Dr. Song Ou-Yang | Urology Courses

7. Tumor of urinary and male-genital system

Tue, 08 Nov 2022 00:00:00 +0000

A1-Type (25 questions)

Which of the following does not belong to the histopathological type of renal cell carcinoma in 2004 WHO?

A. Mucinous tubular and spindle cell carcinoma
B. Papillary adenocarcinoma
C. Chromophobe cell carcinoma
D. Sarcomatoid carcinoma

Which of the following is not the manifestation of bladder cancer?

A. DWI was high signal, and the apparent diffusion coefficient was significantly lower than that of urine
B. Most of the tumors were found in bladder triangle and bilateral walls
C. T1w1 shows equal signal or high signal, and t2w1 shows slightly low signal
D. The first symptom is usually painless gross hematuria

Which of the following is the most common symptom of ureteral cancer ?

A. Frequent urination
B. Gross or microscopic hematuria
C. Urgent urination
D. Dysuria

Which of the following is the most reliable test for the diagnosis of renal cell carcinoma？

A. B-ultrasound
B. KUB and IVU
C. Renal arteriography
D. CT

Which of the following is the characteristics of bladder cancer?

A. Initial hematuria
B. Terminal hematuria
C. Painless gross hematuria
D. Hematuria

Which of the following is typical of hematuria in bladder cancer?

A. Painless gross hematuria
B. Terminal hematuria with bladder irritation
C. Initial hematuria
D. Pain with hematuria

Where is the most common metastasis site of prostate cancer?

A.Liver
B.Bone
C.Lung
D.Bladder
E.Brain

Which of the following types of hematuria should be considered first for bladder tumor?

A. Painless total hematuria
B. Terminal hematuria
C. Post-actively hematuria
D. Initial hematuria
E. Severe hematuria with blood clots

Initial hematuria indicates where the lesion is located?

A. Urethra
B. Bladder
C. The upper urinary tract
D. Bladder neck
E. Trigone of bladder

What diseases are most common in painless gross total hematuria?

A.Urinary tract tumors
B.Urinary tract infection
C.Urinary tract stone
D.Urinary tract anomalies
E.Urinary tract obstruction

Which of the following is a benign renal tumor?

A. Renal clear cell carcinoma
B. Nephroblastoma
C. Renal angiomyolipoma
D. Renal papillary cell carcinoma
E. Collecting duct carcinoma

What is the earliest clinical manifestation of nephroblastoma (William’s tumor)

A. Hematuria
B. Lower back pain
C. Abdominal mass
D. Hypertension
E. Fever

Which of the following is the most common cystic disease in human body? A. Renal cyst B. Liver cyst C. Prostate cyst D. Ureter cyst E. Spleen cyst A
What is the preferred treatment for non-muscle invasive bladder cancer?

A. TURBt
B. Radical cystectomy
C. Radiotherapy
D. Chemotherapy
E. Immunotherapy

What is the preferred treatment for muscle invasive bladder cancer?

A. TURBt
B. Radical cystectomy
C. Radiotherapy
D. Chemotherapy
E. Immunotherapy

What is the examination with the highest accuracy rate to diagnose prostate cancer?

A. Serum PSA level
B. DRE
C. MR of prostate
D. Transrectal ultrasound
E. Prostate biopsy

Which area of the prostate is the main site of prostate cancer?

A. Transition zone
B. Central zone
C. Peripheral zone
D. Urethral zone
E. Anterior fibromuscular stroma

Total hematuria indicates where the lesion is located?

A. Urethra
B. Prostatic Urethra
C. The upper urinary tract
D. Bladder neck
E. Trigone of bladder

What is the first choice examination for renal tumor?

A. X -ray examination
B. Ultrasonic examination
C. CT examination
D. MR examination
E. Endoscopic examination

What is the preferred treatment for kidney cancer smaller than 4cm?

A. Nephron sparing surgery
B. Radical nephrectomy
C. Radiotherapy
D. Chemotherapy
E. Immunotherapy

What kind of disease is the first consideration for infants with kidney tumor?

A. Renal cell carcinoma
B. Renal AML
C. Polycystic kidney disease
D. Wilms tumor
E. Renal pelvis cancer

When a high suspicion of prostate cancer is indicated, the serum PSA should be greater than__.

A. 4 ng/L
B. 10 ng/L
C. 20 ng/L
D. 30 ng/L
E. 40 ng/L

Painless hematuria in middle age should first be considered __.

A. Upper urinary tract stones
B. Urological tumor
C. urinary tract infection
D. urinary tract malformation
E. Prostatic hyperplasia

Which part of the prostate is the most common site of prostate cancer?

A. Bilateral lobe
B. Middle lobe
C. Transitional zone
D. Central zone
E. Peripheral zone

A 40-year-old female was found to have 2 × 3cm solid masses occupying in her left kidney by ultrasound during a physical examination. In order to further confirm the diagnosis, which of the following examination is most helpful?

A. CT
B. Urine cytology for malignant cells
C. excretory urography
D. Nuclear renin imaging
E. Retrograde pyelogram

A4-Type (20 questions)

Male, 56 years old, intermittent whole course gross hematuria with irregular blood clots and mild bladder irritation symptoms for more than 1 year. Weight loss of about 5kg since illness B-ultrasound showed that there was a space occupying lesion with a diameter of 5cm on the left wall of bladder, invading the bladder wall almost to the whole layer, and the lower segment of left ureter was dilated. General examination after admission: normal temperature, pulse 70 times / min, respiration 18 times / min, blood pressure 24 / 12kpa.

The most helpful diagnostic items for bladder cancer are

A. Urine cytology
B. Cystoscopy
C. Intravenous urography
D. Urine culture
E. Radionuclide renogram

The most suitable treatment is

A. transurethral resection of bladder tumor
B. partial cystectomy
C. Transurethral laser resection
D. Total cystectomy, urinary diversion
E. Intravesical chemotherapy and drug infusion

The most suitable treatment is

A. Transurethral resection of bladder tumor
B. partial cystectomy
C. Transurethral laser resection
D. Total cystectomy, urinary diversion
E. Intravesical chemotherapy and drug infusion

Female, 58 years old, intermittent painless gross hematuria for more than 2 months. No abnormality was found in physical examination. B-ultrasound examination showed that “there is a hypoechoic mass with a diameter of 4.5cm in the middle and lower part of the right kidney”

The most likely abnormality of this patient during intravenous nephrography is

A. Right hydronephrosis
B. The right kidney does not develop
C. Delayed development of right kidney
D. The middle and lower calices of the right kidney are elongated and displaced
E. The middle and lower calices of the right kidney are irregular, showing insect erosion like changes

The diagnosis is most likely

A. Renal cell carcinoma
B. Carcinoma of renal pelvis
C. Renal cyst
D. Renal hamartoma
E. Nephroblastoma

Which of following operation mode should be selected ?

A. Removal of right renal tumor
B. Right partial nephrectomy
C. Right kidney and partial ureterectomy
D. Excision of right kidney, perirenal fat sac andHilar lymphadenectomy
E. Sleeve resection of right kidney, right ureter and bladder near the orifice

No tumor metastasis was found during the operation. The first choice of treatment after operation is

A. Adjuvant chemotherapy
B. Adjuvant radiotherapy
C. Traditional Chinese medicine
D. Immunotherapy
E. Clinical observation

A 35 years old woman with persistent hypertension 24 / 16kpa (180/120mmhg), no obvious paroxysmal sharp rise in blood pressure, polyuria at ordinary times, polyuria at night, fatigue of limbs, inconvenient movement, suspected urinary tract infection, taking a variety of antibiotics, traditional Chinese medicine and general antihypertensive drugs have no obvious effect, and the similar situation has been more than years. Admission inspection: normal blood routine, urine culture: no bacterial growth, blood electrolyte: K +: 2.9mmol/L, Na +: 1 48mmol/L, total CO2: 38mmol /L, residual alkali: 5mmol/L, blood glucose: 6.0mmol/L, urea nitrogen: 9.3mmol/L, B-ultrasound: there is a left adrenal gland with a size of 1.6cm × 1.5cm space occupying lesion, initially diagnosed as left adrenocortical tumor, and the proposed treatment scheme is surgical treatment.

What kind of drugs are used for preoperative preparation 1 to 2 weeks before operation?

A. Blood transfusion and rehydration
B. Receptor stimulant
C. Supplement potassium ion solution or spironolactone diuretic
D. Use α Receptor stimulants
E. use of corticosteroids

What treatment do you choose ?

A. Total left adrenalectomy
B. Left adrenal tumor resection
C. Double adrenalectomy + corticosteroid replacement therapy
D. Total left adrenalectomy + partial right adrenalectomy
E. Non-surgical drug therapy

This patient may have

A. Adrenal reticular zone cortical adenoma
B. Adrenal fascicular zone cortical adenoma
C. Adrenal globular zone cortical adenoma
D. Adrenal medullary hyperplasia
E. Adrenocortical hyperplasia

Male, 56 years old, intermittent whole course gross hematuria for more than 1 year. Hematuria is accompanied by irregular small blood clots and mild bladder irritation symptoms, no fever, and the weight loss is about 3kg. B-ultrasound revealed a diameter 4cm tumor on the left wall of the bladder. The invasion of the bladder wall reached almost full thickness, and the upper segment of the left ureter was dilated,suggesting bladder cancer. Physical examination: the temperature is normal.

