcinoma
2) glomerulonephritis
3) vesicoureteral reflux (VUR)
4) acute cystitis
5) bladder tumor
A) 1st, 3rd and 5th answers are correct
B) 1st, 4th and 5th answers are correct
C) 2nd, 3rd and 4th answers are correct
D) 2nd, 4th and 5th answers are correct
E) All 5 answers are correct
B) 1st, 4th and 5th answers are correct
1) renal adenocarcinoma
4) acute cystitis
5) bladder tumor
29
Cause of pain associated with posture or movement can be:
1) rheumatic disease
2) vesicoureteral reflux (VUR)
3) kidney stone is stuck in the ureter
4) nephroptosis
5) spinal disc herniation
A) 1st, 3rd and 5th answers are correct
B) 1st, 4th and 5th answers are correct
C) 2nd, 3rd and 4th answers are correct
D) 2nd, 4th and 5th answers are correct
E) All 5 answers are correct
B) 1st, 4th and 5th answers are correct
1) rheumatic disease
4) nephroptosis
5) spinal disc herniation
30
Pair the andrological abnormalities with the letter signed statements! One disease can be assigned to more statements!
It can be caused by varicocele
A) erectile dysfunction
B) infertility
C) male menopause
D) retrograde ejaculation
B) infertility
31
Pair the andrological abnormalities with the letter signed statements! One disease can be assigned to more statements!
It appears as a frequent complication after TUR (transurethral resection) surgery
A) erectile dysfunction
B) infertility
C) male menopause
D) retrograde ejaculation
D) retrograde ejaculation
32
Pair the andrological abnormalities with the letter signed statements! One disease can be assigned to more statements!
It can be caused by beta-blockers
A) erectile dysfunction
B) infertility
C) male menopause
D) retrograde ejaculation
A) erectile dysfunction
33
Pair the andrological abnormalities with the letter signed statements! One disease can be assigned to more statements!
One way of the treatment can be a vacuum constriction device
A) erectile dysfunction
B) infertility
C) male menopause
D) retrograde ejaculation
A) erectile dysfunction
34
Pair the the kidney stone(s) to the typical description! (One kidney stone type can be assigned to more statements!)
High, alkaline pH levels increase the risk of developing this type of kidney stone.
A) uric acid stone
B) cystine stone
C) calcium oxalate stone
D) struvite stone
D) struvite stone
35
Pair the the kidney stone(s) to the typical description! (One kidney stone type can be assigned to more statements!)
Called as negative stone as well
A) uric acid stone
B) cystine stone
C) calcium oxalate stone
D) struvite stone
A) uric acid stone
36
Pair the the kidney stone(s) to the typical description! (One kidney stone type can be assigned to more statements!)
Good solubility when treated with drugs
A) uric acid stone
B) cystine stone
C) calcium oxalate stone
D) struvite stone
A) uric acid stone
37
Pair the the kidney stone(s) to the typical description! (One kidney stone type can be assigned to more statements!)
To prevent the recurrence, D-Penicillamin or Thiola can be used
A) uric acid stone
B) cystine stone
C) calcium oxalate stone
D) struvite stone
B) cystine stone
38
Pair the the kidney stone(s) to the typical description! (One kidney stone type can be assigned to more statements!)
If presented, reduced meat diet is recommended
A) uric acid stone
B) cystine stone
C) calcium oxalate stone
D) struvite stone
A) uric acid stone
39
Pair the diagnostic procedure name(s) to the relevant description! One procedure can be matched to multiple description!
Used in urinary stone treatment
A) URS (ureterorenoscopy)
B) PCNL (Percutaneous Nephrolithotomy)
C) ESWL (Extracorporeal Shock Wave Lithotripsy)
D) all of them
E) none of them
D) all of them
39
Pair the diagnostic procedure name(s) to the relevant description! One procedure can be matched to multiple description!
Non-endoscopic procedure
A) URS (ureterorenoscopy)
B) PCNL (Percutaneous Nephrolithotomy)
C) ESWL (Extracorporeal Shock Wave Lithotripsy)
D) all of them
E) none of them
C) ESWL (Extracorporeal Shock Wave Lithotripsy)
40
Pair the diagnostic procedure name(s) to the relevant description! One procedure can be matched to multiple description!
Used in BPH treatment
A) URS (ureterorenoscopy)
B) PCNL (Percutaneous Nephrolithotomy)
C) ESWL (Extracorporeal Shock Wave Lithotripsy)
D) all of them
E) none of them
E) none of them
41
Pair the diagnostic procedure name(s) to the relevant description! One procedure can be matched to multiple description!
