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Urological Trainee Questions. More complex questions aimed at the trainee preparing for the FRCS (Urol) examination. There is only one correct answer to each. Multiple Choice Questions. Click on a link below to view the MCQs for that chapter. Select one option to the question and click 'Submit answer' to check your . A 6 year old girl with short stature, streak gonads and mild mental retardation has a renal ultrasound for a first urinary tract infection. A renal anomaly is seen.
Question 2. What is the most common congenital male reproductive disorder? Question 2 Explanation: Cryptorchidism is where the person has undescended testis; it can involve one testicle or both. Testicles are formed in the abdomen and descend into the scrotum during foetal development. Failure to descend, results in this abnormality. Affected persons have an increased risk for development of germ cell tumours and infertility.
Urology MCQs for posgraduate exam
Some cases self-resolve whereas orchiopexy is done to treat others. Question 3. What are risk factors for developing germ cell tumours?
Question 3 Explanation: Most frequently occur in young men with either Klinefelter syndrome or cryptorchidism. Cryptorchidism is the failure of the testicle to descend into the scrotum. Klinefelter syndrome: Question 4.
Question 4 Explanation: Yolk sac tumour is the most common testicular tumour in boys. An elevated AFP and Schiller Duval bodies resemble glomerulus are important features to differentiate from the other types of testicular tumours.
Question 5. What area does prostate cancer spread to most frequently? Question 5 Explanation: Metastasis commonly involves the lumbar spine in late stages of the cancer creating osteoblastic lesions on the bone.
It presents as lower back pain. Question 6. Question 6 Explanation: Usually they are not biopsied as there is a high risk of seeding the scrotum. Instead, investigations include a scrotal ultrasound and blood tests for tumour markers. Treatment is radical orchiectomy as most testicular tumours are malignant.
Question 7. Opening of urethra on the ventral surface of the penis. Opening of urethra on dorsal surface of the penis. Question 7 Explanation: Question 8. What is the causative agent of condyloma acuminatum?
Question 8 Explanation: Condyloma acuminatum is characterized by the growth of benign genital warts. On histology, there will be koilocytic change.
This condition is caused by HPV type 6 or Infection with HPV is also a risk factor for development of squamous cell carcinoma of the penis. Question 9.
Do varicoceles typically appear on the right side or the left side? Question 9 Explanation: Varicoceles are caused by the dilation of the spermatic vein due to increased venous pressure. It is usually left sided because there is an elevated resistance to flow on the left side as the left gonadal vein drains into the left renal vein compared to the right which drains into the inferior vena cava. Sometimes it is associated with a left sided renal cell carcinoma. It can lead to infertility due to the increased temperature.
Epidemiologic studies have implicated cigarette smoking as a risk factor b. If cystoscopy demonstrates a bladder carcinoma as the cause of painless hematuria, no further evaluation is necessary c.
Multi-focal and recurrent bladder tumors are usually treated with transurethral resection and intravesical chemotherapy d. The results of treatment for locally advanced bladder tumors are similar with either radical cystectomy or radiation therapy Answer: a, c The most common malignant neoplasm of the kidney is the hypernephroma or renal cell carcinoma.
Which of the following statement s are true concerning renal neoplasms? Renal cell carcinomas can produce a variety of hormone or hormone-like substances b. Bilateral multifocal renal cell cancers can be associated with the multiple endocrine neoplasia syndrome c. Early control of the renal pedicle is an important aspect of surgical management of renal cell carcinoma e. Patients with renal cell carcinoma in a solitary kidney will inevitably require total nephrectomy and long-term dialysis for the resultant renal failure Answer: a, d A year-old white male presents with asymptomatic testicular enlargement.
Tumor markers, b-fetoprotein AFP and? Orchiectomy should be performed via scrotal approach c. The diagnosis of seminoma should be followed by postoperative radiation therapy d.
With current adjuvant chemotherapy regimens, retroperitoneal lymphadenectomy is no longer indicated for non-seminomatous testicular tumors Answer: c Prostatic size has no consistent relationship to urethral obstruction b. Renal failure secondary to obstructive uropathy occurs as bladder pressure rises and is eventually transmitted proximally to the renal pelvis c.
Hormonal treatment for BPH involves treatment with a 5 a-reductase inhibitor which blocks the conversion of testosterone to the dihydrotestosterone d. Intermittent catheterization, although a temporizing measure, is not an effective treatment for relief of symptoms of BPH Answer: a, b, c A year-old male presents with severe flank pain radiating to the groin associated with nausea and vomiting. Urinalysis reveals hematuria. A plain abdominal film reveals a radiopaque 5 mm stone in the area of the ureterovesical junction.
A likely stone composition for this patient would be uric acid b. The stone will likely pass spontaneously with the aid of increased hydration c.
Stone analysis is of relatively little importance d. Patients with a calcium oxalate stone and a normal serum calcium level should undergo further extensive metabolic evaluation Answer: b Which of the following statements are true concerning male impotence? Psychologic factors account for less than half the cases of male impotence b.
Blunt renal trauma and penetrating renal injuries are managed similarly.
Blunt renal trauma with urinary extravasation always requires surgical exploration. Blunt renal trauma requires exploration only when the patient exhibits hemodynamic instability.
Any kidney fractured by blunt renal trauma must be explored. Carcinoma of the bladder: Is primarily of squamous cell origin.
Is preferentially treated by radiation. May be treated conservatively by use of intravesical agents even if it invades the bladder muscle. May mimic an acute UTI with irritability and hematuria.
Is preferentially treated by partial cystectomy. The major blood supply to the testes comes through the: Hypogastric arteries. Pudendal arteries.
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External spermatic arteries. Internal spermatic arteries.
Patients who have undergone operations for benign prostatic hypertrophy or hyperplasia: Require routine rectal examinations to detect the development of carcinoma of the prostate. Do not need routine prostate examinations. Have a lesser incidence of carcinoma of the prostate. Have a greater incidence of carcinoma of the prostate. To maximize fertility potential, orchidopexy for cryptorchidism should be done before: Age 15 years.
Age 12 years. Age 2 years. Within the age group 10 to 35 years, the incidence of carcinoma of the testis in males with intra-abdominal testes is: Equal to that in the general population. Five times greater than that in the general population. Ten times greater than that in the general population. Twenty times greater than that in the general population.
The appropriate surgical treatment for suspected carcinoma of the testis is: Transscrotal percutaneous biopsy.
Urology MCQs for posgraduate exam
Transscrotal open biopsy. Repeated examinations. Inguinal exploration, control of the spermatic cord, biopsy, and radical orchectomy if tumor is confirmed. If torsion of the testicle is suspected, surgical exploration: Can be delayed 24 hours and limited to the affected side. Can be delayed but should include the asymptomatic side.
Should be immediate and limited to the affected side. Should be immediate and include the asymptomatic side. Epididymitis, either unilateral or bilateral, in a prepubertal male: Is a frequent diagnosis. Can be dealt with on an outpatient basis. Is a major scrotal problem in this age group.Immediately remove both testes because of the increased risk for childhood germcell tumors B.
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