Which of the following is the most helpful examination for bladder cancer?

A. Urine cytology
B. Intravenous urography
C. Urine culture
D. Cystoscopy
E. Radionuclide renogram

The most appropriate treatment for this patient is

A. Transurethral resection of bladder cancer
B. Partial cystectomy
C. Total cystectomy and urinary diversion
D. Transurethral laser resection of bladder tumor
E. Intravesical infusion of chemical drugs
Male, 51 years old, who was healthy in the past and had two times of gross hematuria in recent 4 months. CT examination found solid space occupying lesions in the right renal parenchyma and right renal vein. The outpatient was admitted to the hospital with “right renal cancer and right renal vein embolism”

Which of the following medical history is least likely to exist?

A. Fever
B. Low back pain
C. Frequent urination
D. Emaciation
E. Hemoptysis

The patient also had inferior vena cava thrombosis. The signs reflecting this situation should be

A. Anemia appearance
B. Hypertension
C. Right upper abdominal mass
D. Right varicocele
E. Right lower limb paralysis

KUB + IVP showed that the right renal collecting system was compressed and deformed, the right ureter was normal, the morphology and function of the left kidney was normal, the left ureter was normal, the bladder was normal, and B-ultrasound: the hepatobiliary membrane and spleen were normal. Which of the following examinations is essential to further diagnosis?

A. Renal CT
B. Chest anteroposterior and lateral film
C. Cystoscopy
D. Renal arteriography
E. Right retrograde nephrography

Male, 66 years old. Painless gross hematuria with strip blood mass for 2 months. B-ultrasound showed mild hydronephrosis in the left kidney. No cancer cells were found in 2 times cytological examinations.

Which of the following tests is most valuable for further diagnosis and treatment

A. Blood routine, liver and kidney function
B. Urography and excretory urography
C. Cystoscopy
D. Cystography
E. MRI

If there seems to be a filling defect in the left renal pelvis, urine cytology is suspicious cells. Which of the following is the most reasonable inspection?

A. CT
B. MRI
C. IVU
D. Left renal retrograde angiography
E. Left renal puncture angiography

Patient, male, 53 years old. In the past week, there was no inducement, terminal hematuria 3 times, no fever, no frequent urination, urinary pain and other discomfort. Smoking for 20 years. Chest X-ray showed old pulmonary tuberculosis with a large number of red blood cells by uroscopy.

The most likely diagnosis for this patient is

A. Acute nephritis
B. Bladder cancer
C. Renal cell carcinoma
D. Renal tuberculosis

What is most helpful for the patient to make a clear diagnosis?

A. Urine cytology
B. Intravenous urography
C. B-ultrasound of urinary tract
D. Cystoscopy

X-Type (5 questions)

1.Familial renal cell carcinoma mainly includes

A. VHL syndrome
B. Hereditary papillary renal cancer
C. Hereditary leiomyomatosis renal cell carcinoma
D. BHD syndrome

Which of the following are absolute indications for nephron sparing renal cell carcinoma surgery？

A. Congenital solitary kidney
B. Contralateral renal insufficiency or nonfunction
C. Hereditary renal cell carcinoma
D. Stage T1b renal cell carcinoma (contralateral renal function normal)

Which of the following are indications for bacillus calmette guerin(BCG) intravesical instillation therapy?

A. T1 G3 bladder tumor (or high-grade urothelial carcinoma)
B. Carcinoma in situ of bladder
C. Stage T2 (myometrial invasive) bladder tumor
D. Multiple and recurrent TaG1 or G2 bladder tumors (or low-grade urothelial carcinoma)

Which of the following are Indications for prostate biopsy?

A. Abnormal images of prostate were found by B-ultrasound, CT or MRI, or nodules were touched by digital rectal examination
B. FPSA > 10NG / ml
C. TPSA > 10NG / ml
D. TPSA is 4-10ng / ml, fPSA / TPSA ratio is abnormal or PSAD value is abnormal

Which of the following are Indications of endocrine therapy for prostate cancer?

A.Patients with urinary incontinence after radical surgery for prostate cancer
B.Recurrent and metastatic prostate cancer
C.Adjuvant therapy before radical surgery or radiotherapy for prostate cancer
D.Patients with localized early prostate cancer, or local progressive prostate can not be operated on

Answer

A1-Type

DCBDC ABAAA BCAAB ECCBA DBBEA

A4-Type

BBEDA DDEAC DCEDA BDEBD

X-Type

ABCD ABC ABD ACD BCD

5. Obstruction of urinary tract

Sun, 08 Nov 2020 00:00:00 +0000

A1-Type (20 questions)

When a patient has benign prostatic hyperplasia，which of the following symptoms should not be treated with drugs?

A. With bilateral hydronephrosis
B. Concomitant microscopic hematuria
C. Delayed urination
D. Frequent urination and urgency

Which of the following factors has nothing to do with urinary incontinence after benign prostatic hyperplasia?

A. Bladder urethral angle change
B. Long operation time
C. Low compliance bladder
D. Posterior urethral injury stimulation and prostatic fossa wound infection

Which of the following factors has nothing to do with the symptoms of patients with benign prostatic hyperplasia?

A. Is there any stone
B. Degree of lesion development
C. General health status of patients
D. Is it complicated with inflammation

If a patient with benign prostatic hyperplasia suspects prostate cancer, which of the following tests does not work?

A. Digital rectal examination（DRE）
B. CT
C. MRI
D. Serum PSA level

Which of the following is not included in the differential diagnosis of BPH？

A. Bladder neck contracture
B. Neurogenic bladder
C. Prostate cancer
D. Dladder diverticulum
E. Urethral stricture

Which of the following is the most common cause of hydronephrosis？

A. Double ureteral stenosis
B. Ureteral stone
C. Lower urinary tract obstruction
D. Bladder tumor
E. Ureteral malformation

Which of the following is the preferred method to relieve urinary tract obstruction

A. Indwelling catheterization
B. Cystostomy
C. Nephrostomy or percutaneous nephrostomy
D. Ureterostomy
E. Find out the cause and remove the primary disease

Which of the following conditions of benign prostatic hyperplasia is not suitable for drug treatment?

A. Concomitant microscopic hematuria
B. Frequent urination and urgent urination symptoms are serious
C. Concomitant hydronephrosis
D. Concomitant urinary tract infection
E. Delayed urination

Which of the following is the basis for distinguishing prostate cancer from benign prostatic hyperplasia?

A. Age of onset
B. Degree of dysuria
C. Determination of residual urine volume
D. PSA (prostate specific antigen)
E. Cystography

Which of the following is the most meaningful diagnostic method for hydronephrosis?

A. Physical examination renal palpation
B. Ultrasonic imaging
C. Isotope renal scan
D. Eexcretory and retrograde urography
E. Renal X-ray plain film

Which of the following renal function indicators is generally not affected after renal obstruction？

A. Glomerular filtration rate
B. Renal blood flow
C. urine concentration capacity
D. urinary acidification capacity
E. Urine dilution capacity

For the reference index of hydronephrosis, the thickness of most renal cortex is______

A. <3mm
B. <5mm
C. <2mm
D. >3mm
E. >2mm

Which of the following is a common cause of congenital ureteropelvic junction (UPJ) obstruction？

A. Stone
B. Intraluminal stenosis
C. Retroperitoneal fibrosis
D. Vagal vascular compression
E. Tuberculosis

Which area of the prostate is the main site of benign prostatic hyperplasia(BPH)?

A. Transition zone
B. Central zone
C. Peripheral zone
D. Urethral zone
E. Anterior fibromuscular stroma

What is the most important symptoms of benign prostatic hyperplasia?

A. Frequency of urination
B. Urgency of urination
C. Dysuria
D. Progressive difficulty urinating
E. Infection

What are the most common causes of ureteropelvic junction obstruction (UPJO)?

A. Stone
B. Stricture
C. Vascular compression
D. Tumour
E. Dynamic obstruction

What is the most common and earliest symptoms of benign prostatic hyperplasia?

A. Frequency of urination
B. Urgency of urination
C. Dysuria
D. Progressive difficulty urinating
E. Infection

What is the earliest symptom of BPH?

A．Hematuria
B．Difficulty in urination
C．Frequent urination
D．Urinary retention
E．Urinary pain

Which part of the prostate is the most common site of prostatic hyperplasia?

A. Bilateral lobe
B. Middle lobe
C. Transitional zone
D. Central zone
E. Peripheral zone

What is the differential basis between benign prostatic hyperplasia and prostate cancer?

