 Voiding Dysfunction U06-U11.

1. Urinary Retention.
???) In chronic retention of urine, one statement is not true:
It is usually painless
The bladder is atonic and may distend up to the umbilicus
It may present with uremia
It should be revealed by rapid decompression
Benign hyperplasia of the prostate is a common cause

Answer: 4* It should be revealed by rapid decompression

2. Benign Prostatic Hyperplasia (BPH).

???) The most common cause of acute retention of urine in men is:
Chronic prostatitis
Benign hyperplasia of prostate
Carcinoma of prostate
Urethral stricture
Prostatic abscess

Answer: 2* Benign hyperplasia of prostate

???) The following are indications for prostatectomy, except:

Severe prostatitis
Enlarged prostate felt by PR digital examination
Recurrent acute retention of urine
Chronic retention of urine
Development of urinary complications as infection, hemorrhage and stones

Answer: 2* Enlarged prostate felt by PR digital examination

***) Which of the following is not a possible complication of senile hypertrophy of the prostate:
Hematuria
Hydronephrosis
Recurrent urinary tract infection
Renal failure
Renal cell carcinoma

Answer: 5* Renal cell carcinoma

 Stone Disease U15-U18.

1. Renal Stones.
???) The most accurate method of detecting renal calculi is:
Unenhanced spiral CT
Enhanced spiral CT
Ultrasonography
Excretory urogram
KUB film (kidneys, ureters, bladder).

Answer: 1* Unenhanced spiral CT

???) The best treatment of a 4mm lower ureteric stone is a 30 years old healthy male is:
Immediate surgical removal
Immediate endoscopic removal
Immediate extracorporal shock with lithotripsy
Diuretic drugs
Plenty of fluids and pain killer

Answer: 5* Plenty of fluids and pain killer

2. Uric Acid Stones.

???) Which of the following urinary calculi is radiolucent:
Calcium oxalate
Uric acid
Cystine stone
Mixed stone
Triple phosphate stone

Answer: 2* Uric acid

3. Cystine Stones.
???) One of the following is a radio-lucent urinary stone:
Cholesterol
Cystine
Urate
Oxalate
Phosphate

Answer: 2* Cystine

???) As regarding cystine stones all of the following are true, except:
They are primary uncommon urinary stones
They are inherited stones
They are radio-opaque
Can be treated conservatively
They develop in alkaline urine

Answer: 3* They are radio-opaque

  Urological Neoplasms U18-U27.
1. Malignant Renal Neoplasms.
***) The most common clinical picture of renal cell carcinoma is:
Pyrexia
Hematuria
Mass in the flank
Left sided varicocele
Flank pain

Answer: 2* Hematuria

2. Prostatic Carcinoma.
???) Concerning prostatic carcinoma, all of the following statements are correct, except:
Many cases remain symptom free for long time
Signs and symptoms are similar to benign prostatic hyperplasia
Blood stream spread is mainly to the bone
Bone metastases are osteolytic
Stilbestrol is useful in management

Answer: 4* Bone metastases are osteolytic

3. Testicular Tumors.
???) The following tumors are benign, except:
Leiomyoma
Chondroma
Seminoma
Meningioma
Dermoid cyst

Answer: 3* Seminoma

???) A 35 years old male presented with bilateral gynecomastia and RL. testicular tumor. The
most likely pathological diagnosis is:
Lymphoma
Seminoma
Teratocarcinoma
Choriocarcinoma
Metastatic carcinoma

Answer: 2* Seminoma

???) Serum alpha-fetoprotein is raised in one of the following tumors

Malignant teratoma of the testis
Carcinoma of the prostate
Malignant lymphoma
Carcinoma of the breast
Carcinoma of the sigmoid colon

Answer: 1* Malignant teratoma of the testis

 Scrotal Mass U27-U29.

1. Varicocele.
???) Chronic scrotal pain is most often due to:
Testicular trauma
Cryptorchidism
Testicular torsion
Varicocele
Orchitis

Answer: 4* Varicoceles

2. Hydrocele.
???) A 2 years old child with oblong cystic swelling in the inguinal canal that moves downward
pull of the testis has:
Indirect inguinal hernia
Direct inguinal hernia
Encysted hydrocele
Vagial hydrocele
Femoral hernia

Answer: 3* Encysted hydrocele

???) A smooth oval cystic swelling associated with the spermatic cord that moves downwards
with gentle traction upon the testis is:
Irreducible indirect inguinal hernia
Varicocele
Encysted hydrocele
Communicated hydrocele
Vaginal hydrocele

Answer: 3* Encysted hydrocele

3. Testicular Torsion.
???) Concerning torsion testicles all of the following are true, except:
The condition is rare in normal fully descended testicles
The highest incidence is between 10 and 25 years of age
The condition stimulates strangulated inguinal hernia or epididimoorchitis
Acute straining during defecation or lifting heavy weight is an axciting cause
Treatment consists of exploration of the affected side only

