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Urology Mid-block Questions

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Hepatic flexure is
anterior to the right kidney
Sympathetic denervation paralyzes:
Sphincter vesicea
In Erection origin of sympathetic innervation:
T11-L2
Renin secreted from
Juxtaglomerular
The functional unit of the kidney:
Nephron
Number of nephrons in the kidney:
1-3 million
In the neuroanatomical classification of a pathologic bladder, Cerebral infarction categorized as:
suprapontine
Micturition Reflex center in infants:
Sacral
Voluntary control of urination in adults:
cerebral cortex
Best for ureteric stone:
KUB CT
45-year-old man inability to insert catheter, urethral stricture:
Ascending urethrography
50% stenosis of Renal artery origin:
Refractory hypertension
Retrograde ejaculation after TURP:
75%
Locally advanced CaP treatment:
External beam radiotherapy
MoA of a-antagonist drug for prostate:
relaxation of smooth m. of prostatic capsule
First line for diagnosis of CaP:
PSA and DRE
Involvement of seminal vesicle in which stage of prostate cancer:
T3
IPSS >19 score is considered:
severe symptoms
Pulsatile contraction of which muscle for ejection of semen:
Bulbocavernosus
Contraindication of PDE 5:
Nitrates
Patient taking Spironolactone, monitor:
Hyperkalemia
Patient taking potassium sparing diuretic, diet should avoid:
High potassium
Patient taking thiazide develops dysrhythmia:
Hypokalemia
ADH absence, collecting tubule becomes impermeable to:
Water
ADH works on:
collecting duct
Which part create Hyperosmolarity in medulla:
Loop of Henle
Which of the following Increase Na reabsorption:
Increased oncotic pressure
Increase in osmotic pressure due to increase:
Albumin
Tm= 320, PL of glucose =4 mg/ml GFR= 100, glucose excretion in urine:
80
,
...
Urine= 2ml/min, [inulin] in plasma= 20, plasma concentration of inulin= 0.5, renal blood flow 20% of the cardiac output 5L/min. What is the filtration fraction:
20% ((Doctor said will be deleted))
Decrease of what increases GFR:
Albumin concentration
Na/glucose symporter at:
PCT
Main cause of hypoosmolar urine at TALH:
Na/K/ 2Cl symporter
ACE is present in capillaries of:
Lungs
"Third Spaces" include:
Peritoneal cavity and Ascites
Sensible fluid loss includes:
urine and sweat
Primary Function of Loop of Henle:
Solute Reabsorption
Bulbourethral gland secretes in which part of the urethra:
penile urethra
Complete Glucose reabsorption in which part:
PCT
Prostate cancer early stage presentation:
Asymptomatic
Apex of the bladder:
Anterior
Most superior structure:
Interuretric crest, Trigone, bladder neck, uvula viscae
Cells that secrete Renin:
Juxtaglomerular cells
type of epithelial lining in Prostatic urethra:
Transitional
The main goal in treating urogenic bladder:
Preserve renal function
Type of incontinence that occurs with exercise:
Stress Incontinence
Main purpose of sodium reabsorption in PCT:
glucose reabsorption
Part of nephron where Na reabsorption and regulation of volume:
Distal and Collecting duct
What contains receptors of sodium:
Macula Densa
Gold standard for GFR:
Inulin
Rank of Prostate cancer in Saudi men:
Sixth
Prostate cancer involving transition zone:
20%
Best imaging for prostate cancer:
TRUS/ MRI/ CT??
BPH patient should take combined therapy, medication include:
Tamsulosin + Dutasteride
A 78-year-old diabetic with low grade low stage CaP, best treatment option:
Watchful waiting
Hormone therapy is best for which stage of CaP:
Metastatic
Screening regarding CaP:
controversial
Separation of ill patient to prevent spread of disease:
Isolation
A person who is contagious and can infect others:
Reservoir
To control the spread of microorganisms in health care facilities:
Hand hygiene before and after each patient
Patient with MRSA and is isolated, he feels depressed:
Explain to patient reason for isolation and answer questions
Patient with edema and liver cirrhosis, give:
Spironolactone
Patient using which diuretic might experience erectile dysfunction?
Thiazide
High ceiling and high efficiency diuretics:
Loop
Which of the following structures is lateral to urinary bladder in both males and females?
Obturator internus
Which of the following characterizes the collecting tubules?
Have large lumen and no brush border
Which of the following types of tissues predominate in lining the kidney tubules?
Simple cuboidal epithelium
Which of the following characterizes the membranous urethra?
Lined with pseudosratified columnar epithelium
If the kidney is found to be less echogenic than the liver, then kidney is said to be:
Hypo-echoic
Which of the following is considered the first-line diagnostic tests for prostate cancer?