A. Age of onset
B. Degree of dysuria
C. Measurement of residual urine volume
D. Serum PSA measurement
E. Cystography

A2-Type (15 questions)

The patient,a 28 years old male, right lumbar dull pain for 1 week with chills and fever for 3 days. Physical examination: T: 38.5 °, indifferent expression, percussion pain of right kidney, previous history of urinary stone. B-ultrasound of urinary system showed severe hydronephrosis in the right kidney, enhanced echo of hydronephrosis in the renal pelvis, mild hydronephrosis in the left kidney, 0.4cm thick right renal cortex and 1.6cm thick left renal cortex. The blood biochemical test showed that the renal function was normal. The first treatment for the patient is______

A. Right nephrostomy
B. Right ureteropelvic junction plasty
C. Right nephrectomy
D. Left nephrectomy

The patient, a 22-year-old male, was treated for “hydronephrosis for half a year”. Meningocele was found at birth and operated at 8 months old. The patient had difficulty urinating since childhood, accompanied by frequent urination and dry stool, but had not been examined. Hydronephrosis was found in both kidneys during physical examination half a year ago. Urinary B-ultrasound showed moderate hydronephrosis in both kidneys, and the residual urine volume was 50ml. The maximum urine flow rate was 12.3ml/s and the urine volume was 130ml. Serum creatinine was 150 μmol/L。What should you do with the patient at this time?

A. Double nephrostomy
B. Transfer to nephrology clinic
C. Indwelling catheter and continuous bladder drainage
D. Ask the patient to urinate by pressing the abdomen and recheck regularly

The patient, a 56 years old female, was hospitalized for “progressive aggravation of bilateral hydronephrosis for 3 months half a year after endometrial cancer surgery”. The patient underwent double adnexectomy and extended lymphadenectomy for endometrial cancer six months ago. Dysuria occurred after operation, and urinary B-ultrasound showed hydronephrosis. Hydrocephalus is gradually aggravated. At present, it is severe hydrocephalus, and the blood creatinine is 455 μmol/L.The residual urine of urinary system B-ultrasound was 230ml, the maximum urinary flow rate was 8.5ml/s, and the urine volume was 180ml. The most likely cause of bilateral hydronephrosis is_____

A. Indwelling urinary catheter during operation causes urethral injury and urethral stricture
B. The operation injured the pelvic plexus, resulting in neurogenic bladder dysfunction
C. Extensive dissection during operation damaged the blood supply of bladder and led to bladder dysfunction
D. Postoperative pain, resulting in dare not urinate

The patient, a 42 years old female, was hospitalized mainly because of “frequent urination with intermittent bed wetting at night for 1 year”. The patient had a history of diabetes for 10 years, oral hypoglycemic drugs, but poor blood glucose control. The patient had no obvious urinary incontinence and dysuria during the day. The best treatment for this patient is_____

A. Long term indwelling catheter
B. Long term indwelling cystostomy tube
C. Intermittent cleaning and self catheterization
D. Waiting for observation

The patient,a 70 years old male, was treated for acute urinary retention in emergency department. Physical examination: swelling of bladder area. At this point, the most important processing is_______

A.Contact the urologist on duty and perform B-ultrasound examination at the same time
B.Digital rectal examination was performed to determine the size of prostate
C.Indwelling catheterization and drainage of urine
D.Ask the patient to refrain from drinking and apply a hot towel to the lower abdomen

The patient,a 82 years old male. After drinking the day before yesterday, he had abdominal pain, frequent urination and less volume. Usually, the stool is dry, once every 2 ~ 3 days. Physical examination: the abdomen is swollen, the lower abdomen is marked, the whole abdomen is tender, the lower abdomen is heavier, the muscle tension is not obvious, and the bowel sound is active. After enema with soapy water, more feces were excreted, and abdominal pain was not significantly relieved. The most likely diagnosis for this patient is______

A. Acute cystitis
B. Acute urinary retention
C. Sigmoid volvulus
D. Habitual constipation

A 32 years old male patient was diagnosed with right renal tuberculosis one year ago and underwent right nephrectomy. He continued to use antituberculous drugs after operation, but his urinary frequency did not improve. IVP (intravenous pyelography) showed mild hydronephrosis in the left kidney and a bladder the size of a table tennis ball. Treatment should be considered______

A. Continue anti tuberculosis treatment
B. Nephrostomy
C. Left ureterostomy
D. Left nephrectomy
E. Colonic augmentation cystoplasty

A 29 years old male patient underwent left kidney and left ureterectomy for tuberculosis of the left kidney, left ureter and bladder one year ago. After the operation, he was treated with anti tuberculosis for 8 months. At present, the routine urine examination of the patient is negative. IVP shows mild hydronephrosis in the right kidney, but the symptoms of frequent urination are significantly aggravated. The reason is______

A. Urethral syndrome caused by tuberculosis
B. Failure to control bladder tuberculosis
C. Tuberculosis recurrence
D. Complicated with urinary system infection
E. Bladder contracture

The patient is a 70 years old male who can’t urinate for 8 hours after drinking, has unbearable lower abdominal distension, and has had “prostatic hypertrophy” for 5 years. Examination: suprapubic swelling and percussion sound. Which of the following processing is wrong?

A. Hot compress in bladder area
B. Catheterization
C. Intravenous diuretics
D. Suprapubic cystostomy
E. Oral antibiotics

A 80 years old male patient, had progressive dysuria and repeated urinary retention for 3 years. Past diabetes, coronary heart disease and hypertension. Physical examination: the prostate is Ⅱdegree hypertrophic, with smooth surface and hard elasticity. Urea nitrogen: 15mmol / L. The bottom of the bladder reaches the two transverse fingers under the umbilicus. Which of the following is the best treatment?

A. Simple catheterization
B. Suprapubic cystostomy
C. transurethral resection of the prostate
D. Transvesical prostatectomy
E. Oral diethylstilbestrol

The patient is a 30-year-old male with no urine for 1 day. He has had severe pain in the back waist twice in the past year. In order to clarify the cause of urinary closure. Which of the following is the preferred check?

A. Transvenous pyelography
B. Retrograde pyelography
C. Renal angiography
D. Renal CT examination
E. KUB plain film

The patient was 73 years old, with frequent micturition, weak voiding, thin urine, and not finishing urination , and had been aggravated for more than 10 years. Past: diabetes for 15 years, has been taking medication. Which of the examinations that should be done in the first visit is not necessary?

A. Anal examination
B. Urinary flow rate
C. Urinary ultrasound and residual urine volume examination
D. Blood biochemistry and PSA examination
E. IVP+KUB

The patient, a 5-year-old male, complained of intermittent swelling and pain in the right waist in recent 1 year, no hematuria, frequent urination, urgency and pain, and no dysuria. Physical examination: the right upper abdomen is slightly full. A soft mass can be touched in the right renal area, and move up and down with breathing. Which of the following diseases is the patient most likely to have?

A. Ureteropelvic junction stenosis
B. Nephroblastoma
C. Posterior urethral valve
D. Neurogenic bladder due to meningocele
E. Renal cell carcinoma

A 62 year old male patient came to see a doctor because of dysuria for 6 years and inability to urinate for 1 day. The cystic mass was palpated in the lower abdomen. By digital rectal examination, the prostate was II degree swollen, tough, smooth, and the central sulcus disappeared. Blood PSA 2ng / ml,BUN 15mmol/L, Cr 267μmol/L. Which of the following is the most likely diagnosis?

A. Prostate cancer
B. Benign prostatic hyperplasia
C. Prostate sarcoma
D. Prostatitis
E. None of the above

The patient was a 25-year-old female with right low back pain for 1 month. The right kidney hydronephrosis was found by B-ultrasound, the right kidney was not developed by IVP, and the left kidney was normal. The case was finally diagnosed as right pyeloureteral junction stenosis with huge hydronephrosis, and the thickness of renal cortex was 1.0cm. The best treatment is______

A. Right pyeloureteroplasty
B. Right pyelostomy
C. Right nephrectomy
D. Right ureteral dilatation
E. Close follow-up

A3-Type (20 questions)

Male, 73 years old, frequent micturition and urgent micturition for 5 years. In recent 1 year, he had slow micturition, thin urinary line and dripping after micturition. He had two cerebral infarction five years ago, which was significantly improved after 2 years of neurologic treatment. At present, he has no other obvious sequelae except walking slightly unstable

Which examination is not necessary at the first visit of the patient?

A. Cystoscopy for prostate size
B. Digital rectal examination
C. Serum PSA
D. urinary flow rate
E. Prostate ultrasound to understand the size of prostate and residual urine

The patient’s urine flow rate was checked three times, and the urine volume was 70 At 100, Qmax is 8ml / s. Which of the following is the most reasonable treatment methods？

A. Recheck the urine flow rate again, and the urine volume should be more than 150ml
B. The urine flow rate of the existing urine volume was used as a reference
C. The balloon urinary catheter was indwelling, 150 normal saline was injected, and then the urinary catheter was removed for urinary flow rate examination
D. Clamp the patient’s anterior urethra until 150ml is saved, and then check the urinary flow rate
E. After direct injection of more than 150ml normal saline through the urethra, the urinary flow rate was checked immediately

If you want to determine whether the patient has dysuria caused by benign prostatic hyperplasia to decide whether to perform prostatectomy, which of the following tests is best？ A. CT examination of prostate B. Cystourethrography c. Renogram or dynamic renal scan D. Urodynamic examination E. Prostate biopsy confirmed the presence or absence of benign prostatic hyperplasia D

A 5 years old boy, found right abdominal mass in bath for 1 month. Physical examination: There is a mass in the right upper abdomen, 3cm below the costal margin, soft. B-Ultrasound showed severe hydronephrosis in the right kidney, and the thickness of renal cortex was 0.5cm. He can not cooperate with intravenous nephrography.