The procedure is performed through the skin
A) URS (ureterorenoscopy)
B) PCNL (Percutaneous Nephrolithotomy)
C) ESWL (Extracorporeal Shock Wave Lithotripsy)
D) all of them
E) none of them
B) PCNL (Percutaneous Nephrolithotomy)
42
Pair the diagnostic procedure name(s) to the relevant description! One procedure can be matched to multiple description!
It can be a diagnostic procedure too
A) URS (ureterorenoscopy)
B) PCNL (Percutaneous Nephrolithotomy)
C) ESWL (Extracorporeal Shock Wave Lithotripsy)
D) all of them
E) none of them
A) URS (ureterorenoscopy)
43
Pair the diagnostic procedure name(s) to the relevant description! One procedure can be matched to multiple description!
The procedure is only performed in intubation narcosis
A) URS (ureterorenoscopy)
B) PCNL (Percutaneous Nephrolithotomy)
C) ESWL (Extracorporeal Shock Wave Lithotripsy)
D) all of them
E) none of them
E) none of them
44
In case of acute renal colic the first choice of medications should be narcotic pain medication, therefore this patients should be directed to the nearest Urology Department immediately.
A) both the statement and the explanation are true and a causal relationship exists between them
B) both the statement and the explanation are true but there is no causal relationship between them
C) the statement is true, but the explanation is false
D) the statement is false, but the explanation itself is true
E) both the statement and the explanation are false
E) both the statement and the explanation are false
45
After the TUR surgery of superficial bladder cancer local BCG intravesical installation should be performed, because this is the only drug for this procedure.
A) both the statement and the explanation are true and a causal relationship exists between them
B) both the statement and the explanation are true but there is no causal relationship between them
C) the statement is true, but the explanation is false
D) the statement is false, but the explanation itself is true
E) both the statement and the explanation are false
E) both the statement and the explanation are false
45
Cystoscopy should be performed 3 months after the TUR surgery of non muscle invasive bladder tumor because this is the best way to detect the possible recurrence.
A) both the statement and the explanation are true and a causal relationship exists between them
B) both the statement and the explanation are true but there is no causal relationship between them
C) the statement is true, but the explanation is false
D) the statement is false, but the explanation itself is true
E) both the statement and the explanation are false
A) both the statement and the explanation are true and a causal relationship exists between them
46
If urinary diversion is done by using small bowels than constant bacteruria will be present, so patients will have hyperchloremic acidosis.
A) both the statement and the explanation are true and a causal relationship exists between them
B) both the statement and the explanation are true but there is no causal relationship between them
C) the statement is true, but the explanation is false
D) the statement is false, but the explanation itself is true
E) both the statement and the explanation are false
D) the statement is false, but the explanation itself is true
47
While performing radical prostatectomy in case of intermediate risk prostate cancer a lymphadenectomy is also performed because with nerve sparing surgery the postoperative erectile disfunction is less likely.
A) both the statement and the explanation are true and a causal relationship exists between them
B) both the statement and the explanation are true but there is no causal relationship between them
C) the statement is true, but the explanation is false
D) the statement is false, but the explanation itself is true
E) both the statement and the explanation are false
B) both the statement and the explanation are true but there is no causal relationship between them
48
First diagnostic procedure:Case: A 65-year-old man comes to the hospital with a complaint of frequent urination. He also has pain in the lower back and in his legs. There is no blood in the urine. Urination is not painful, but there is a decrease urin flow.
A) DRE (digital rectal examination)
B) PSA (prostate specific antigen)
C) Transrectal ultrasound (TRUS)
D) prostate biopsy
A) DRE (digital rectal examination)
49
The patient’s PSA level is 20 ng/ml. DRE shows a large, not sensitive prostate with hard, uneven surface. What is the most likely diagnosis?Case: A 65-year-old man comes to the hospital with a complaint of frequent urination. He also has pain in the lower back and in his legs. There is no blood in the urine. Urination is not painful, but there is a decrease urin flow.
A) Suspicion of prostate cancer
B) BPH (Benign prostatic hyperplasia)
C) chronic prostatitis
D) acute prostatitis
A) Suspicion of prostate cancer
50
Which answer is not an option to treat urge urinary incontinence/overactive bladder?
A) botulinum toxin injection into the detrusor muscle
B) anticholinergic therapy
C) intravesical epirubicin instillation
D) beta 3 adrenoreceptor agonist
E) sacral neuromodulation
C) intravesical epirubicin instillation
50
What is TRUE regarding the statements below.
Case: A 65-year-old man comes to the hospital with a complaint of frequent urination. He also has pain in the lower back and in his legs. There is no blood in the urine. Urination is not painful, but there is a decrease urin flow.
1) Perform prostate biopsy, if posible perform prostate MRI beforhand (not mandatory).
2) The presence of prostate cancer is very likely, therefore radical prostatectomy should be performed.