Answer: 5* Treatment consists of exploration of the affected side only

???) In cases of torsion testicles all are true, except:

Orchidopexy of the affected side only
Undescended testis is more liable for torsion
Orchidopexy of both testis must be done
It affects young age males
Clinically it simulates acute epididymoorchitis

Answer: 1* Orchidopexy of the affected side only

???) Concerning torsion testicle all of the following are true, except:
The highest incidence is between 40 and 50 years of age
Although acute straining is a predisposing factor some cases occur during sleep
Clinically it simulates epididimo-orchitis or strangulated inguinal hernia
The condition develops more commonly in the incompletely descended testicles
After dealing surgically with the affected side exploration and fixation of the opposite side
should be done

Answer: 1* The highest incidence is between 40 and 50 years of age

???) Which of the following simulates clinically torsion of the testicle:

Encysted hydrocele
Communicated hydrocele
Varicocele
Acute epididymo-orchitis
Indirect inguinal hernia

Answer: 4* Acute epididymo-orchitis

???) The commonest cause of acute scrotal pain in a 12 years old child with no fever and normal
urine analysis is:
Epididimitis
Orchitis
Varicocele
Torsion of testicle
Hydrocele

Answer: 4* Torsion of testicle

 Trauma U32-U34.
1. Renal Trauma.
???) As regarding renal injury, all of the following are true, except:
It may follow direct blow or fall upon the loin
It may be an isolated injury or associated with injury of other intra-abdominal organs
Swelling of the flank and hematuria are important manifestations
The magnitude of the injury is variable
Nephrectomy is the ideal method of treatment whatever the degree of injury

Answer: 5* Nephrectomy is the ideal method of treatment whatever the degree of injury

???) As regard to kidney injuries all of the following are true, except:
Direct blows or fall upon the loin are common causes of such injuries
Although hematuria is a cardinal sign it may not make its appearance until some hours after the
accident
Associated injury of other abdominal viscera may occur
IVU should be done
In all cases direct exploration of the kidney should be done to preserve the kidney

Answer: 5* In all cases direct exploration of the kidney should be done to preserve the kidney

2. Urethral Injuries.
???) Ureteral injuries are least common as a result of:
Radical hysterectomy
Penetrating or blunt trauma
Abdominoperineal resection
Anterior resection of the sigmoid
Radiation therapy of carcinoma of the cervix

Answer: 2* Penetrating or blunt trauma

???) Concerning rupture of the bulbous urethra all of the following are true, except:
Falling astride a projecting object is the usual cause of injury
After the accident the condition is highly suspected by triad of urethra hemorrhage, perineal
hematoma and retention of urine
If the patient is allowed to pass urine extravasation of urine usually occurs subcutaneously
The usual treatment is immediate urethral catheterization applied in the emergency room and left
for one week
A course of antibiotics is given and continued until complete healing of the urethra

Answer: 4* The usual treatment is immediate urethral catheterization applied in the emergency
room and left for one week

 Pediatric Urology U36-U40.

1. Nephroblastoma (Wilms' Tumor).
???) Concerning nephroblastoma (Wilm's tumor), all the following are true, except:
Arising from embryonic nephrogenic tissue, so it is a mixed tumor
Originally it is situated in one pole of the kidney, and bilateral cases occasionally are seen
The most common presentation is a progressively enlarging abdominal mass noticed by the
parents
Progressive deterioration of general health, anemia and pyrexia are common manifestations
The tumor spreads mainly by lymph to the para-aortic lymph nodes

Answer: 5* The tumor spreads mainly by lymph to the para-aortic lymph nodes

2. Cryptorchidism (Ectopic Testes).

???) Undescended testicle is commonly associated with:
Direct inguinal hernia
Hypospadia
Indirect inguinal hernia
Paraphimosis
Femoral hernia

Answer: 3* Indirect inguinal hernia

???) Concerning undescended testicle, all of the following are true, except:
The testis may be incompletely descended or in an ectopic site
The condition may be unilateral or bilateral
In neglected bilateral cases sterility usually occurs
The affected testis is more liable to trauma, torsion and malignancy
In unilateral cases surgical treatment has to be done just after puberty

Answer: 5* In unilateral cases surgical treatment has to be done just after puberty

???) Regarding undescended testicle all of the following are true, except:
It is usually associated with a hernial sac
It is more liable for torsion than the normally descended testicle
Neglected bilateral cases are associated with decreased spermatogenesis
Orchiopexy does not reduce the risk of malignant degeneration
Surgical correction should be done around the age of puberty

Answer: 5* Surgical correction should be done around the age of puberty