In order to understand the location and degree of renal and ureteral obstruction, Which of the following is the most appropriate inspection?

A. CT plain scan
B. M positive water imaging examination
C. Radionuclide renogram
D. Dynamic scanning of radionuclides in kidney
E. Transvesicoscopic retrograde nephrography and ureterography

Under analgesic anesthesia, ultrasound-guided right nephrostomy and angiography showed that the junction of nephrostomy and ureter was narrow. The drainage volume of fistula tube was about 400ml per day, and the proportion of drainage urine was 1.015. What is the most reasonable treatment for the patient？

A. Right nephrectomy
B. Permanent right nephroplasty
C. Total resection of right kidney and ureter
D. Remove the nephrostomy tube and maintain the original state
E. Right nephroureteroplasty

Which of the following tests is most necessary before surgery to determine whether the affected kidney should be removed？

A. CT plain scan
B. MRI Hydrography
C. Radionuclide renogram
D. Dynamic scanning of radionuclides in kidney
E. IVP check

Male, 76 years old, was hospitalized because he could not urinate for 10 hours. The patient had dysuria for 3 years, often interrupted urinary flow, and could resume micturition after changing posture. Urinate 3 ~ 5 times at night. Physical examination: generally good, the lower abdomen is swollen, and the voiced boundary is located at 2 fingers under the umbilicus. There are several 2 ~ 4cm strong light masses in the bladder by B-ultrasound.

The patient’s diagnosis was

A. Benign prostatic hyperplasia with urinary tract infection
B. Urethral stricture
C. Benign prostatic hyperplasia
D. Neurogenic bladder
E. Benign prostatic hyperplasia with bladder stones

If the diagnosis is clear, the first reasonable treatment should be

A. Insert a catheter to make the urine flow out slowly without indwelling the catheter
B. Urgent cystostomy
C. Suprapubic bladder puncture to extract urine
D. Antibiotics and diuretic therapy, continue to observe
E. Indwelling catheter after catheterization

After admission, the patient’s heart, lung and kidney functions were good, and he was ready for open surgery to remove the prostate. The reasonable treatment was

A. Transurethral resection
B. transvesical resection
C. retropubic resection
D. transperineal resection
E. presacral resection

A 16-year-old male, with acid swelling in the right waist and aggravation after fatigue, came to see a doctor without a history of fever and renal colic. Ultrasound showed moderate hydronephrosis in the right kidney. Urine routine is normal.

The initial diagnosis should be considered as

A. Renal tuberculosis
B. Renal tumor
C. Congenital posterior urethral valve
D. Congenital stricture of nephroureteral junction
E. Right ureteral stone

What further inspection should be done first?

A. Retrograde ureterography
B. Intravenous urography
B. CT
D. Abdominal plain film
E. Radionuclide scanning

If the diagnosis is clear, which of following treatments should be selected？

A. Right nephrectomy
B. drug therapy
C. Permanent nephrostomy
D. Right nephroureteroplasty

Male, 76 years old, was hospitalized because he could not urinate for 10 hours. The patient had dysuria for 3 years, often interrupted urinary flow, and could resume micturition after changing posture. Urinate 3 ~ 5 times at night. Physical examination: the lower abdomen is swollen, and the voiced boundary is located at 2 fingers under the umbilicus. There are several 2 ~ 4cm strong light masses in the bladder by B-ultrasound.

The case has a 3-year history. After questioning the history, it should be emphasized that the initial symptoms of patients with benign prostatic hyperplasia is

A. Urinary leakage
B. Laborious urination
C. Frequent urination
D. Urinary incontinence
E. Hematuria

Which part of the patient’s prostate should be removed?

A. Compressed and narrow posterior urethra
B. Seminal caruncle
C. Total prostate
D. Benign prostatic hyperplasia
E. Benign prostatic hyperplasia and prostatic capsule

Which of the following is not a pathological change caused by lower urinary tract obstruction in benign prostatic hyperplasia?

A. Bladder wall hypertrophy
B. ureteral reflux
C. hydronephrosis
D. Impairment of renal function
E. Atypical hyperplasia of bladder mucosa

Male, 73 years old, has frequent micturition, weak voiding, thin urine, and not finishing urination. It has been aggravating for more than ten years and often occurs acute urinary retention. Past history: diabetes 15 years, medication treatment.

The most unlikely problem for patients is

A. Benign prostatic hyperplasia
B. Chronic urinary retention
C. Detrusor weakness
D. Detrusor - External sphincter dyssynergia
E. Overactive bladder

Which of the examinations that should be done in the first visit is not necessary?

A. Anal diagnosis
B. Urinary ultrasound and residual urine volume examination
C. Blood biochemistry and PSA
D. IVP and KUB

According to the examination results, the diagnosis of benign prostatic hyperplasia and diabetes is clear. In order to decide whether or not to undergo prostatectomy, which of the following examinations is the best?

A.prostate CT
B.Cystoscopy
C.Renal radionuclide scan
D.Urodynamic examination
E.Prostate biopsy

Female, 25 years old, right low back pain for 1 month, right hydronephrosis was found by B-ultrasound, IVP, right kidney did not develop, and left kidney was normal.

The next examination method is

A. Right retrograde intubation angiography
B. Right renal puncture angiography
C. CT
D. MRI
E. Renogram

The above case was finally diagnosed as right renal Meng ureteral junction stenosis with giant hydronephrosis, and the thickness of renal cortex was 1.0cm. The best treatment is

A. Angioplasty of right renal ureteral junction stenosis
B. Right nephrostomy
C. Right nephrectomy
D. Right ureteral dilatation
E. Conservative treatment

B1-Type (10 questions)

A. Radionuclide scanning
B. B-type ultrasonic
C. Intravenous pyelography
D. Puncture pathological examination
E. Urodynamic examination

It can be used to distinguish benign prostatic hyperplasia from prostate cancer
It can be used to distinguish benign prostatic hyperplasia from neurogenic bladder

A. Filling incontinence
B. Paroxysmal hypertension
C. Interruption of urination
D. Two upper abdominal masses
E. Painless hematuria

Benign prostatic hyperplasiamay cause
Polycystic kidney may cause
Pheochromocytoma may cause

A. Drug therapy, such as hormone and a receptor blocker
B. Catheterization
C. Prostatectomy or transurethral resection of prostate
D. cystostomy
E. Antibiotics

Male, 70 years old, with significant frequent urination in recent two years, laborious urination, gradually aggravating, unable to urinate for one day.
The patient was ineffective in taking medication, repeated urinary retention, physical examination, large degree prostate, anal sphincter.Normal tension normal ECG.
One month after prostatectomy, the patient still had frequent urination, routine urination and leukocyte 3-5 /HP.
male, 75 years old, had a urinary retention before March. At present, frequent micturition and dysuria occurred five years ago.Acute myocardial infarction occurs, and the current heart condition is relatively stable.
Male, 68 years old, progressive dysuria for three years, nocturia 4-5 times / day, no special diseases in other systems. B-ultrasound showed benign prostatic hyperplasia with residual urine of 120ml.

X-Type (5 questions)

What are the possible reasons of acute urinary retention？

A. Urethral injury
B. Benign prostatic hyperplasia
C. Acute injury of central nervous system
D. Drug factors

The determinations of urinary flow rate without clinical guiding significance are______

A. Maximum urinary flow rate
B. Mean urinary flow rate
C. Urinary flow time
D. Urethral pressure

The two most commonly used drugs for benign prostatic hyperplasia are_______ A. 5α Reductase inhibitor B. 5α Reductase agonist C. α Receptor agonist D. α Receptor blocker
Which of the following are complications of benign prostatic hyperplasia？

A. Renal failure
B. Canceration
C. Inguinal hernia
D. Painless hematuria

Which of the following are common causes of male acute urinary retention?

A. Benign prostatic hyperplasia
B. Urinary tract stenosis
C. Urinary stone
D. Prostatitis

Answer

A1-Type

ABCBD CECDD ECBAD BACCD

A2-Type

ACBCC BEECB EEABA

A3-Type

AADBA DEEBD BECDE EDDAA

B1-Type

DEADB BCECC

X-Type

ABCD BCD AD ACD ABC

6. Urinary stone disease (Urolithiasis)

Sun, 08 Nov 2020 00:00:00 +0000

A1-Type (20 questions)

Which of the following is the best treatment for bladder diverticulum stones?