3) The only role of transrectal ultrasound during biopsy is to target the prostate.
4) In case prostate biopsy proves that there is cancer present and the patient is in good shape and staging examination shows no distant metastasis then curative treatment (radical prostatectomy or irradiation) is suggested.
5) In case prostate biopsy is not performed than only hormonal therapy is given.
A) 1st, 2nd and 3rd answers are correct
B) 1st, 3rd and 4th answers are correct
C) 1st, 4th and 5th answers are correct
D) 1st, 3rd and 5th answers are correct
E) 2nd, 3rd, and 4th answers are correct
B) 1st, 3rd and 4th answers are correct
1) Perform prostate biopsy, if posible perform prostate MRI beforhand (not mandatory).
3) The only role of transrectal ultrasound during biopsy is to target the prostate.
4) In case prostate biopsy proves that there is cancer present and the patient is in good shape and staging examination shows no distant metastasis then curative treatment (radical prostatectomy or irradiation) is suggested.
51
The possible side effects of the anticholinergic treatment used for urge urinary incontinence are the following:
1) dry mouth
2) obstipation
3) problems with eye movement coordination
4) urinary retention
A) Answers 1, 2 and 3 are correct
B) Answers 1 and 3 are correct
C) Answers 2 and 4 are correct
D) Only answer 4 is correct
E) All of the answers are correct
E) All of the answers are correct
1) dry mouth
2) obstipation
3) problems with eye movement coordination
4) urinary retention
52
Pair the given urinary stone with the correct statement. (one stone to each statement!)
irritative urinary symptoms
A) small, resting kidney stone
B) staghorn kidney stone
C) 5-10 mm large, 600 HU density
D) 4 mm large stone in the mid-ureter
E) intravesical stone
E) intravesical stone
53
Pair the given urinary stone with the correct statement. (one stone to each statement!)
mostly symptom free
A) small, resting kidney stone
B) staghorn kidney stone
C) 5-10 mm large, 600 HU density
D) 4 mm large stone in the mid-ureter
E) intravesical stone
A) small, resting kidney stone
54
Pair the given urinary stone with the correct statement. (one stone to each statement!)
causes renal colic, but likely to spontaneously pass
A) small, resting kidney stone
B) staghorn kidney stone
C) 5-10 mm large, 600 HU density
D) 4 mm large stone in the mid-ureter
E) intravesical stone
D) 4 mm large stone in the mid-ureter
55
Pair the given urinary stone with the correct statement. (one stone to each statement!)
ideal stone for ESWL therapy
A) small, resting kidney stone
B) staghorn kidney stone
C) 5-10 mm large, 600 HU density
D) 4 mm large stone in the mid-ureter
E) intravesical stone
C) 5-10 mm large, 600 HU density
56
Pair the given urinary stone with the correct statement. (one stone to each statement!)
Percutaneous nephrolithotomy (multiple surgeries if required)
A) small, resting kidney stone
B) staghorn kidney stone
C) 5-10 mm large, 600 HU density
D) 4 mm large stone in the mid-ureter
E) intravesical stone
B) staghorn kidney stone
57
What is the most likely diagnosis? One correct answer.Case: 60 years old male patient with the following symptoms: narrow and interrupted urine stream, nycturia. He did not have fever or blood in his urine.
A) urethral sctricture
B) prostatitis
C) BPH
D) urethral injury
C) BPH
58
After noting the patients history and symptoms which examinations should be performed?
Case: 60 years old male patient with the following symptoms: narrow and interrupted urine stream, nycturia. He did not have fever or blood in his urine.
1) urine test
2) cystoscopy
3) detection of residual urine after urination with ultrasound
4) detection of residual urine after urination with bladder catheter
A) Answers 1, 2 and 3 are correct
B) Answers 1 and 3 are correct
C) Answers 2 and 4 are correct
D) Only answer 4 is correct
E) All of the answers are correct
B) Answers 1 and 3 are correct
1) urine test
2) cystoscopy
3) detection of residual urine after urination with ultrasound
59
Please connect the given urine deviation technique with the correct situation. (each urine deviation matches one siuation)
Urinary retention developed due to spinal anesthesia following surgery for inguinal hernia in a young male patient
A) urinary bladder catheter for long term urine deviation
B) suprapubic catheter (epicystostomy) for long term urine deviation
C) one time transurethral urine catheterisation
D) intermitting, transurethral self catheterization
E) wide (20 Ch), three way, irrigation catheter insertion
C) one time transurethral urine catheterisation
60
A patient had a digital rectal examination which showed aproximately 50ml, large prostate with a normal palpation. PSA was 2,3 ng/ml. These two suggested that the patient didn’t have prostate cancer. Uroflowmetry showed decreased urin flow, and bladder ultrasound revealed 100ml residual urine. The patient did not have UTI, but complains of erectile dysfunction. What kind of first line therapies should not be suggested in this case?Case: 60 years old male patient with the following symptoms: narrow and interrupted urine stream, nycturia. He did not have fever or blood in his urine.
