Started on Friday, 17 November 2023, 10:30 AM

State Finished
Completed on Friday, 17 November 2023, 11:28 AM
Time taken 58 mins 37 secs
Grade 40.00 out of 60.00 (67%)

Question 1

Incorrect

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Kumar is being investigated for a possible male infertility, the following physical findings may be possible cause/es, EXCEPT:

a. penile curvature of 20o 

b. gynecomastia

c. (-) morning erection

d. obstructed vas deferens

Question 2

Correct

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Which of the following stones are radiolucent in X-rays?

a. Calcium Phosphate

b. Calcium Oxalate

c. Uric acid 

d. Struvite

Question 3

Correct

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A 45-year-old woman has been complaining of slowly progressive headaches and urinary frequency. She has papilledema on
funduscopy. Besides treatment of the brain lesion, the patient may benefit from

a. indwelling catheterization

b. intermittent catheterization

c. anticholinergic medication 

d. Any of these choices.

e. suprapubic catheterization
Question 4

Correct

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Prostatic disease is best diagnosed with:

a. Perineal US

b. Cystoscopy

c. Scrotal US

d. Transrectal US 

Question 5

Correct

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Non-invasive technique to disintegrate urinary calculi with the patient is immersed in a water bath

a. Physical Method
b. ESWL
c. Percutaneous Nephrostomy
d. Excretory Pyelography
procedure to break up stones inside the urinary
tract, bile ducts or pancreatic duct with a series of 
shock waves generated by a machine called a
lithotripter.The shock waves enter the body and
are targeted using an X-ray.

Question 6

Correct

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Which of the following statement is TRUE regarding Urolithiasis?

a. None of the choices are TRUE

b. More common in Women than in Men
c. Maximum rate at 30-50 years of age
d. Common in ages 10 – 18 years of age
exhibits a higher incidence in
individuals aged between 30 and
50 years old. This age range
correlates with a period in life
where factors such as diet, 
lifestyle, and metabolic changes
may contribute to the formation
of kidney stones.

Question 7

Incorrect

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Inspite of a successful embryo transfer, Kumar and Novu still could not maintain the pregnancy. A good laboratory test could be:

a. neither choice is correct

b. Post-coital test

c. both choices are correct 

d. Acrosome reaction
Question 8

Incorrect

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The gold standard for imaging in hematuria workup;

a. All options are correct 

b. All options are incorrect

c. MR urography

d. Renal and bladder ultrasound examination with retrograde pyelogram

e. Multi-phasic CT urography

Question 9

Correct

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A patient with rigidity, bradykinesia, masked facies, resting tremor, and shuffling gait for the past four years is now complaining of
urinary frequency, urinary urgency and nocturia. The most appropriate treatment for him is

a. intermittent catheterization

b. Any of these choices.

c. anticholinergic medication 

d. indwelling catheterization

e. suprapubic catheterization

Question 10

Incorrect

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The chances of Kumar solving his infertility problem is high if this parameter is NORMAL:

a. sperm motility

b. sperm count 

c. absent agglutination

d. sperm morphology
Question 11

Incorrect

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The prognosis of patients with incontinence from neurogenic bladder is generally

a. excellent as long as secondary complications such as urosepsis are avoided 

b. poor because lack of specialists such as urologists and public unawareness of urologic intervention programs

c. poor because nerves do not regenerate

d. poor because most of the time, there are existing comorbidities such as diabetes mellitus

e. excellent with modern health care

Question 12

Correct

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When bladder fullness is sensed by the higher brain centers, this structure is inactivated to allow the person to delay urination until
finding a socially acceptable time and place.

a. Cerebral cortex

b. Limbic system

c. Pontine micturition center 

d. None of these choices.

e. Periaqueductal gray matter

Question 13

Correct

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In newborns and infants, the urine fills the bladder and a stimulatory signal is sent to this structure to trigger the detrusor to contract
resulting in coordinated voiding.

a. Sacral region of the spinal cord 

b. Periaqueductal gray matter of the midbrain

c. Nucleus of Onuf of the anterior horn of the spinal cord

d. Amygdala of the limbic system

e. Pontine micturition center

Question 14

Correct

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48 year old male is admitted to the hospital for intravenous hydration and analgesics after experiencing her third bout of renal colic in
the past year. Previous intravenous pyelograms revealed recurrent right and left sided 3mm caliceal stones. A current sonogram
shows a 3mm right caliceal stone and a 2mm distal ureteral stone. Physical examination of the heart and lungs is unremarkable.
Abdominal examination revealed flank tenderness. Which of the following is the LEAST likely diagnosis?