A. Transurethral electrohydraulic lithotripsy
B. Transvesical mechanical lithotripsy
C. Suprapubic bladder lithotomy
D. Expel stones through Chinese herbal medicine
E. Extracorporeal shock wave lithotripsy

Which of the following is not a concomitant sign of downward movement of ureteral stones?

A. Fever
B. Hematuria
C. Lumbar colic
D. Nausea and vomiting
E. Irritability

Which of the following is wrong when using antibiotics in extracorporeal shock lithotripsy?

A. Antibiotics are generally not given
B. Use when white blood cells in urine exceed normal before treatment
C. Use when stones are large
D. Conventional application
E. Use when there are symptoms of infection

Which of the following is the characteristic of hematuria of renal ureteral stones?

A. Painless gross hematuria
B. End stage hematuria
C. Hematuria with bladder irritation
D. Hematuria with dysuria
E. Low back pain and hematuria after exercise

On the incidence of urinary stones, which of the following is wrong?

A. More men than women
B. More south than North
C. Upper urinary stones are common in China
D. There are more primary stones than secondary stones in bladder stones
E. The etiology of urinary stone is unknown

After unilateral ureteral obstruction for more than _______, renal function will change irreversibly to a certain extent.

A. 1 hour
B. 12 hours
C. 24 hours
D. 48 hours
E. 72 hours

Which of the following is a typical feature of bladder stones?

A. Hematuria with lumbar colic
B. Frequent urination, urgency and pain
C. Pyuria
D. Dysuria, interruption of urine flow, and urination after changing body position
E. Increased nocturia and progressive aggravation of dysuria

The main method to diagnose urinary stone is______

A. Ultrasonic examination
B. Radionuclide renogram
C. Radionuclide renal scan
D. Excretory urography
E. Feeling of falling in perineum

Which of the following is most likely to have hematuria with colic?

A. Kidney stone
B. Renal tuberculosis
C. Renal tumor
D. Nephroptosis
E. Renal edema

The patient had bladder irritation and radiation pain in the urethra and penile head. The most likely diagnosis was？

A. Distal ureteral stone
B. Middle ureteral stone
C. Renal pelvis stones
D. Upper ureteral stone
E. Renal calyceal stones

What is the preferred treatment for urinary stones below 2cm?

A. MET
B. ESWL
C. URL
D. PCNL
E. LUL

Which of the following types of stone is not urinary tract stone?

A. Kidney stone
B. Ureter stone
C. Gallbladder stone
D. Bladder stone
E. Urethral stone

Which is the most chemical type of urinary stone?

A. Calcium stone
B. Struvite stone
C. Uric acid stone
D. Cystine stone
E. Phosphate stone

What is the preferred treatment for urinary stones above 2cm?

A. MET
B. ESWL
C. URL
D. PCNL
E. LUL

Which are the typical symptoms of bladder stones?

A. Hematuria with lumbar colic
B. Pus urine
C. Increased nocturia and aggravation of urination
D. Difficulty in urination, interruption of urine flow, change of position can be urinated again
E. Urinary frequency, urinary urgency, and pain

Which is the most common clinical urinary tract stones?

A. Uric acid stones
B. Phosphate stones
C. Oxalate stones
D. Cysteine stones
E. Xanthine stones

17.Pain and hematuria associated with activity should first be considered ___.

A. Upper urinary tract stones
B. Urological tumor
C. Urinary tract infection
D. Urinary tract malformation
E. Prostatic hyperplasia

Which of the following types of hematuria should be considered first for renal and ureteral stone?

A. Painless total hematuria
B. Terminal hematuria
C. Post-actively hematuria
D. Initial hematuria
E. Severe hematuria with blood clots

Which disease is commonly associated with symptoms of interrupted urination.

A. Bladder cancer
B. Kidney stone
C. Ureteral stones
D. Bladder stones
E. Penile cancer

Which of the following types of hematuria should be considered first for renal and ureteral stone?

A. Painless total hematuria
B. Terminal hematuria
C. Post-actively hematuria
D. Initial hematuria
E. Severe hematuria with blood clots

A2-Type (20 questions)

The patient, a 39 years old female, was hospitalized for left lumbar acid and swelling. Ultrasound showed hydronephrosis in the left renal pelvis and a 2.1cm stone in the renal pelvis. IVP showed moderate hydronephrosis in the left kidney, unobstructed ureter and normal right kidney. The best treatment for this patient is____

A. Transrenal sinus lithotomy
B. Percutaneous nephrolithotomy
C. Observe and wait for the aggravation of ponding before treatment
D. Extracorporeal Shock Wave Lithotripsy (ESWL)

The patient, a 25-year-old female, had right lower abdominal pain with irritation sigh of bladder in recent six months. Physical examination: soft abdomen, deep tenderness in the right lower abdomen and tapping pain in the right waist. Urine routine: red blood cell(+ +), white blood cell (+). Renogram: right obstructive curve, what disease should be considered?

A. Right lower ureteral stone
B. Acute appendicitis
C. Chronic adnexitis
D. Chronic cystitis

The patient, a 32-year-old male with severe pain in the right waist for 1 hour,was accompanied by nausea and vomiting. The pain radiated to the inner thigh. Urine routine: red blood cell: 10 ~ 20 / HP, white blood cell: observed occasionally. The most reasonable diagnosis for the patient was______

A. Staghorn stone of right kidney
B. Ureteral stone
C. Bladder stone
D. Renal tuberculosis
E. Renal tumor

Male, 50 years old, recurrent renal colic for 3 years, often with small stones in urine. He came to the outpatient department and asked the doctor to guide preventive measures. Which of the following factors has nothing to do with promoting the formation of upper urinary tract stones?

A. There is too much meat in the diet
B. Long term bedridden
C. There is too little cellulose in the diet
D .Increased urinary citrate
E. Renal tubular acidosis

The patient, a 45 years old female, with a history of recurrent urinary tract infection for 4 years. Recently, B-ultrasound found right kidney stone with hydronephrosis. The urinary pH was 7.5. The most likely component of this stone was_____

A. Cystine stones
B. Xanthine stones
C. Urate stones
D. Oxalate stone
E. Phosphate stoness

The patient is a 30-year-old male with no function of left renal tuberculosis, 2 right ureteral stones with a diameter of 1.5cm, hydronephrosis in the right kidney and no uremia. What should be done first?

A. Anti tuberculosis treatment, waiting for stones to be discharged
B. Immediate ureterolithotomy
C. Right ureterolithotomy under anti tuberculosis treatment
D. Drainage of right hydronephrosis
E. Remove the nonfunctional left kidney

The patient was a young male with sudden epigastric pain, nausea and vomiting. Routine urine examination showed that the field of vision was full of red blood cells, 5-10 white blood cells / HP, and the blood routine was normal. Considering the right ureteral stone, the most appropriate emergency treatment method was_______

A. Drink plenty of water
B. Oral antibiotics
C. Anti inflammatory, antispasmodic and analgesic
D. ESWL
E. Surgical exploration

The patient, a 29 years old female, was treated for 3 months due to blunt pain in the left waist. After B-ultrasound and KUB + IVP examination, it was found that there was a 2.0cm×3.0cm stone in the left renal pelvis, left hydronephrosis, left ureter and right kidney and ureter were normal. The preferred treatment for the patient was_____

A. Traditional Chinese medicine stone removal
B. Temporary observation
C. Endoscopic lithotripsy
D. Open surgery
E. Extracorporeal shock wave lithotripsy (ESWL)

The patient was male, 67 years old. B-ultrasound found that the diameter of bladder stones was 1.5cm, combined with bladder diverticulum. Which of the following treatments is most appropriate？

A. ESWL
B. Traditional Chinese medicine stone removal
C. Self dumping
D. Cystoscopic mechanical lithotripsy
E. Cystolithotomy

The patient was a 47 years old male with a height of 170cm and a weight of 110kg. Pyelography showed moderate hydronephrosis in the left kidney and stones in the middle of the left ureter, with a diameter of 1.5cm,the stone in the upper segment of the right ureter is 1.2cm, and there is no hydronephrosis in the right kidney. The best treatment is_____

A. Simultaneous bilateral extracorporeal impact lithotripsy
B. First left extracorporeal impact lithotripsy
C. First left nephrostomy
D. Open the left ureter and take stones first
E. Retrograde catheterization of left ureter to drain urine

The patient had a stone in the upper right ureter with a diameter of 1.0cm. Excretory urography showed mild hydronephrosis in the right kidney. After 3 months of non-surgical treatment, KUB rechecked that the stone moved down 1.0cm. How should it be treated？

A. Right pyelostomy
B. Review after 3 months of non-surgical treatment
C. Integrated traditional Chinese and Western medicine treatment
D. Ureterolithotomy
E. Oral antibiotics to prevent infection

The patient was a 36 years old female with recurrent right low back pain and microscopic hematuria for 2 years. Kub showed multiple stones under the right kidney and the diameter of stones in the lower segment of the right ureter was 2cm. What kind of operation should we consider first?

