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IFOM TEST urology

Опис:
4 курс IFOM
Перелік питань:
1. A 14-year-old boy presents in the ED with very severe pain of sudden onset in his right
testicle. There is no fever, pyuria, or history of recent mumps. The testis is swollen,
exquisitely painful, “high riding,” and with a “horizontal lie.” The cord is not tender. What is it?

A. * Testicular torsion.

B. Acute epididymitis.

C. Pyelonephritis.

D. Acute orhitis.

E. Hydrocele.

2. A 24-year-old man presents in the ED with very severe pain of recent onset in his right scrotal
contents. There is a fever of 103°F and pyuria. The testis is in the normal position, and it appears
to be swollen and exquisitely painful. The cord is also very tender. What is it?

A. * Acute epididymitis.

B. Acute orhitis.

C. Hydrocele.

D. Testicular torsion.

E. Trauma of the testis.

3. A 72-year-old man is being observed with a ureteral stone that is expected to pass spontaneously.
He develops chills, a temperature spike to 104°F, and flank pain. What is it?

A. * Renal colic, acute pyelonephritis

B. Urostas

C. Renal colic

D. Acute paranephritis

E. Acute cyctitis

4. An adult woman relates that 5 days ago she began to notice frequent, painful urination, with small
volumes of cloudy and malodorous urine. For the first 3 days she had no fever, but for the past 2
days she has been having chills, high fever, nausea, and vomiting. Also in the past 2 days she has
had pain in the right flank. She has had no treatment whatsoever up to this time. What is it?

A. * Pyelonephritis

B. Renal colic
C. Acute paranephritis

D. Urostas

E. Acute cyctitis

5. A 62-year-old man presents with chills, fever, dysuria, urinary frequency, diffuse low back pain,
and an exquisitely tender prostate on rectal exam. What is it?

A. * Acute bacterial prostatitis

B. Acute cyctitis

C. Acute paranephritis

D. Acute orhitis

E. Renal colic

6. A 33-year-old man has urgency, frequency, and burning pain with urination. The urine is cloudy
and malodorous. He has mild fever. On physical examination the prostate is not warm, boggy, or
tender. What is it?

A. * Prostatitis

B. Acute orhitis

C. Renal colic

D. Acute paranephritis

E. Pyelonephritis

7. You are called to the nursery to see an otherwise healthy-looking newborn boy because he has
not urinated in the first 24 hours of life. Physical examination shows a big distended urinary
bladder. What is it?

A. * Meatal stenosis or posterior urethral valves

B. Renal colic

C. Pyelonephritis

D. Acute paranephritis

E. Acute cyctitis

8. A bunch of newborn boys are lined up in the nursery for you to do circumcisions. You notice that
one of them has the urethral opening in the ventral side of the penis, about midway down the
shaft. What is it?

A. * Hypospadias
B. Epispadias

C. Phimosis

D. Acute cyctitis

E. Cavernite

9. A newborn baby boy has one of his testicles down in the scrotum, but the other one is not. On
physical examination the missing testicle is palpable in the groin. It can easily be pulled down to
its normal location without tension, but it will not stay there; it goes back up. What is it?

A. * Retractile testicle

B. Cavernite

C. Epispadias

D. Hypospadias

E. Anorchism

10. A mother brings her 6-year-old girl to you because “she has failed miserably to get proper toilet
training.” On questioning you find out that the little girl perceives normally the sensation of
having to void and voids normally and at appropriate intervals, but also happens to be wet with
urine all the time. What is it?

A. * Low implantation of one

B. Acute cyctitis

C. Enuresis

D. Nocturia

E. Chronic urinary retention

11. A 16-year-old boy goes on a beer-drinking binge for the first time in his life. Shortly thereafter he
develops colicky flank pain. What is it?

A. * Ureteropelvic junction obstruction

B. Acute cyctitis

C. Chronic urinary retention

D. Cavernite

E. Enuresis

12. A 62-year-old man reports an episode of gross, painless hematuria. Further questioning
determines that the patient has total hematuria rather than initial or terminal hematuria. What can
be the cause of hematuria?

A. * Kidneys. Bladder. Ureter

B. Prostate

C. Ureter Prostate

D. Kidneys, Urethra

E. Urethra, Bladder

13. A 70-year-old man is referred for evaluation because of a triad of hematuria, flank pain, and a
flank mass. He also has hypercalcemia, erythrocytosis, and elevated liver enzymes. What is it?

A. * Renal cell carcinoma

B. Trauma of the Kidney

C. Pyelonephritis

D. Glomerulonephritis

E. Kidney tuberculosis

14. A 55-year-old chronic smoker reports 3 instances in the past 2 weeks when he has had painless,
gross, total hematuria. In the past 2 months he has been treated twice for irritative voiding
symptoms, but has not been febrile, and urinary cultures have been negative. What can be
suspected in this situation?

A. * Bladder cancer

B. Glomerulonephritis

C. BPH

D. Kidney tuberculosis

E. Trauma of the Kidney

15. A 59-year-old black man is told by his primary care physician that his prostatic specific antigen
(PSA) has gone up significantly since his last visit. He has no palpable abnormalities in his
prostate by rectal exam. What is suspected?