The combination of DRE (digital rectal exam) and PSA (prostate specific antigen)​ assays
Which of the following factors decreases the peritubular capillary reabsorption?
Increased peritubular capillary hydrostatic pressure
Which of the following best describes glomerulotubular balance?
Tubular reabsorption matched to GFR
What percentage of prostate cancer originates form transitional zone of the prostate?
20%
Which of the following is considered the first serum marker for prostate cancer (historical point of view)?
Acid phosphatase
Which of the following represents the most commonly seen order of structures in kidney hilum?
Renal vein, 2 renal arteries, renal pelvis/ureter, renal artery
.
.
What's the function of intercalated cells in the distal tubules?
H secretion and K & HCO3 reabsorption
A 56-year-old lady presented to the clinic with a history of urine leakage that happened while she was exercising. What type of urinary incontenince is this?
Stress
As blood in vasa recta is flowing into the depths of medullary, what's going to happen?
It gains solutes and loses water (becomes hypertonic)
Voiding lower urinary tract symptoms include which of the following?
Hesitancy
Hormonal therapy is most effective with which type of prostate cancer?
Metastatic
Which of the following represents the infantile micturition center?
Sacral micturition reflex center
A 50-year-old man patient was treated for his resistant hypertension. Later on, he developed some enlarged tender breast tissue. What drug is he likely using?
Spironolactone
Which of the following drugs has a preventive role in acute mountain sickness?
Acetazolamide
The elevation behind the urethral opening in the bladder is created by superior extension of which part of the prostate?
Median lobe
Hyponatremic dehydration occurs in which of the following conditions?
Salt and water loss with only water replacement
What ions predominate in the interstitial fluid?
Na and Cl
Prostate cancer is associated with deficiency of which of the following vitamins?
Vitamin D
Which of the following contributes to the production of concentrated urine?
Decreased blood flow to medullary tissue
The use of which of the following represents a contraindication for use of PDE-5 inhibitors?
Nitrates (A phosphodiesterase type 5 inhibitor is a drug used to block the degradative action of cGMP-specific phosphodiesterase type 5 on cyclic GMP in the smooth muscle cells lining the blood vessels supplying the corpus cavernosum of the penis.)
A 45-year-old male patient presents with signs that made suspect he has urethral injury. They weren't able to insert the catheter. What's the most suitable imaging modality to assess his condition?
Ascending urethrography
A patient presents to the clinic with Hematuria. You suspect him to have renal mass. What's the modality of choice to start investigating the patient's condition with?
Renal ultrasound with Doppler
Which of the following decreases potassium excretion?
Acidosis
Which of the following is an action of aldosterone?
Increases ENaC (Epithelial sodium channel) activity at distal tubules
Which of the following enzymes catalyzes the rate limiting step in androgen biosynthesis
Cholesterol monooxygenase
Androgens affect carbohydrates and fast metabolism in what way?
Stimulate citric acid cycle
Which of the following is ideally used to measure GFR?
Inulin
Which of the following has the highest clearance?
PAH
In which part of the renal collecting system does the tubular fluid have the same tonicity or osmolality as the plasma?
PCT
Excess in which of the following can cause hypertension and hypervolemia (hypernatremia)?
Aldosterone
An IPSS score of > 19 indicate which of the following?
Severe symptoms
Which of the following increases the GFR in a normal healthy adult?
Increased hydrostatic pressure in glomerular capillaries
Which of the following combination therapy is most suitable for patients with voiding lower unready tract symptoms secondary to benign prostatic hyperplasia (BPH)?
Tamsulosin and Dutasteride
Which of the following diuretics should be avoided in patients having an allergy to sulfa-containing drugs?
Hydrochlorothiazide
Androgen produced from:
Leydig cells
Rate limiting enzyme in synthesis of androgens:
Cholesterol monooxygenase
Action of androgen:
synthesis of glucose from seminal vesicle
.
...
Which of the following decreases K excretion via principle cells?
Increased Na reabsorption across the proximal nephron
Which of the following factors is increased to cause penile erection?
Blood flow from hypogastric arterial system
IPSS score > 8 categorizes LUTS severity as:
Moderate
Which of the following is the cause of edema due to liver disease?
Deceased oncotic pressure in glomeruli
Which of the following is the main stimulus to activate thirst center and ADH release?
Hyperosmolality
A patient has serum creatinine of 200 and creatinine clearance of 38. He's in a steady state. What do you think about the performance or accuracy of Creatinine clearance in this case
Overestimates the GFR
The main goal in treating neurogenic bladder is:
To preserve renal function
An indication for surgical therapy of BPH?