A. Right nephrectomy
B. Right pyelolithotomy
C. Right renal parenchyma lithotomy
D. Right nephrostomy
E. Right ureterolithotomy

The patient is a 35 years old female with sudden right upper abdominal pain with nausea and vomiting. She has a history of stone excretion in the past. Which of the following is the most likely diagnosis?

A. Right kidney stone
B. Right ureteral stone
C. Gallstones
D. Right renal tuberculosis
E. Choledocholithiasis

The patient had a right kidney stone with a diameter of 1.8 cm and a narrow right ureteropelvic junction. The appropriate treatment is______

A. Pyelolithotomy + Pyeloplasty
B. Ureteroscopy and nephrolithotomy
C. Ureterolithotomy
D. Drug conservative treatment
E. ESWL

The patient, a 56 years old male, had left nephrectomy 4 years ago, right lumbar pain with repeated episodes of microscopic hematuria for 1 year, and had no urine for nearly 3 days. Physical examination: hazy mind, systemic edema, blood pressure 180 / 100mmhg, blood creatinine 560 μ Mol / L, no obvious abnormality is found in abdominal plain film, and the most likely diagnosis of the patient is______

A. Ureteral stone
B. Calyceal stones
C. Renal artery embolization
D. Rupture of renal cyst
E. Renal pelvis tumor

A 43 years old female patient was treated for left lumbar pain. Ultrasound examination found hydronephrosis in the left renal pelvis. There was a stone with a diameter of 2.0cm in the renal pelvis. IVP: moderate hydronephrosis in the left kidney, unobstructed ureter and normal right kidney. At this time, the best treatment is______

A. Pyelolithotomy
B. Percutaneous nephrolithotomy
C. ESWL (extracorporeal shock wave lithotripsy)
D. Observe and re treat after the water accumulation is aggravated
E. Transrenal sinus lithotomy

A 36 years old female with recurrent right low back pain and microscopic hematuria for 2 years. KUB and IVP showed multiple stones in the right kidney and stones in the upper segment of the left ureter, with a diameter of 1.2cm, hydronephrosis in both kidneys and good renal function. What kind of treatment should we consider first?

A. Left ureteral extracorporeal lithotripsy
B. Right pyelolithotomy
C. Right renal parenchyma lithotomy
D. Right nephrostomy
E. Left ureterolithotomy

The patient was a 42 years old male. The size of left kidney stone was 1.0cm found by B-ultrasound. He had no obvious symptoms at ordinary times, occasional discomfort of lumbar acid swelling, previous health and no history of stone excretion. The patient’s preferred treatment is?

A. Pyelolithotomy
B. Percutaneous nephrolithotomy
C. Oral lithotripsy drugs
D. Extracorporeal shock wave lithotripsy
E. Litholytic therapy

The patient was a young woman who came to the emergency department with right renal colic and accompanied by gross hematuria. After examination, it was determined that there was a stone with a diameter of 3.0cm in the right renal pelvis, irregular shape and mild hydronephrosis. Which of the following is the most suitable treatment？

A. Right nephrostomy and nephrolithotomy
B. ESWL
C. Ureteroscopy
D. Double-J + ESWL
E. Nephrolithotomy

The patient was a 70 years old male with dysuria for 10 years, aggravated in recent one year, accompanied by frequent urination, urgency and pain. Physical examination: the second degree of prostate is enlarged and smooth. The size of prostate by B-ultrasound is 2cm × 6cm × 8cm, multiple strong light mass echoes with sound shadow in the bladder, with a diameter of 0.5cm. No stone shadow was found on the X-ray plain film of the bladder. What is the most likely component of the bladder stone in this patient?

A. Calcium oxalate stone
B. Calcium phosphate stones
C. Uric acid stones
D. Cystine stones
E. Magnesium amine phosphate stone

A4-Type (20 questions)

Male, 26 years old, due to repeated right lumbar colic and sometimes spread to the right lower abdomen for 4 months, was treated by outpatient, outpatient blood routine examination and urine routine examination once.Normal, the pain attack mostly occurs after work, smokeless and alcoholic. No relevant family history.

In order to diagnose whether there is renal and ureteral stone, what is the most important method to use at this time?

A. Isotope renogram
B. CT
C. B-ultrasound
D. Cystoscopy
E. Abdominal plain film and intravenous pyelography

The size of right renal pelvis stone was 2.0cm x 0.9cm confirmed by plain film and IVP, with mild to moderate hydronephrosis. The best treatment to take at this time is

A. Taking traditional Chinese medicine to expel stones
B. Extracorporeal shock wave lithotripsy (ESWL)
C. Antispasmodic, analgesic, diuretic, hot compress, infusion and other palliative treatment
D. Ureteroscopic lithotomy

After ESWL fails, the most inappropriate treatment at this time is

A. Pyelolithotomy
B. Nephrostomy perfusion of litholytic drugs and ultrasonic lithotripsy
C. Right nephrectomy
D. Percutaneous nephrolithotomy
E. Ureteroscopic lithotripsy and lithotomy

Male, 65 years old, had progressive dysuria for 4 years and intermittent dysuria for 10 days. The abdominal plain film showed that there was a round dense shadow with a diameter of 2.5cm in the bladder area.

The most valuable auxiliary examination for diagnosis is

A. Cystoscopy
B. Intravenous nephrography
C.CT
D.MRI
E. Lateral abdominal plain film

The treatment that the patient should take is

A. Extracorporeal shock wave lithotripsy
B. Transurethral resection of prostate
C. Lithotomy of bladder and prostatectomy
D. Transurethral lithotripsy
E. Drug exclusion of stones

Male, 43 years old, right lumbar dull pain for 2 years. B-ultrasound examination showed that the diameter of right kidney stone was 2cm, the right kidney had mild hydronephrosis, and the left kidney had no abnormality.

On KUB plain film, what disease should distinguish with right kidney stone?

A. Appendicitis
B. Gastric ulcer
C. Horseshoe kidney
D. Gallstone
E. Right kidney double kidney double ureter malformation

The stone usually causes damage to the human body

A. Canceration, obstruction and secondary infection
B. Direct injury, obstruction, infection and malignant transformation
C. Acute complete obstruction and chronic incomplete obstruction
D. Hydronephrosis, impairment of renal function, atrophy of renal parenchyma and canceration
E. Bleeding, infection, scar formation and perirenal infection

The most common complication caused by ESWL in this patient was

A. Osteoarthropathy
B. Urine alkalization
C. renal failure
D. Hematuria
E. Severe cardio cerebrovascular disease

If stones accumulate in the lower ureter after ESWL, what method can be considered to deal with?

A. Nephrectomy
B. Diet regulation, drinking plenty of water
C. Percutaneous nephrolithotomy
D. Ureteroscopic lithotripsy
E. Litholytic therapy

The patient, a 20-year-old female, had right lower abdominal pain with bladder irritation in the past year. Physical examination showed soft abdomen, deep tenderness in the right lower abdomen and tapping pain in the right waist. Urine routine red blood cell: + + / HP, white blood cell: + / HP.

What kind of examination should be performed for further diagnosis?

A. Renal ultrasound
B. Cystoscopy
C. Blood routine
D. Renal CT
E. All the above are right

Renogram: the right side shows an obstructive curve,which of the following are the most likely diagnoses?

A. Chronic cystitis
B. Acute appendicitis
C. Chronic adnexitis
D. Acute pyelonephritis
E. Lower ureteral stone

According to the above examination results, the treatment methods that can be taken are

A. Extracorporeal shock wave lithotripsy
B. Oral traditional Chinese medicine stone removal
C. Percutaneous nephrolithotripsy
D. Antibiotics
E. Drinking plenty of water

The patient, a 10-year-old boy, had frequent micturition, urgency, pain, difficulty in micturition and interruption of urinary flow in the past year. He could continue micturition after changing his body position.

First of all, we should consider

A. Acute cystitis
B. Prostatitis
C. Urethral stricture
D. Bladder stones
E. Ureteral stone

In order to make a clear diagnosis, the examination to be taken is

A. Bladder B-ultrasound
B. Cystoscopy
C. Blood routine
D. Renal CT
E. All the above are right

In the ultrasonic examination, it was found that the internal diameter of the bladder was about 5cm, and the strong echo was considered to be bladder stone. Which of the following is the most reasonable treatment?

A. Extracorporeal shock wave lithotripsy
B. Oral traditional Chinese medicine stone removal
C. Percutaneous nephrolithotripsy
D. Surgical lithotomy
E. Drinking plenty of water

The patient was a 42 years old male. The size of left kidney stone was 1cm found by B-ultrasound. He had no obvious symptoms at ordinary times, occasional discomfort of lumbar acid swelling, previous health and no history of stone excretion.

The patient’s preferred treatment is

A. Pyelolithotomy
B. Percutaneous nephrolithotomy
C. Oral lithotripsy drugs
D. Extracorporeal shock wave lithotripsy
E. Litholytic therapy

What are the most common symptoms of upper urinary tract stones

A. Pain and hematuria
B. Frequent urination, urgency and pain
C. Frequent urination and hematuria
D. Pain and hematuria
E. Remove stones and pain

Which of the following is the most appropriate treatment for a clear diagnosis？

A. Urine culture
B. Cystoscopy
C．CT
D．KUB+IVP
E. Urine flow rate examination

The patient was a young woman who came to the emergency department with right renal colic and accompanied by gross hematuria. After examination, it was determined that there was a stone with a diameter of 3.0cm in the right renal pelvis, irregular shape and mild hydronephrosis.