a. Hyperparathyroidism

b. Sarcoidosis

c. Rheumatoid arthritis 

d. Gout

Question 15

Incorrect

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A 60-year-old male patient has had ataxia, orthostatic hypotension, parkinsonism, and autonomic dysfunction for the past two years.
Which of the following is a likely urinary manifestation?

a. Urinary retention

b. Detrusor-sphincter dyssynergia

c. Urinary incontinence

d. Any of these choices. 

e. Spasticity of the internal urinary sphincter

Question 16

Correct

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Indications for Active Stone Removal are the following, EXCEPT

a. Bilateral Obstruction

b. Stone with Urinary Tract Infection

c. Persistent pain that can be resolved with NSAIDS 

d. Unilateral Obstruction with impaired renal function

Question 17

Incorrect

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RC a 48 year-old male patient had hematuria and some dysuria. Investigations revealed red patches in the bladder. The CT scan
shows left hydroureteronephrosis and abnormal thickened dilated ureter. Bladder biopsies revealed granulomatous lesions in the
bladder. Chest X-ray was unremarkable, Urinalysis, (+) pyuria and Urine culture returned negative. QuantiFERON, (+). What is the
source of hematuria?

a. Kidneys

b. All options are correct

c. Urinary bladder 

d. All options are incorrect

e. Ureters

Question 18

Incorrect

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A large brain tumor especially above the pons may result in any of the following, EXCEPT:

a. Bladder emptying too quickly

b. Oliguria 

c. Bladder emptying too frequently

d. Nocturia

e. No exception.

Question 19

Incorrect

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AB a 60year-old man presented to the ER due to 2 episodes of gross hematuria which were self-limiting. S/S for the past 6months;
Urinary hesitancy, Decreased force of urinary stream. Non-Smoker, No pain, No trauma. The most common cause of hematuria for his
age group;

a. Benign prostatic hyperplasia

b. Cystitis

c. Urolithiasis

d. Glomerulonephritis

e. Bladder cancer 
Question 20

Incorrect

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The medical history of Kumar who is suspected to have male infertility was seen at your clinic. Which of the following information is
strongly suggestive that your suspicions are true:

a. upper body segment greater than lower body segment

b. pubic hair is triangular in shape

c. balding

d. Delayed onset of growth spurt 

Question 21

Correct

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In industrialized country, what is the most common type of Urinary stone?

a. Calcium Oxalate 

b. Struvite

c. Calcium Phosphate

d. Xanthine

Question 22

Incorrect

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The physical examination of Kumar showed dilated vessels along his spermatic cord. This is related to:

a. Asthenospermia

b. Neither choice is correct

c. both choices are correct 

d. Azoospermia

Question 23

Correct

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The following are theories of stone formation, EXCEPT?

a. Inhibitor of Crystallization

b. Stone Matrix

c. Nucleation

d. Stone binding 
Question 24

Correct

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Which of the following is most likely to form in an Alkaline urine?

a. Struvite

b. Calcium Phosphate 

c. Uric acid

d. Calcium Oxalate

Question 25

Incorrect

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Kumar is undergoing work up for a possible male infertility, Which of the following information is significant:

a. all choices are correct 

b. he did not develop a growth spurt until he was 16 years old

c. absence of facial hair

d. difficulty of urinating upon waking up because of tumescence

Question 26

Correct

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The first symptom of neurogenic bladder secondary to diabetes is

a. urgency

b. loss of sensation of bladder filling 

c. loss of motor function

d. suprapubic pain

e. increased voiding intervals

Question 27

Correct

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Excretory pyelography must NOT be carried out in the following patients:

a. Serum Creating of < 200 umol/L

b. No history of Diabetes

c. No know allergy to the contrast media

d. With Myelomatosis 
Question 28

Correct

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Which of the following has the highest overall passage rate of ureteral stones?

a. Distal Ureteral Stones 

b. Proximal Ureteral stones

c. Calculi Stones

d. Mid-Ureteral Stones

Question 29

Correct

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Which of the following medication can help the stone pass thru?

a. Allopurinol

b. NSAIDs

c. Potassium Citrate

d. Calcium Channel Blockers 

Question 30

Correct

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Immediately after traumatic spinal cord injury from a motor vehicle accident, which of the following is likely to happen?

a. Urinary incontinence

b. Urinary retention 

c. Spasticity of the internal urinary sphincter

d. Detrusor-sphincter dyssynergia

e. Any of these choices.