Failure of medical therapy
Which part of the nephron is impermeable to water?
TALH
The radiologic study for a 64-year-old male presenting with painless microscopic hematuria is:
CT with IV contrast
Increase in which of the following will stimulate renin release?
Blood loss
Which of the following lies directly anterior to the left kidney?
Pancreas
A 65-year-old patient suffers a vascular cerebral infarction. He then develops a neurogenic bladder. How would you classify this etiology?
Supra-pontine
Which of the following is an event in PCT?
H is anti-ported against Na
Which of following causes bladder neck contraction and detrusor muscle relaxation upon stimulation?
Hypogastric plexus (Sympathetic supply)
Pulsatile contraction of which muscle is responsible for the ejection of sperms?
Bulbocavernosus
Best imaging tool for ureteric stones is:
KUB CT
The highest amount of water re-absorption occurs in:
Proximal tubule
The fluid leaving loop of Henli is: A- Hyper-tonic
Hypo-tonic
The action of ADH is mediated by which second messenger system ?
Cyclic AMP
The exchange of salts between the ascending limb of vasa recta and the ISF is?
Passive
Which Of the following is not a part of the filtration membrane?
Parietal epithelium of Bowman's capsule
Which of the following is a component in the ultrafiltrate and the plasma?
Glucose
Macula densa is found in which of the following?
DCT
Which of the following kidney structures would be palpable in Bimanual Examination on a normal adult?
Inferior Pole
The kidneys receive blood supply from the renal artery. Which lumbar Vertebra is at that level?
L2
44 year old male patient presenting with gross hematuria and right flank pain. He is suspected to have renal stones. Which of the following is the best imaging modality?
Unenhanced CT
Which of the following represents a right to the consumer of healthcare services?
Involvement in decision making
Which of the following is considered a portal of entry in the chain of infection?
Genitourinary tract
Most of the filtered potassium is reabsorbed in which part of the renal tubules?
PCT
The plasma level that saturates Transport Maximum for a transport system is?
Renal threshold
The only part of the renal tubular system that reabsorbs sodium passively is?
Thin ascending loop of Henle
Which of the following is an example of secondary active transport in the renal tubular system?
SGLT-2
The movement of water and solutes from interstitial fluid into peri tubular capillaries follows:
Starling forces
Which of the following is true regarding urine formation?
Secretion is movement of fluid that resembles plasma into the tubular system
Which of the following is the major anion in intracellular fluids?
HPO4
Which of the following is true regarding osmolarity in normal conditions?
Interstitial fluid and intracellular fluid osmolarity are equal
Which of the following represents an insensible mode of fluid loss?
Lungs (breath)
Immediate compensation to excessive fluid loss is mediated by?
Increase in cardiac output
Which of the following is NOT a component in the long term regulation of blood pressure?
Norepinephrine
The main clinical presentation of prostate cancer is:
Asymptomatic
A 75 year old patient with prostate cancer in only one lobe of the prostate and without extraprostatic extension. What stage of CaP is this patient?
T2
1st line investigation for screening and diagnosis of prostate cancer?
DRE + PSA
The most important long term complication of radical prostatectomy is:
Impotence
Hormone therapy is reserved as 1st line for palliative treatment at which stage of prostate cancer?
Metastatic
In case of injury to spinal cord level T9, which of the following is NOT a feature of pathologic voiding that would occur?
Areflexic bladder
Which of the following is true regarding the micturition reflex?
Somatic fibers are responsible for contraction of external urethral sphincter
Stimulation of parasympathetic fibers causes contraction of the detrusor muscle. This action is mediated by activation of which receptors?
Muscarinic
Which of the following drugs is used as a preventative measure for acute mountain sickness?
Acetazolamide
Which of the following is a Thiazide-like Diuretic?
Metolazone
Ischiocavernosal muscle contraction occurs in which phase of penile erection?
4
What drug causes Gynecomastia?
Potassium Sparing Diuretics
Detumescence and ejaculation are mediated by:
Sympathetic
The initial obligatory event in penile erection is:
Vascular
Psychogenic Erectile dysfunction will occur with:
Sudden loss of function
which of the following is true regarding surgical treatment of BPH?
Retrograde ejaculation occurs in 75% of cases
Which of the following is considered as a storage LUTS?
Urgency
Correction of severe symptomatic hyponatremia should be performed at an appropriate rate of 6- 12 mEq/L in the first 24 hours and 18 mEq/L or less in the 48 hours that follow. If those standards were not applied and the electrolyte imbalance was corrected rapidly, what is the major complication that could give rise to quadriplegia and locked-in syndrome?
Central Pontine Myelinolysis (Osmotic Demyelination Syndrome)