Which of the following is the most suitable treatment？

A.Right nephrostomy and nephrolithotomy
B.ESWL
C. Ureteroscopy
D. Double-J + ESWL
E. Nephrolithotomy

What is the most appropriate examination?

A. Intravenous pyelography
B. Renal, ureteral CT
C. B-ultrasound examination of kidney and ureter
D. Right renal retrograde angiography
E. Perform abdominal X-ray plain film after enema

B1-Type (10 questions)

A. Hard, rough, irregular, often mulberry like, brown
B. Fragile, rough, irregular, grayish white, yellow or brown
C. X-ray is not displayed
D. Smooth, yellowish to brown, waxy appearance

Which of the following is the characteristic of urinary calcium oxalate stones?
Which of the following is the characteristic of urinary cystine stones ?

A. Hematuria characteristics of renal tuberculosis
B. Hematuria characteristics of renal tumors
C. Hematuria characteristics of renal stone
D. Hematuria characteristics of nephritis
E. Hematuria characteristics of cystitis

Terminal hematuria with frequent urination, urgency and pain
Painless gross hematuria is
Gross hematuria with renal colic

A. Renal colic
B. Lumbar mass
C. Low back pain hematuria with bladder irritation syndrome
D. Low back pain, with chills, fever and other systemic symptoms
E. No obvious clinical symptoms, only hematuria after activity. Which of the following cases is most likely to have the above symptoms

Upper urinary tract stones, secondary to acute nephritis
When the stone causes complete obstruction of the nephroureteral junction or ureter A

A. Nephrectomy
B. Non operative treatment
C. Nephrolithotomy
D. Ureteroscopic lithotripsy
E. Extracorporeal shock wave lithotripsy (ESWL) Which treatment method should be given priority in the following cases?

8.The woman was pregnant for 3 months and had a stone at the lower end of the right ureter with a diameter of 0.6cm.

9.The diameter of right kidney stone is 2.0cm.

X-Type (5 questions)

Typical manifestations of kidney and ureteral stone include_____

A. Renal colic
B. Microscopic hematuria
C. Shiver
D. Tenderness

Which of the following stones prevent recurrence by alkalizing urine_____

A. Cystine stone
B. Calcium phosphate stone
C. Uric acid stone
D. Magnesium ammonium phosphate stone

Which of the following are the common features of urolithiasis and cholelithiasis?

A. Abnormal calcium metabolism
B.The incidence rate of B. is related to the geographical distribution.
C. Stones contain a certain amount of calcium
D. It can be treated by extracorporeal lithotripsy

Which of the following are the factors that affect the formation of urinary stone？

A. Infection
B. Obstruction
C. Foreign matter
D. Renal injury
E. Physical strength

Which of the following are indications for ureteral stone surgery?

A. Non operative treatment is ineffective
B. Stone diameter greater than 1.0cm
C. Obstruction caused by stones affects renal function
D. Stones cause colic intolerable
E. Hard stones that are difficult to break with shock waves

Answer

A1-Type

CADED CDDAA BCADD CACDC

A2-Type

DABDE CCCED DEBAA CADAC

A4-Type

EBCAC DBDDA EADAD DADAC

B1-Type

ADABC DABE

X-Type

AB AC BC ABCD ABC

8. Others

Sun, 08 Nov 2020 00:00:00 +0000

A2-Type (6 questions)

The patient is a one-and-a-half-year-old male with empty right scrotum. Physical examination: a mass the size of a broad bean can be palpated in the right groin, which is diagnosed as right cryptorchidism. At present, the most appropriate treatment is_______

A. Observe and wait for self descent
B. Short term application of chorionic gonadotropin
C. Testicular fixation
D. Orchiectomy was performed

The patient was a 20-year-old male. Physical examination showed that there was a cyst in the groin or above the testis. The light transmission test was positive. There was a clear boundary between the cyst and the testis. Which of the following is the most likely diagnosis?

A. Testicular hydrocele
B. Hydrocele of spermatic cord
C. Communicating hydrocele
D. Testicular tumors
E. Semen cyst

The patient was a 10-year-old boy. His parents found that his testis in the right scrotum was absent. HCG treatment was ineffective, and he was hospitalized for surgical treatment. When is it most appropriate to do cryptorchidism descent fixation?

A. Under 5 years old
B. Under7 years old
C. Under 9 years old
D. Under 2 years old
E. Up to 12 years old

The patient is a 1-year-old male with right testicular hydrocele. Which of the following is the best treatment?

A. Medical observation
B. Immediate drainage
C. Medication
D. Tunica vaginalis reversal
E. Puncture and aspiration

The patient was a 60 years old male. Recently, it was found that the left scrotum was gradually enlarged but not painful. It had nothing to do with body position. The left testis and epididymis could not be palpated. The light transmission test was positive.Which of the following is the most likely diagnosis？

A. Testicular hydrocele
B. Hydrocele of spermatic cord
C. Communicating hydrocele
D. Semen cyst
E. Incarcerated indirect inguinal hernia

The patient was a female, 50 years old, with a history of 3 deliveries. For half a year, she often had symptoms of urinary incontinence when she coughed and went downstairs. Which of the following is a possible diagnosis for this patient

A. Urgent urinary incontinence
B. Filling incontinence
C. Stress urinary incontinence
D. True urinary incontinence
E. Volumetric incontinence

A3-Type (6 questions)

The patient was a 76 years old male with frequent micturition and progressive dysuria for more than 10 years. After a week of fatigue, the symptoms became worse, and the urine was dripping, accompanied by involuntary overflow of urine. Physical examination: the bladder is full of three fingers on the pubis, the lower limbs are slightly swollen, and the prostate is increased by III degree in anal examination,central sulcus disappeared.

Which of the following is preferred in clinical treatment?

A. Diuretic use to help urinate
B. Continue observation by taking drugs for benign prostatic hyperplasia
C. Indwelling catheter catheterization
D. Emergency surgical prostatectomy
E. Microwave treatment of prostate

What type of incontinence does the patient have?

A. Mental incontinence
B. Stress urinary incontinence
C. Urgent urinary incontinence
D. True urinary incontinence
E. Filling incontinence

The patient is a 51 years old male. He has found polycystic kidney and polycystic liver for more than 20 years. In the past year, he has developed chronic renal failure and is ready for renal transplantation.

The patient’s illness is a congenital genetic disease. The cause is______

A. Autosomal dominant inheritance
B. Autosomal recessive inheritance
C. Sex chromosome dominant inheritance
D. Sex chromosome recessive inheritance
E. Nonspecific genetic diseases

Which of the following conditions is not suitable for surgical treatment？

A. Moderate ascites
B. Small amount of pleural effusion
C. With chronic prostatitis
D. Anemia, hemoglobin 70g / L
E. With gastric and duodenal ulcers

Female, 34 years old, with a history of frequent urination and urgent urination for more than three years, with repeated symptoms, sometimes severe and sometimes mild. After receiving a variety of antibiotics in the external hospital, the condition has not improved. A small amount of red blood cells and white blood cells are occasionally found in many routine urine tests. Recently, the symptoms of urgent urination are aggravated and urinary incontinence is occasionally found.

What is the clinical diagnosis of this patient?

A. Acute cystitis
B. Chronic cystitis
C. Overactive bladder
D. Interstitial cystitis
E. Urinary tuberculosis

What kind of urinary incontinence does this patient have?

A. Mental incontinence
B. Stress urinary incontinence
C. Urgent urinary incontinence
D. Filling incontinence
E. True urinary incontinence

X-Type (5 questions)

Which of the following are not serious hazards of cryptorchidism?

A. Affect fertility
B. Affect testicular development
C. High chance of tumor
D. Affect the growth and development of children
E. Affect the development of penis

Which of the following can be used to distinguish communicating hydrocele from indirect inguinal hernia?

A. The former light transmission test is positive
B. The latter can also touch the testicle when standing
C. The former has no reduction
D. The latter has no sense of impact when coughing
E. The former compression inner ring is invalid

Congenital abnormal renal position can be located in______

A. Lumbosacral
B. Pelvic cavity
C. Thorax
D. Opposite side
E. Abdomen

Which of the following statements are correct about renal cysts?

A. Family history
B. Asymptomatic in early years
C. Progressive exacerbation
D. The main hazard is renal function damage
E. It is often unilateral

Which of the following are correct indications for nephroptosis fixation?

