2- 63 year old male underwent TURBT (trans urethral resection of urinary bladder tumour) for

solitary 4 cm urinary bladder tumour histopathology revealed T2a TCC (transitional cell
carcinoma ) high grade, metastatic workup is negative (N0 , M0) .the next step is :

A. intravesical BCG( Bacille Calmette–Guérin ) .

B. chemotherapy and radiotherapy .
C. radical cystectomy with urinary diversion #
D. partial cystectomy and follow up after 3 month
E. reassurance and follow up after 1 year .

. one of the following is NOT an indication for varicocelectomy -3

A. Testicular pain

B. abnormal spermogram

C . Bilateral grade 3 varricocele

D . Reduction of testicular size

E . Urinary tract infection #

A 4 year old boy presented with left testicular swelling since birth, examination revealed soft, -4
fluctuated, trans illuminated left testicular swelling which is disappeared on lying position . the
:most appropriate diagnosis is

A. vaginal hydrocele

B. Oblique inguinal hernia

C. Infantile hydrocele

*D. Patent processus vaginalis

E. Encysted hydrocel of the cord

: One of the following is NOT an indication of renal exploration in a patient with renal trauma -5

A. Expanding retroperitoneal hematoma

B. hypotension despite resuscitation

C. Pulsatile hematoma

D. Renal artery injury

*E. sub capsular haematoma

A 65 years old male presented with LUTS lower urinary tract symptoms ) investigation revealed -6
that he has prostatic enlargement ( volume 100g ) and PSA ( prostate specific antigen ) 50 ng/ml.
: the next step in management of this patient is

A- TVP (trans- vesical prostatectomy )

B- TURP (trans- urethral resection of the prostate)

* C- Trans- rectal prostatic biopsy

D. Radical prostatectomy

E- Hormonal therapy

EMQ

: Theme : Urethral diseases management

a) Conservative management
b) VIU ( visualized internal urethrotomy )
c) Urthroplasty with end to end anastomosis
d) Urthroplasty with graft repair
e) Trial of urethral catheterization
f) Antibiotic
g) Ascending cysto-urethrogram
For each of the following presentations, select the most appropriate treatment from the above
.list. Each option may be used once, more than once or none at all

1- 25 years old man, sexually active presented with excessive urethral discharge straining ,
weak stream urine , hesitancy. creatinin 0.8 mg/dl . ultrasonography show thick wall of the
urinary bladder , no vesical stone or diverticulum and normal both kidney . (F) Antibiotic

2- 35 years old male presented with perineal trauma, examination shows blood in the external
urethral meatus . ( G ) Ascending cysto-urethrogram

3- 27 years old male presented with obstructive lower urinary tract symptoms (LUTS) ,
s.creatinine 0.8 mg/dl ..ultrasonography show thick wall of the urinary bladder, no vesical
stone or diverticulum and normal both kidney. ascending cysto –urethrogram show short
urethral stricture about half centimeter in the bulbar urethra (b) Visualized internal
Urethrotomy

Problem 1
25 years old male from Port-Sudan presented with severe colicky right loin pain radiating to
the right testicle associated with vomiting.
1- the first step in management is:

A. urine general, and ultrasonography

B. analgesia and intra venous fluids *
C. renal function test
D. intravenous antibiotics
E. analgesia and cystoscopy
 2- the diagnostic laboratory investigations for this patient must include :

A. Complete blood count , urine general , renal function test

B. urine general, renal function test, serum uric acid *
C. Complete blood count, renal function test, Serum calcium
D. urine general , renal function test, serum phosphate
E. urine general , Serum calcium, serum phosphate

3- CT – KUB was done to this patient and it showed Right upper ureteric stone measuring
7mm , with mild hydronephrosis the appropriate management for this patient is :

A. pcnl (percutaneous nephrolithotomy ).

B. Extracorporeal shock wave lithotripsy *
C. ureteral stent using fluoroscopy
D. percutaneous nephrostomy tube .
E. Uretrolithotomy and ureteral stenting

: the advise that you give to this patient to prevent recurrence is -4

A . increase salt and increase water intake

*B. decrease salt and increase water intake

C. decrease salt and decrease water intake

D. increase salt and decrease water intake

E. decrease salt and increase protein intake

 Problem 2

68 year man with , urgency , urge-incontenence ,voiding diary revealing 12 void in 24

hours ,nocturia (3 times ), weak stream urine ,hesitancy . A uroflowmetry revealed a flattened
pattern with a peak flow of 6 ml/s .

1. his condition is best described as :

A. Benign prostatic hyperplasia
B. Urethral stricture
C. urinary bladder over activity
D. urinary bladder under activity
E. lower urinary tract symptoms *

2- his irritative symptoms include :

A. nocturia , hesitancy, urgency , urgeincontenence

B. frequency , weak stream urine , hesitancy, nocturia

C. urgency , urge-incontenence, frequency, nocturia *

D. weak stream urine , hesitancy ,nocturia, urgency

E. urgency , week stream urine, frequency, nocturia

3- The imaging study that must be done to this patient is :

A. abdominal and pelvic ultrasonography *

B. CTU (CT kidney-ureter- bladder wit contrast
C. CT- KUB (CT kidney-ureter- bladder without contrast)
D. MRI abdomen and pelvic

E. Isotope renal scan

4- investigations revealed urinary bladder stone 7 cm and prostate volume 200 ml with no
suspicion of malignancy . the appropriate next step is :

A. TURP (trans urethral resection of the prostate )and cystolitholapexy

B. Radical prostatectomy and removal of the stone
C. Trans vesical prostatectomy (TVP) and removal of the stone *
D. Vesicolithotomy and medical treatment of the prostate
E. medical treatmemt for the prostate and ESWL for the stone

Photo (1)

: this photo shows -1

a. urodynamic study

* b. uroflowmetry

c. cystometry

d. urinary pressure flow study

e. Urethral Pressure Profilometry

: this test is NOT used in one of the following diseases -2

a. adenocarcinoma of the prostate

b. benign prostatic hyperplasia

c. neurogenic bladder

* d. bladder carcinoma

e. urethral stricture

photo 2

years old boy complaining of right testicular pain for 4 days , no other urinary tract symptoms , 12
no history of trauma . Exploration for the right testicle was done. This picture was taken after 15
.minutes of exploration
- : the urologist suspected condition that need testicular exploration this condition is -1

a. testicular abscess

b. epdidymo-orchitis

c. testicular tuberculosis

d. testicular haematoma

* e. testicular torsion

: the appropriate radiological investigation that must be done for this patient is .2

# a. Doppler ultrasound

b. CT scan

c. MRI

d. plain X ray pelvis

e. vasography

: the appropriate treatment for this patient is .3

a. Closure and wide spectrum antibiotics

b. evacuation of the abscess and antibiotics

c. bilatereral orcedopexy and bed rest

# d. right orchedectomy and left ochedopexy

e. right ochedectomy and testicular elevation