Question 31

Correct

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GH a 67 year old male presented to the clinic; Gross hematuria for 2 weeks, Passing clots per urethra for 2 days, Unable to void for 8
hours, Smoker x 30 years, Urinalysis: 4+ Hgb, >50 RBC/HPF, Creatinine is elevated. Your management plan would include;

a. All options are correct 

b. All options are incorrect

c. Large 3-way catheter

d. KUB ultrasound

e. Cystoscopy

Question 32

Correct

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Complications of renal stones treatment;

a. Ureteric obstruction from stone fragments

b. Ureteral edema

c. Hematuria

d. All options are incorrect

e. All options are correct 

Question 33

Incorrect

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Kumar is to undergo semen analysis. The following is critical in this examination:

a. collect the specimen using a penile condom

b. collect the semen either by masturbation or by coitus interruptus

c. wash the penis prior to collection 

d. coitus is not allowed 7 days before collection

Question 34

Correct

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Physical examination of Kumar who is suspected to have infertility would include the following, EXCEPT:

a. penis

b. epidydimis

c. testis

d. ampulla of the vas deferens 

Question 35

Incorrect

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Kumar was diagnosed with azoospermia. This consistent with:

a. neither choice is correct

b. cystic fibrosis

c. both choices are correct 

d. non-palpable seminal vesicle

Question 36

Correct

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What are the possible treatment options for ureterolithiasis?

a. Extracorporeal shockwave lithotripsy

b. All options are incorrect

c. Ureteroscopy and laser stone fragmentation

d. All options are correct 

e. Medical therapy (usually with tamsulosin)

Question 37

Incorrect

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Kumar and Novu is under going work up for infertility. Kumar was noted to be exophthalmic and lethargic. This findings may be
related to:

a. Neither choice is correct

b. Both choices are correct 

c. Decrease frequency of sexual intercourse

d. Sluggish sperm motility

Question 38

Correct

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Severe injury to the sacral cord results in loss of bladder function and affected patients will develop

a. Urinary incontinence

b. Urinary retention 

c. Detrusor-sphincter dyssynergia

d. Any of these choices.

e. Autonomic dysreflexia

Question 39

Correct

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Type of stone formed by Proteus Mirabilis or Proteus vulgaris?

a. Calcium Oxalate

b. Struvite 

c. Calcium Phosphate

d. Uric acid

Question 40

Correct

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If indwelling urethral catheterization is necessary, such as in long-term conditions, the catheters must be changed at least

a. quarterly

b. bimonthly

c. weekly

d. biweekly

e. monthly 

Question 41

Correct

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Diagnostic tests that help diagnose BPH include all of the following EXCEPT:

a. A digital rectal exam

b. Testosterone levels 

c. Urinalysis

d. Plasma prostate-specific antigen (PSA) levels

Question 42

Incorrect

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Kumar and Novu has an unexplained infertility. What test is best done for normal sperm count but has a low seminal fluid volume.

a. Post-coital Test

b. both choices are correct 

c. Sperm motility test

d. neither choice is correct

Question 43

Correct

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Which of the following is the most common site of urinary stone impaction?

a. Renal calix

b. Near the pelvic brim

c. Uteropelvic Junction

d. Uterovesical Junction 

Question 44

Incorrect

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Kumar loves to drink and smoke pot he is more likely to have problems w/:

a. low volume of ejaculate

b. low sperm count

c. gynecomastia

d. All choices are correct 

Question 45

Correct

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Which of the following is not a characteristic feature of genito-urinary TB?

a. All options are correct

b. Renal colic 

c. All options are incorrect

d. Painless hematuria

e. Chronic urgency that do not respond to antibacterial drug regimens

Question 46

Incorrect

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Kumar was diagnosed with a palpable mass on the prostate. The location of the mass is on the midline. This is most likely related to:

a. ampulla of the vas deferens 

b. All choices are possible

c. remnants of the mesonephric duct

d. absent kidney

Question 47

Incorrect

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Injury to the sacral nerves may be brought about by any of the following, EXCEPT:

a. Pernicious anemia 

b. Poliomyelitis

c. Guillain-Barre syndrome

d. No exception.

