泌尿外科选择题(英语)

Urology-11.An84yearoldmanpresentstoyourofficecomplainingofafivedayhistoryofpassingterminalbrightredbloodyurine.Hereportsmarkedurgencyandfrequencybutisotherwisewellandafebrile.Inretrospect,heremembersbeingquiteillwithaninfectionintherecentpast.Analysisofavoidedspecimenshows3smoothandroundedRBCs/hpf.WhichofthefollowingisNOTincludedinyourdifferentialdiagnosis?a)benignprostatichpertrophy(BPH)b)post-streptococcalglomerulonephritisc)astonelodgedatthevesico-uretericjunctiond)asuperficialbladdertumoure)acoliformpositiveUTI2.Ofthefollowingconditions,whichisnotconsideredaurologicalemergency?a)paraphimosisb)priapismc)orchitisd)testiculartorsione)autonomicdysreflexia3.AnormalsemenanalysisincludesallofthefollowingEXCEPT:a)pHbetween7.5-8.1b)aspermcount20millionsperm/mlc)WBC10/hpfd)motility50%e)60%normalmorphologicalforms4.Amotherbringshertoilet-trained,5yearolddaughtertoseeyouwitha3dayhistoryofdysuria,increasedfrequency,andurgencyincontinence.Herpastmedicalhistoryissignificantforabag-specimenpositiveUTIcharaterizedbyhighfeverandvomitingat2yearsofage.Atthetime,shewaslosttofollowup.Whichofthefollowingwouldbeappropriateforyourinitialmanagementofthispatient?a)voidingcystourethrogram(VCUG)b)amidstreamurinespecimenc)nuclearcystogramd)DMSArenalscane)abdominalultrasound5.A55yearoldmanreluctantlyadmitstodifficultyinmaintaininganerectionsufficientforsexualintercourseforthepasttwoyears.Hereportsbeinghealthy,however,hehasnotseenaphysicianin10years.Whichofthefollowingwouldnotsuggestapotentialcauseforhiserectiledysfunction?a)elevatedbloodpressureb)galactorheac)acanthosisnigracansd)varicocelee)eruptivexanthoma6.A50yearoldmanpresentswitha2monthhistoryofirritativevoidingsymptomsandafever.Heinitiallysawhisfamilydoctorwhotreatedhimforcystitiswithciprofloxacinfor5days.Henowpresentstoyoubecausehissymptomshavereturnedsoonafterhefinishedhiscourseofantibiotics.AllofthefollowingarelikelyTRUEexcept:a)heneverhadaUTIb)hemighthavecomplainedofdiscomfortwhenridingabicyclec)hemighthavealsoexperiencedbackpaind)thispatientdoesnotneedtobeinvestigatede)hecouldofhadprostatitisandshouldhavebeentreatedatleast3weeks7.WhichofthefollowingisNOTacommonplaceforimpactionofakidneystone?a)Ureteralpelvicjunctionb)Pelvicbrimc)Ureteralvesicaljunctiond)Vesicourethraljunction8.Urinarycontinenceinwomenismaintainedby____?a)internalsphincterb)middlecircularlayerofthebladderneckc)externalsphincterd)lowerbladderpressure9.Prostatecanceroccursmostcommonlyinwhichzoneoftheprostate?a)centralzoneb)urethralzonec)transitionalzoned)perioheralzone10.kidneyfunctioninapreoperativepatientisbestmeasuredby____?a)serumblood,urea,nitrogen,andcreatinineb)creatinineclearancec)renalultrasoundd)computedtomographyscan11.whichofthefollowingstudiesisNOTusefulinevaluatingapatientwithbenignprostatichypertrophy(BPH)?a)internationalprostatesymptomscorequestionnaireb)cystoscopyc)pre-voidultrasoundd)pressure-flowstudy12.transurethralresectionsyndromeafterendoscopicresectionoftheprostateoccursbecauseof__?a)airembolismduringtheprocedureb)bloodlossfrompostoperativeirrigationc)absorptionofirrigantd)relaxationoftheurethralsphincterfromspinalanesthesia13.whichofthefollowingcanoccurasaparaneoplasticmanifestationofrenalcellcarcinoma?a)hepaticdysfunctionb)hypocalcemiac)thrombocytopeniad)pulmonaryedema14.Appropriatetreatmentforasuperficialbladdercanceris___?a)endoscopicresectionandfulgurationb)full-thicknessresectionwitha1-cmmarginc)full-thicknessresectionwitha3-commargin(subtotalcystectomy)d)totalcysterctomy15.Initialtherapyformetastaticprostatecanceris___?a)totalprostatectomy(sphincter-preserving)b)radicalprostatectomyc)chemotherapyd)bilateralorchiectomy16.whichofthefollowingisanabsoluteindicationforsurgicaltreatmentofarenalinjury?a)majorurinaryextravasationb)vascularinjuryc)expandingperirenalhematomad)20%devitalizedrenalparenchymaAnswerstoQ1-161.b2.c3.a4.a5.d6.d7.d8.c9.d10.b11.c12.c13.a14.a15.d16.cUrology-2Questions1and21.A62-year-oldAfricanAmericanmaleattorneypresentstoaprostate-screeningclinicduringNationalAwarenessWeek.Oncarefulquestioning,hehasnotedslighturgency,frequencynocturia,andadecreaseintheforceofmicturition.Heisreferredtohavebloodteststoincludewhichofthefollowing?(A)Carcinoembryonicantigen(CEA)(B)Prostaticacidphosphatase(C)Alkalinephosphatase(D)Prostate-specificantigen(PSA)(E)Lacticdehydrogenase(LDH)2.Generalexaminationfromhisurologistisnoncontributory.Arectalexaminationrevealshemorrhoidsandaleft-sidedirregularmassintheprostate.Followingnormalbloodtests,heshouldhavewhichofthefollowing?(A)Computedtomography(CT)scanofthepelvis(B)Magneticresonanceimage(MRI)oftheprostate(C)Colonoscopyandbiopsyoftheprostateundergeneralanesthetic(D)Biopsyofthenodule(E)Bonescan3.A62-year-oldpostalofficerdevelopsminimalurinarysymptoms.HisPSAleveliselevatedandcontinuestoincreaseduringa6-monthperiodofobservation.Thenextstepinevaluation,iftransrectalultrasound(TRUS)prostatebiopsy(Fig.1)werepositiveforadenocarcinomaofprostate,wouldbe:(A)Refertooncologistforchemotherapy(B)MetastaticevaluationincludingCTandbonescans(C)RepeatPSAa