A. * Cancer of the prostate

B. BPH

C. Glomerulonephritis

D. Kidney tuberculosis

E. Bladder cancer

16. A 62-year-old man had a radical prostatectomy for cancer of the prostate 3 years ago. He now
presents with widespread bony pain. Bone scans show metastases throughout the entire skeleton,
including several that are very large and very impressive. What treatment to appoint to the
 patient?

A. * Lluteinizing hormone-releasing hormone agonists and s antiandrogens

B. Antibiotics

C. Detoxification therapy

D. Diet therapy and hormonal

E. Hormonal and Antibiotics

17. A 25-year-old man presents with a painless, hard testicular mass. It is clear in the physical
examination that the mass arises from the testicle rather than the epididymus. To be sure, a
sonogram was done. The mass was indeed testicular. What is it?

A. * Testicular cancer

B. Bladder cancer

C. Hydrocele

D. Testicular torsion

E. Trauma of the testis

18. A 25-year-old man is found on a pre-employment chest x-ray to have what appearsto be a
pulmonary metastasis from an unknown primary tumor. Subsequent physical examination
discloses a hard testicular mass, and the patient indicates that for the past 6 months he has been
losing weight for no obvious reason. What is it?

A. * Ttesticular cancer

B. Testicular torsion

C. Trauma of the testis

D. Hydrocele

E. Acute orchitis

19. A 60-year-old man shows up in the ED because he has not been able to void for the past 12 hours.
He wants to, but cannot. On physical examination his bladder is palpable halfway up between the
pubis and the umbilicus, and he has a big, boggy prostate gland without nodules. He gives a
history that for several years now he has been getting up 4 or 5 times a night to urinate. Because
of a cold, 2 days ago he began taking antihistaminics, using “nasal drops,” and drinking plenty of
fluids. What is it?

A. * Acute urinary retention

B. Trauma of the testis

C. Nocturia
D. Nicturia

E. Anuria

20. On postoperative day 2 after surgery for repair of bilateral inguinal hernias, a patient reports that
he “cannot hold his urine.” Further questioning reveals that every few minutes he urinates a few
milliliters of urine. On physical examination there is a large palpable mass arising from the pelvis
and reaching almost to the umbilicus. What is it?

A. * Acute urinary retention with overflow incontinence

B. Nocturia

C. Nicturia

D. Anuria

E. Chronic urinary retention

21. A 42-year-old woman consults you for urinary incontinence. She is the mother of 5 children. Ever
since the birth of her last child 7 years ago, she leaks a small amount of urine whenever she
sneezes, laughs, gets out of a chair, or lifts any heavy objects. She relates that she can hold her
urine all through the night without any leaking whatsoever. What is it?

A. * Stress incontinence

B. Acute urinary retention with overflow incontinence

C. Nocturia

D. Nicturia

E. Chronic urinary retention

22. A 72-year-old man who in previous years has passed 3 urinary stones is now again having
symptoms of ureteral colic. He has relatively mild pain which began 6 hours ago but does not
have much nausea and vomiting. CT scan shows a 3-mm ureteral stone just proximal to the
ureterovesical junction. What treatment to offer to the patient?

A. * Antispasmodics, phytodiuretics, physiotherapy

B. Physiotherapy

C. Lithotripsy

D. Surgical treatment

E. Diet therapy

23. A 54-year-old woman has a severe ureteral colic. CT scan shows a 7-mm ureteral stone at the
ureteropelvic junction. What treatment to offer to the patient?

A. * Sshock-wave lithotripsy (SWL)

B. Surgical treatment
C. Diet therapy

D. Physiotherapy

E. Antispasmodics, phytodiuretics, physiotherapy

24. A 72-year-old man has for the past several days noticed bubbles of air coming out with the urine
when he urinates. He also gives symptoms suggestive of mild cystitis. What can be the cause of
this pathology?

A. * Fistula between the bowel and the bladder

B. Acute urinary retention with overflow incontinence

C. Cancer Prostate

D. Cancer Urinary Bladder

E. Acute Cystitis

25. A 32-year-old man has sudden onset of impotence. One month ago he was unexpectedly unable
to perform with his wife after an evening of heavy eating and heavier drinking. Ever since then he
has not been able to achieve an erection when attempting to have intercourse with his wife, but he
still gets nocturnal erections and can masturbate normally. What is it?

A. * Ppsychogenic impotence

B. Vascular impotence

C. Priapism

D. Cryptorchism

E. Ishuria paradox

26. Ever since he had an abdominoperineal resection for cancer of the rectum, a 52-year-old man has
been impotent. . What is it?

A. * Organic impotence

B. Ishuria paradox

C. Priapism

D. Ppsychogenic impotence

E. Diabetic impotence

27. A 66-year-old diabetic man with generalized arteriosclerotic occlusive disease notices gradual
loss of erectile function. At first he could get erections, but they did not last long; later the quality
of the erection was poor; and eventually he developed complete impotence. He does not get
nocturnal erections. What can be advised to the patient?
A. * Sildenafil, tadalafil, and vardenafil

B. Antispasmodics, phytodiuretics, physiotherapy

C. Physiotherapy

D. Vardenafil, Physiotherapy

E. Sildenafil, phytodiuretics, physiotherapy