A) alpha blocker
B) 5 alpha reductase inhibitor
C) alpha blocker+5 alpha reductase inhibitor
D) LHRH analogues
E) phosphodiesterase 5 inhibitors
D) LHRH analogues
61
Please connect the given urine deviation technique with the correct situation. (each urine deviation matches one siuation)
Acute prostatitis and complete retention
A) urinary bladder catheter for long term urine deviation
B) suprapubic catheter (epicystostomy) for long term urine deviation
C) one time transurethral urine catheterisation
D) intermitting, transurethral self catheterization
E) wide (20 Ch), three way, irrigation catheter insertion
B) suprapubic catheter (epicystostomy) for long term urine deviation
62
Please connect the given urine deviation technique with the correct situation. (each urine deviation matches one siuation)
Urinary retention developed due to BPH
A) urinary bladder catheter for long term urine deviation
B) suprapubic catheter (epicystostomy) for long term urine deviation
C) one time transurethral urine catheterisation
D) intermitting, transurethral self catheterization
E) wide (20 Ch), three way, irrigation catheter insertion
A) urinary bladder catheter for long term urine deviation
63
Please connect the given urine deviation technique with the correct situation. (each urine deviation matches one siuation)
Blood and clots in urine, resulting bladder tamponade
A) urinary bladder catheter for long term urine deviation
B) suprapubic catheter (epicystostomy) for long term urine deviation
C) one time transurethral urine catheterisation
D) intermitting, transurethral self catheterization
E) wide (20 Ch), three way, irrigation catheter insertion
E) wide (20 Ch), three way, irrigation catheter insertion
64
Please connect the given urine deviation technique with the correct situation. (each urine deviation matches one siuation)
Definitive bladder dysfunction developed due to neurogenic causes, akontractile detrusor function
A) urinary bladder catheter for long term urine deviation
B) suprapubic catheter (epicystostomy) for long term urine deviation
C) one time transurethral urine catheterisation
D) intermitting, transurethral self catheterization
E) wide (20 Ch), three way, irrigation catheter insertion
D) intermitting, transurethral self catheterization
65
Surgical treatment methods suitable for BPH:
1) TURP (Transurethral Resection of the Prostate)
2) Open adenomectomy
3) Laser prostate enucleation
4) Radical prostatectomy
A) Answers 1, 2 and 3 are correct
B) Answers 1 and 3 are correct
C) Answers 2 and 4 are correct
D) Only answer 4 is correct
E) All of the answers are correct
A) Answers 1, 2 and 3 are correct
1) TURP (Transurethral Resection of the Prostate)
2) Open adenomectomy
3) Laser prostate enucleation
66
Characteristic feature of uroflowmetry curve for BPH:
A) Normal
B) Flat, plateau-like flow
C) Decreased maximum and average flow rate with a prolonged flow
D) Voiding volume less than 50 ml
C) Decreased maximum and average flow rate with a prolonged flow
66
Characteristic of TUR syndrome, except:
A) Hyperkalemia
B) Intravascular hemolysis
C) Occurs during TURP
D) Renal function cannot deteriorate
D) Renal function cannot deteriorate
67
What is the most likely cause of fever?Case: A 35-year-old female patient presents with right-sided flank pain and fever of 39 degrees Celsius. CT imaging revealed a 12 mm stone in the right ureter with dilated renal pelvis and swollen kidney parenchyma.
A) Urocystitis
B) Complicated acute pyelonephritis due to upper urinary tract obstruction
C) Rupture of the renal pelvis
D) Nephrotic syndrome
E) Renal tuberculosis
B) Complicated acute pyelonephritis due to upper urinary tract obstruction
68
What treatment option(s) is/are suitable?Case: A 35-year-old female patient presents with right-sided flank pain and fever of 39 degrees Celsius. CT imaging revealed a 12 mm stone in the right ureter with dilated renal pelvis and swollen kidney parenchyma.
1) Broad-spectrum antibiotic therapy
2) Percutaneous nephrostomy
3) Double-J catheter
4) Extracorporeal shock wave lithotripsy (ESWL)
A) Answers 1, 2 and 3 are correct
B) Answers 1 and 3 are correct
C) Answers 2 and 4 are correct
D) Only answer 4 is correct
E) All of the answers are correct
A) Answers 1, 2 and 3 are correct
1) Broad-spectrum antibiotic therapy
2) Percutaneous nephrostomy
3) Double-J catheter
69
In which case of complication might kidney removal be necessary?Case: A 35-year-old female patient presents with right-sided flank pain and fever of 39 degrees Celsius. CT imaging revealed a 12 mm stone in the right ureter with dilated renal pelvis and swollen kidney parenchyma.