e. Neurosyphilis

Question 48

Correct

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The most common type of urinary bladder cancer (>85% tumors);

a. Hemangioma

b. Papillary adenocarcinoma

c. Lymphoma

d. Anaplastic carcinoma

e. Transitional Cell Carcinoma 

Question 49

Correct

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You are advising Kumar to modify his lifestyle in order to help him with his infertility problem. You would ask him to refrain from the
following EXCEPT:

a. drinking tea 

b. 3 bottles of beer/ day

c. cigarette smoking

d. eating a high carbohydrate and fatty food

Question 50

Correct

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CV a 57year-old man presented to the ER due to 2 episodes of gross hematuria which were self-limiting. S/S for the past 6months;
Urinary hesitancy, Decreased force of urinary stream. Non-Smoker, No pain, No trauma. To evaluate the lower urinary tract symptoms
you would select;

a. Cystoscopy + urethrogram 

b. PET Scan

c. Ultrasound

d. CT scan

e. MRI

Question 51

Correct

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Operative procedure within the kidney without using the standard large flank incisions and mobilization of the kidney

a. Excretory Pyelography

b. Percutaneous Nephrostomy 

c. ESWL

d. Physical Method
Question 52

Correct

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Patient who is has shellfish, anchiovies, and red meat on his diet tend to develop what time of renal stone?

a. Calcium Oxalate

b. Uric acid 

c. Struvite
 d. Calcium Phosphate

Question 53

Correct

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Which is the most effective management of urethral stricture?

a. Sequential dilation

b. Urethral reconstruction 

c. All options are incorrect

d. Urethrotomy

e. All options are correct

Question 54

Correct

Mark 1.00 out of 1.00

TC a 48 year-old male patient had hematuria and some dysuria. Investigations revealed red patches in the bladder. The CT scan
shows left hydroureteronephrosis and abnormal thickened dilated ureter. Bladder biopsies revealed granulomatous lesions in the
bladder. Chest X-ray was unremarkable, Urinalysis, (+) pyuria and Urine culture returned negative. QuantiFERON, (+) What is the
treatment?

a. All options are correct

b. Nephroureterectomy

c. All options are incorrect

d. Rifampicin + Isoniazid + Pyrazinamide + Ethambutol 

e. Rifampicin + Isoniazid + Fluconazole

Question 55

Correct

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This is the only test able to assess bladder contractility and the extent of a bladder outlet obstruction.

a. Filling cystometrogram

b. Postvoid residual bladder volume

c. Cystogram

d. Voiding cystometrogram 

e. Videourodynamics
Question 56

Correct

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When a male person stands at the urinal in front of a waiting line, self-consciousness occurs. The internal urethral sphincter
contracts, hampering the ability to urinate. This is mainly due to

a. sympathetic fibers 

b. somatic fibers

c. sympathetic and parasympathetic fibers

d. autonomic and somatic fibers

e. parasympathetic fibers

Question 57

Correct

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If the urethral pressure is abnormally low or if the intravesical pressure is abnormally high, this will occur.

a. Any of these choices.

b. Autonomic dysreflexia

c. Detrusor-sphincter dyssynergia

d. Urinary retention

e. Urinary incontinence 

Question 58

Correct

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BP, a 55year-old man presented to the ER due to 2 episodes of gross hematuria which were self-limiting. S/S for the past 6months;
Urinary hesitancy, Decreased force of urinary stream. Non-Smoker, No pain, No trauma. Differential diagnosis include;

a. All options are incorrect

b. Urethral Stricture

c. All options are correct 

d. Benign Prostatic Hyperplasia

e. Urinary tract infection

Question 59

Correct

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A 38 year- old gentleman was seen in clinic 2 weeks after admission with acute right groin pain. Urinalysis returned hematuria with
RBC casts. What other laboratory parameters will be suggestive of glomerular source of hematuria?

a. All options are incorrect

 b. Proteinuria 

c. Normal creatinine

d. Normal RBC morphology

e. All options are correct

Question 60

Incorrect

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Treatment for early stage urinary bladder cancer;

a. Radiotherapy

b. All options are correct 

c. Transurethral resection of urinary bladder tumor

d. Intravesical immunotherapy

e. Combination chemoradiotherapy