Thursday, February 5, 2009

37 - urinary tract mcqs - part 1

1q: a patient presents with hematuria of several days and dysmorphic RBC casts in urine. what is the site of origin ?

a. kidney
b. ureter
c. bladder
d. urethra

answer: a . kidney .

2q: a patient ramu presents with hematuria for many days. on investigations he is found to have renal calculi, calcifications in the wall of the urinary bladder and small
contracted bladder. what is the most probable cause ?

a. schistosomiasis
b. amyloidosis
c. tuberculosis
d. carcinoma urinary bladder

answer: a . schistosomiasis . if the question states - small contracted bladder associated with calcified lesion in the kidney , then the answer is probably
tuberculosis .

3q: treatment of choice for grade four vesicoureteric reflux with recurrent UTI ?

a. cotrimoxazole
b. bilateral reimplantation of ureter
c. injection of collagen in the ureter
d. endoscopic resection of ureter

answer: a . cotrimoxazole . ( if anybody can explain this answer please post in comments )

4q: which of the following statements is true of primary grade four - five vesicoureteric reflux in young children ?

a. renal scarring usually begins in the midpolar regions
b. postnatal scarring may occur even in the absence of urinary tract infections
c. long term outcome is comparable in patients treated with either antibiotic prophylaxis or surgery
d. oral amoxicillin is the choice antibiotic for prophylaxis

answer: only b is correct . renal scarring usually begins in the polar regions and not in the midpolar regions. medical management is usually ineffective in these patients. amoxicillin is the drug of choice for children upto 6 weeks of age , but after 6 weeks trimethoprim and sulfomethoxazole combination is the drug of choice because after this age , the biliary system of the infant is developed enough to handle these drugs .

5q: a 60 year old man presents with hematuria at onset of micturition . what is the probable cause ?

a. urethral stone
b. bladder tumor
c. ureteric stone
d. prostatitis

answer: a . urethral stone . if the hematuria is at the end of micturition then it is usually a bladder stone .

6q: what will be the next investigation to be done in case of a 2 year old female child with first episode of UTI ?

a. abdominal ultrasound
b. DMSA scan
c. 6 monthly urine culture
d. nothing actively needed

answer: a. abdominal ultrasound to detect any renal anamolies .

7q: a 25 year old male presents to emergency with history of road traffic accident two hours ago. the patient is hemodynamically stable. abdomen is soft. on catheterization of bladder , hematuria is noticed. the next step in the management should be -

a. immediate laparotomy
b. retrograde cystourethrography ( RGU )
c. diagnostic peritoneal lavage ( DPL )
d. contrast enhanced computed tomography ( CECT ) of abdomen

answer: d. CECT of abdomen .

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