A) Concomitant localized peritonitis
B) Polyarthritis
C) Rupture of renal pelvis
D) Pyelonephritis with apostematous complications leading to urosepsis
E) Bladder rupture
D) Pyelonephritis with apostematous complications leading to urosepsis
70
What disease(s) most commonly present with symptom called silent hematuria?Case: A 65-year-old male patient with macroscopic hematuria presents at the urology outpatient clinic. He does not complain of urinary retention or painful urination. He does not mention any abdominal discomfort.
1) Acute prostatitis
2) Benign prostatic hyperplasia
3) Upper urinary tract cancer
4) Bladder cancer
A) Answers 1, 2 and 3 are correct
B) Answers 1 and 3 are correct
C) Answers 2 and 4 are correct
D) Only answer 4 is correct
E) All of the answers are correct
D) Only answer 4 is correct
4) Bladder cancer
71
Which conditions can increase the risk of developing hematuria?
Case: A 65-year-old male patient with macroscopic hematuria presents at the urology outpatient clinic. He does not complain of urinary retention or painful urination. He does not mention any abdominal discomfort.
1) Diabetes mellitus
2) Chronic liver disease
3) Hypertension
4) Anticoagulant therapy
A) Answers 1, 2 and 3 are correct
B) Answers 1 and 3 are correct
C) Answers 2 and 4 are correct
D) Only answer 4 is correct
E) All of the answers are correct
C) Answers 2 and 4 are correct
2) Chronic liver disease
4) Anticoagulant therapy
72
Which tests can help to determine the origin of hematuria? Case: A 65-year-old male patient with macroscopic hematuria presents at the urology outpatient clinic. He does not complain of urinary retention or painful urination. He does not mention any abdominal discomfort.
1) Cystoscopy
2) Urine dipstick test
3) CT urography
4) Urodynamic testing
A) Answers 1, 2 and 3 are correct
B) Answers 1 and 3 are correct
C) Answers 2 and 4 are correct
D) Only answer 4 is correct
E) All of the answers are correct
B) Answers 1 and 3 are correct
1) Cystoscopy
3) CT urography
72
In the contrast-enhanced abdominal and pelvic CT scan, what should we ask from the radiologist? If they can confirm the presence of ………….:Case: 50-year-old male. After a day of drinking alcohol, he experiences blunt abdominal trauma. He was brought to the emergency department by ambulance. He is conscious and oriented. Vital signs: Blood pressure: 140/80 mmHg, Pulse: 80/min. On physical examination, he complains of diffuse abdominal pain, with the point of maximum tenderness located above the symphysis pubis. He hasn't urinated for hours.
A) Gastric rupture
B) Bladder rupture
C) Rib fracture
D) Spinal injury
B) Bladder rupture
73
Which tests need to be performed?Case: 50-year-old male. After a day of drinking alcohol, he experiences blunt abdominal trauma. He was brought to the emergency department by ambulance. He is conscious and oriented. Vital signs: Blood pressure: 140/80 mmHg, Pulse: 80/min. On physical examination, he complains of diffuse abdominal pain, with the point of maximum tenderness located above the symphysis pubis. He hasn't urinated for hours.
A) Chest X-ray
B) Abdominal and pelvic CT with contrast agent
C) Abdominal X-ray
D) Bowel transit study
B) Abdominal and pelvic CT with contrast agent
74
In case of intraperitoneal bladder injury, the treatment is:Case: 50-year-old male. After a day of drinking alcohol, he experiences blunt abdominal trauma. He was brought to the emergency department by ambulance. He is conscious and oriented. Vital signs: Blood pressure: 140/80 mmHg, Pulse: 80/min. On physical examination, he complains of diffuse abdominal pain, with the point of maximum tenderness located above the symphysis pubis. He hasn't urinated for hours.
A) Transurethral balloon catheter
B) Epicystostomy
C) Bilateral percutaneous nephrostomy
D) Surgical exploration, bladder suturing and revision of the intestinal tract
D) Surgical exploration, bladder suturing and revision of the intestinal tract
75
What is the most likely diagnosis?Case: A non-pregnant woman presents to the emergency department with fever and lower back pain. Previously, she experienced the symptoms of lower urinary tract infection. Her lower back is tender to percussion, and urine dipstick test shows hematuria and pyuria.
A) Upper urinary tract cancer
B) Acute pyelonephritis
C) Pyelo-ureteral reflux
D) Acute cystitis
B) Acute pyelonephritis
76
What tests would you preform first?Case: A non-pregnant woman presents to the emergency department with fever and lower back pain. Previously, she experienced the symptoms of lower urinary tract infection. Her lower back is tender to percussion, and urine dipstick test shows hematuria and pyuria.
1) Laboratory tests (complete blood count, CRP, kidney function)
2) Urine culture
3) Ultrasound
4) CT
A) All answers are correct
B) Answers 1 and 3 are correct
C) Answers 1, 2 and 3 are correct
D) Answers 1, 3 and 4 are correct
E) Answers 1, 2 and 4 are correct
C) Answers 1, 2 and 3 are correct
1) Laboratory tests (complete blood count, CRP, kidney function)
2) Urine culture
3) Ultrasound
77
What treatment would you choose?Case: A non-pregnant woman presents to the emergency department with fever and lower back pain. Previously, she experienced the symptoms of lower urinary tract infection. Her lower back is tender to percussion, and urine dipstick test shows hematuria and pyuria.
1) Antibiotics, hydration, antipyretics, bed rest
2) Antibiotics
3) Change of antibiotic if renal asbcess is confirmed
4) Urinary diversion in case of renal pelvic dilatation
A) Answers 2 and 4 are correct
B) Answers 1 and 3 are correct
C) Answers 1 and 4 are correct
D) Answers 2, 3 and 4 are correct
E) Answers 1, 3 and 4 are correct
C) Answers 1 and 4 are correct
1) Antibiotics, hydration, antipyretics, bed rest
4) Urinary diversion in case of renal pelvic dilatation
78
Until the results of urine culture are available, empirical antibiotic treatment is initiated. Among the following, which one is forbidden to administer:Case: A non-pregnant woman presents to the emergency department with fever and lower back pain. Previously, she experienced the symptoms of lower urinary tract infection. Her lower back is tender to percussion, and urine dipstick test shows hematuria and pyuria.
A) Cephalosporin
B) Fluroqinolone if there is allergy to cephalosporin
C) Potentiated penicillin derivative
D) Nitrofuranotin
D) Nitrofuranotin
79
86 For the first line treatment of uncomplicated acute cystitis, all of the following can be suggested, except:
A) Nitrofurantoin
B) Fosfomycin
C) D-mannose
D) Fluoroquinolone
E) Nonsteroidal anti-inflammatory drug
D) Fluoroquinolone
80
In case of acute prostatitis
A) We use antibiotics and prostate massage
B) We give antibiotics and provide free urine outflow with urethral catheter
C) Local cooling of the prostate and administration of non-steroidal anti-inflammatory drugs
D) PSA (prostate-specific antigen) levels are determined to exclude possible tumors
E) broad-spectrum antibiotics, non-steroidal anti-inflammatory drugs, and epicystostomy in case of urinary retention
E) broad-spectrum antibiotics, non-steroidal anti-inflammatory drugs, and epicystostomy in case of urinary retention
81
First-line treatment for acute epididymitis without urinary retention:
1) epididymectomy
2) antibiotics
3) non-steroidal anti-inflammatory drugs
4) icing of the affected area
5) urinary diversion with epicystostomy (suprapubic catheter)
A) Answers 1, 3, 5 are correct
B) Answers 2, 3, 4 are correct
C) Answers 2, 3, 5 are correct
D) Answers 1, 2, 5 are correct
B) Answers 2, 3, 4 are correct
2) antibiotics
3) non-steroidal anti-inflammatory drugs
4) icing of the affected area
82
For pregnant women
1) to manage complicated urinary tract inflammation, fluoroquinolone is only recommended in the 2nd trimester
2) asymptomatic bacteriuria has to be treated
3) penicillin derivatives should be the first choice for urinary tract infections
4) pyuria and pyelectasia require urinary diversion as soon as possible
A) Answers 1 and 2 are correct
B) Answers 2 and 4 are correct
C) Answers 1 and 4 are correct
D) Answers 2 and 3 are correct
E) All of the answers are correct
D) Answers 2 and 3 are correct
2) asymptomatic bacteriuria has to be treated
3) penicillin derivatives should be the first choice for urinary tract infections
83
Staging tests were negative. What curative therapy is recommended for the patient?Case: A 65-year-old patient was found to have a firm prostate, PSA 12ng/ml, therefore a transrectal ultrasound-guided prostate biopsy was performed.
A) radical prostatectomy, radiotherapy
B) transurethral prostate resection, adjuvant chemoinstillation
C) radical cystoprostatectomy
D) radical prostatectomy, 6 cycles of early docetaxel chemotherapy
A) radical prostatectomy, radiotherapy
83
What are the possible side effects after prostate biopsy?
Case: A 65-year-old patient was found to have a firm prostate, PSA 12ng/ml, therefore a transrectal ultrasound-guided prostate biopsy was performed.
A) febrile state
B) blood in the urine/feces
C) voiding difficulty
D) all of the above
D) all of the above
A) febrile state
B) blood in the urine/feces
C) voiding difficulty
84
The biopsy confirmed Gleason 4+3, ISUP Grade 3 adenocarcinoma. Which staging tests are recommended? Case: A 65-year-old patient was found to have a firm prostate, PSA 12ng/ml, therefore a transrectal ultrasound-guided prostate biopsy was performed.
A) bone isotope, renal isotope scan
B) urine cytology, cystoscopy, chest CT scan
C) pelvic MRI scan, chest CT scan, bone isotope
D) chest-abdomen-pelvis CT scan, uroflowmetry
C) pelvic MRI scan, chest CT scan, bone isotope
85
The patient underwent radical prostatectomy. What complications can occur after that?Case: A 65-year-old patient was found to have a firm prostate, PSA 12ng/ml, therefore a transrectal ultrasound-guided prostate biopsy was performed.
A) hand-foot syndrome, urethral stricture
B) urethral stricture, incontinence, erectile dysfunction
C) incontinence, febrile neutropenia
D) erectile dysfunction, retrograde ejaculation
B) urethral stricture, incontinence, erectile dysfunction
86
Possible methods of monitoring prostate cancer:
A) PSA, chest and abdomen CT scan, bone scan, PSMA PET-CT scan
B) PSA, bone isotope scan, urine cytology
C) chest CT scan, bone isotope scan, cystoscopy
D) PSA, osteodensitometry, abdominal ultrasound
A) PSA, chest and abdomen CT scan, bone scan, PSMA PET-CT scan
87
A possible method of treating metastatic prostate cancer as a complementation to androgen deprivation hormone therapy:
1) chemotherapy (docetaxel, cabazitaxel)
2) alpha radiation radium isotope therapy
3) androgen receptor pathway inhibitors (enzalutamide, apalutamide, abiraterone acetate)
4) radical prostatectomy
A) Answers 1, 2 and 3 are correct
B) Answers 1 and 3 are correct
C) Answers 2 and 4 are correct
D) Only answer 4 is correct
E) All of the answers are correct
A) Answers 1, 2 and 3 are correct
1) chemotherapy (docetaxel, cabazitaxel)
2) alpha radiation radium isotope therapy
3) androgen receptor pathway inhibitors (enzalutamide, apalutamide, abiraterone acetate)
88
Which of the following tests are not essential for treatment planning?Case: A 64-year-old man has his femur broken in a sudden movement. During his emergency care, physical examination revealed a right varicocele, X-ray describes a solitary, lytic lesion of the femur destroying the femoral cortex. Abdominopelvic CT confirms an 8 cm tumor in the right kidney, forming a tumor thrombus extending through the renal vein into the inferior vena cava.
A) Chest CT or X-ray
B) Kidney biopsy and exploratory biopsy of the femur
C) ECG, blood type and antibody screening, blood count, renal and hepatic function, coagulation parameters
D) Anaesthetic examination
B) Kidney biopsy and exploratory biopsy of the femur
89
What treatment plan would you recommend if no metastases were confirmed elsewhere in the examinations (chest CT, bone scan) and the life expectancy of the patient was more than one year?Case: A 64-year-old man has his femur broken in a sudden movement. During his emergency care, physical examination revealed a right varicocele, X-ray describes a solitary, lytic lesion of the femur destroying the femoral cortex. Abdominopelvic CT confirms an 8 cm tumor in the right kidney, forming a tumor thrombus extending through the renal vein into the inferior vena cava.
A) Surgical fixation of a fractured femur to relieve the patient's pain and restore mobility.
B) Surgical removal of the primary renal tumor and tumor thrombus in one session.
C) Excision of the bone metastasis and, if possible, bone replacement.
D) The above answers A-B-C in that order
D) The above answers A-B-C in that order
A) Surgical fixation of a fractured femur to relieve the patient's pain and restore mobility.
B) Surgical removal of the primary renal tumor and tumor thrombus in one session.
C) Excision of the bone metastasis and, if possible, bone replacement.
90
Which of the following would not be an option if multiple metastases would appear that could not be surgically removed during follow-up?Case: A 64-year-old man has his femur broken in a sudden movement. During his emergency care, physical examination revealed a right varicocele, X-ray describes a solitary, lytic lesion of the femur destroying the femoral cortex. Abdominopelvic CT confirms an 8 cm tumor in the right kidney, forming a tumor thrombus extending through the renal vein into the inferior vena cava.
A) Tyrosine kinase inhibitor medication (e.g. sunitinib)
B) mTor inhibitor medication (e.g. temsirolimus)
C) Irradiation of lung metastases
D) In case of pain caused by bone metastases, palliative irradiation of the area to relieve symptoms
C) Irradiation of lung metastases
91
Typical symptoms of kidney tumor, except:
A) haematuria
B) palpable abdominal lesion
C) pain in the lower back or abdomen
D) sudden onset of varicocele
E) palpable inguinal lymph nodes
E) palpable inguinal lymph nodes
92
The recommended procedure for the examination of renal tumors, except:
A) abdominopelvic CT or MR scan
B) intravenous urography
C) chest CT or X-ray
D) CT of the skull for central nervous system nodules
E) in case of bone pain, pathological fracture, palpable lesion, targeted X-ray of the area and whole body bone scan
B) intravenous urography
93
A possible treatment for clear cell renal cell carcinoma:
1) Radical nephrectomy, or kidney-sparing tumor excision
2) Tumour destruction using minimally invasive techniques (e.g. radiofrequency ablation or cryoablation)
3) Close monitoring
4) Irradiation of the kidney
5) Use of chemotherapy
A) Answers 1, 2 and 3 are correct
B) Answers 1 and 3 are correct
C) Answers 2 and 4 are correct
D) Only answer 4 is correct
E) All of the answers are correct
A) Answers 1, 2 and 3 are correct
1) Radical nephrectomy, or kidney-sparing tumor excision
2) Tumour destruction using minimally invasive techniques (e.g. radiofrequency ablation or cryoablation)
3) Close monitoring
94
The primary site of metastasis in invasive squamous cell carcinoma of the penis is …
A) Lung
B) Inguinal lymph nodes
C) Testicle, epididymis
D) Retroperitoneal lymph nodes
B) Inguinal lymph nodes
95
Which of the following is one of the high-risk precancerous conditions of penile cancer?
1) Condyloma acuminatum
2) Bowen's disease
3) Balanitis
4) Lichen sclerosus
A) Answers 1, 2 and 3 are correct
B) Answers 1 and 3 are correct
C) Answers 2 and 4 are correct
D) Only answer 4 is correct
E) All of the answers are correct
C) Answers 2 and 4 are correct
2) Bowen's disease
4) Lichen sclerosus
96
What are the most common symptoms of bladder cancer?
A) Fever
B) Blood in urine
C) Painful urination
D) Weight loss
B) Blood in urine
97
When do we use local chemotherapy for urinary bladder cancer?
1) For all endoscopically non-muscle-invasive looking tumors within 6 hours after surgery
2) 6 hours before surgery for all endoscopically non-muscle-invasive looking tumors
3) In case of pT1 low-grade tumor based on histopathology for 6 weeks after surgery, once weekly if no early local treatment was applied
4) for large solid tumors where only partial resection was possible
A) Answers 1, 2 and 3 are correct
B) Answers 1 and 3 are correct
C) Answers 2 and 4 are correct
D) Only answer 4 is correct
E) All of the answers are correct
B) Answers 1 and 3 are correct
1) For all endoscopically non-muscle-invasive looking tumors within 6 hours after surgery
3) In case of pT1 low-grade tumor based on histopathology for 6 weeks after surgery, once weekly if no early local treatment was applied
98
Routine test for the detection of bladder cancer?
1) Ultrasound examination of the abdomen and pelvis
2) Urine cytology
3) Cystoscopy
4) Urine tumor marker test
A) Answers 1, 2 and 3 are correct
B) Answers 1 and 3 are correct
C) Answers 2 and 4 are correct
D) Only answer 4 is correct
E) All of the answers are correct
A) Answers 1, 2 and 3 are correct
1) Ultrasound examination of the abdomen and pelvis
2) Urine cytology
3) Cystoscopy
99
In case of non-obstructive azoospermia, as the most serious fertility disorder, what are the chances of a man becoming a father?
A) Unfortunately, there is no chance in this case
B) Microsurgical vas deferens reconstructive surgery is an option
C) Surgical (if possible microsurgical) sperm extraction can be performed, with a background of cryopreservation. After a successful intervention intracytoplasmic sperm injection (ICSI) can be performed.
D) Antioxidant drug treatment is an option.
C) Surgical (if possible microsurgical) sperm extraction can be performed, with a background of cryopreservation. After a successful intervention intracytoplasmic sperm injection (ICSI) can be performed.
100
What is an essential part of the diagnosis of erectile dysfunction in patients between the ages of 40 and 60?
A) Psychiatry consultation
B) Cardiology consultation
C) MR scan of minor pelvis
D) Bone scintigraphy due to the increased risk of prostate cancer
B) Cardiology consultation