A. The symptoms of low back acid and low back pain are obvious and affect work. The symptoms can be relieved after lying flat
B. Severe hydronephrosis caused by nephroptosis
C. Nephroptosis with infection or stones
D. Severe renal ptosis, causing distortion of vascular pedicle and ureter, and colic symptoms
E. Accompanied by severe other organ ptosis

Answer

A2-Type

BBDAA C

A3-Type

CEAEC E

X-Type

DE AB ABCD ABCD ABCD

4. Genitourinary tuberculosis

Sat, 07 Nov 2020 00:00:00 +0000

A1-Type (10 questions)

Which of the following is the hematuria characteristic of renal tuberculosis?

A. Mostly terminal hematuria
B. Most of them are painless gross hematuria
C. Concurrent with Renal colic
D. Concurrent with bladder irritation

Which of the following is the hematuria characteristic of bladder tuberculosis?

A. Painless gross hematuria
B. Terminal hematuria with bladder irritation
C. Initial hematuria
D. Pain with hematuria

Which of the following is the most common complaint of kidney tuberculosis patients when attending a doctor?

A. Renal pain and mass
B. Urinary incontinence
C. Pyuria
D. Frequent urination and urinary pain
E. Hematuria

Which of the following is the most common route of infection for renal tuberculosis?

A. retrograde infection
B. Hematogenous infection
C. Direct infection
D. Lymphatic infection
E. Contact infection

Which of the following is the first site of urinary tuberculosis to be infected and have clinical manifestations?

A. Ureter
B. Bladder
C. Urethra
D. Unilateral kidney
E. Bilateral kidney

When one side of renal tuberculosis has no function and the contralateral kidney is normal, which of the following treatment methods should be used?

A. Antituberculous drug therapy
B. Partial nephrectomy
C. Bladder enlargement
D. Nephrectomy of affected side
E. Nephrostomy

Which of the following is the first site of male genital tuberculosis?

A. Testicles
B. Prostate
C. Epididymis
D. Seminal vesicle
E. Vas deferens

Which of the following is true about urogenital tuberculosis?

A. The incidence rate of renal tuberculosis is basically the same in men and women.
B. Renal tuberculosis is mostly caused by blood infection
C. Male genital tuberculosis first occurs in the testis
D. Surgery is the main treatment
E. Hematuria is the main symptom

Which treatment should be more suitable for patients with early renal tuberculosis?

A. Active anti tuberculosis and conservative treatment
B. Unilateral nephrostomy
C. Colonic bladder surgery
D. Cavity drainage
E. Nephrectomy as soon as possible

What is the main infection pathway of urinary tuberculosis?

A. Ascending infection
B. Bloody infection
C. Lymphatic infection
D. Direct spread infection
E. Indirect spread infection

A2-Type (17 questions)

The patient is a 30-year-old male with no function of left renal tuberculosis, 2 right ureteral stones with a diameter of 1.5cm, hydronephrosis in the right kidney and no uremia. What should be done first?

A. anti tuberculosis treatment, waiting for stones to be discharged
B. immediate ureterolithotomy
C. right ureterolithotomy under anti tuberculosis treatment
D. drainage of right hydronephrosis
E. remove the nonfunctional left kidney

The patient is a 26 years old male. In the past 4 years, he has frequent urination, urgent urination, painful urination, sometimes turbid urine, with terminal hematuria. General antibiotics are ineffective. Urine examination: 40 ~ 50 pyocyte, red blood cells 20 ~ 30/ HP, protein (+). Right renal tuberculosis was diagnosed and right nephrectomy was performed. In the process of continuing anti tuberculosis after discharge, the most important thing to pay attention to is______

A. Bed rest
B. Epididymis resection
C. regular chest CT
D. B-ultrasound examination and renal function examination of contralateral kidney shall be performed regularly
E. Regular tuberculosis examination

The patient was 23 years old and had mild swelling and pain in the right scrotum for 4 years. Physical examination: the right epididymal tail touches 1.5cmx1.0cmx1.0cm induration, without tenderness, and the ipsilateral vas deferens is thick and hard. The patient’s most likely diagnosis is_____

A. Epididymitis
B. Epididymal tumor
C. epididymal tuberculosis
D. Epididymal cyst
E. Peyronie’s disease

The patient is a 25-year-old female with frequent micturition, urgency and pain for more than 1 year. Sometimes the urine is turbid, and the treatment effect of taking a variety of antibiotics is not good. Routine urine examination showed that pH was 5.0, specific gravity was 1.020, red blood cells 30 ~ 40 / HP, white blood cells and pyocyte were full of vision, protein (+ +). The patient’s most likely diagnosis is______

A. Chronic cystitis
B. Bladder tumor
C. Acute cystitis
D. Urinary tuberculosis
E. Cystitis glandularis

The patient, a 24-year-old male, has a mass in the left scrotum in the past 3 months, which has gradually enlarged, no pain, no fever, punctured and purulent one month ago, and there is no significant improvement in anti infection treatment. The following most likely diagnosis is______

A. Filariasis in scrotum
B. Testicular tumors
C. Acute epididymitis
D. Acute orchitis
E. Epididymal tuberculosis

The patient, male, 35 years old, is a migrant worker. In February 2000, he began to have frequent urination, urgent urination and urination pain, lower abdominal discomfort, irregular use of norfloxacin, no significant improvement in symptoms, and the frequent urination, urgent urination and urination pain became more and more serious. The most likely diagnosis is

A. Renal tuberculosis
B. Chronic prostatitis
C. Bladder stones
D. Bladder triangle tumor
E. Bladder cancer

The patient, male, aged 65, has been diagnosed with right renal tuberculosis and bladder tuberculosis. Which of the following medical history and physical examination is wrong as the diagnostic basis of urogenital tuberculosis?

A. Persistent progressive exacerbation of chronic cystitis
B. The right kidney is palpable and the surface is uneven
C. Palpable mass in bladder area
D. Induration of prostate
E. Nodular enlargement of epididymis and beaded induration of spermatic cord

The patient was a 28 years old male with frequent urination, urgency, pain and hematuria for 2 months. The red and white blood cells in urine were full of vision, and acid fast bacilli were found. IVP and retrograde pyelography showed that the left kidney was normal. There is a cavity with a diameter of 1.5cm on the upper calyce of the right kidney, which communicates with the renal pelvis. It has been treated with streptomycin and isoniazid for 6 months. The symptoms have not improved. Which of the following is an appropriate treatment?

A. Continue anti tuberculosis treatment and regular review
B. Right nephrectomy
C. Right partial nephrectomy
D. Right renal incision and drainage
E. Right nephrotic focus removal

The patient, a 40 years old male, found swelling of the right scrotum for 2 weeks with no obvious pain. Physical examination: nodular mass of the right epididymis, thickening of the right vas deferens, beaded nodules. Which of the following diseases may the patient have?

A. varicocele
B. scrotal filariasis
C. epididymitis
D. epididymal tuberculosis
E. testicular hydrocele

The patient was a 32 years old male with intractable bladder irritation. The symptoms were not significantly relieved after antibiotics. There are red and white blood cells in the urine, and the urine culture is negative for 3 times. Which of the following is the most likely diagnosis?

A. Urinary tuberculosis
B. Cystitis
C. Urinary stone
D. Pyelonephritis
E. Bladder foreign body

The patient was a 31 years old female with frequent micturition, urgency and pain for 6 years. Routine urine examination showed 30 ~ 50 white blood cells / HP and 15 ~ 25 red blood cells / HP. Excretory urography showed scattered small flake high-density shadows in the right kidney, no development in the right kidney, moderate hydronephrosis in the left kidney, and the bladder on the film was the size of a table tennis ball. Which of the following is the most likely diagnosis？

A. Bilateral renal tuberculosis
B. Left renal tuberculosis
C. Tuberculosis of right kidney and bladder
D. Right renal tuberculosis
E. Multiple stones in the right kidney + stones in the left ureter

The patient was a 36 years old male with frequent and urgent urination; Urination pain for 2 years, sometimes gross hematuria, has been treated in local hospitals, and has not improved. Urine routine pyocyte 20 ~ 30 / HP, red blood cells 10 ~ 20 / HP, which of the following is the most likely diagnosis？

A. Chronic cystitis
B. Chronic pyelonephritis
C. Chronic prostatitis
D. Chlamydia bladder infection
E. Urinary tuberculosis

A 25-year-old female patient with bladder irritation symptoms for 2 years and 6 months. Routine urine examination showed that there were a large number of red blood cells and white blood cells in urine. Blood biochemical examination found that urea nitrogen and creatinine increased significantly. IVP showed no development of right kidney, severe hydronephrosis of left kidney and poor bladder development. What is the most likely disease for this patient?

A. Chronic pyelonephritis
B. Chronic cystitis
C. Urinary tuberculosis
D. Kidney stones with hydronephrosis
E. Interstitial cystitis

The patient, a 32 years old male, found a vaginal cyst, swelling and mass for more than 2 months, which has increased in recent 3 months. He has been married for 5 years and has not given birth. Physical examination: irregular induration can be palpated on both epididymal tails and adhered to scrotal skin. The most effective treatment is______

A. Antibiotic treatment
B. Strengthen nutrition and bed rest
C. Physiotherapy
D. Antituberculous drug treatment
E. Local hot compress

The patient is a 25-year-old female with frequent micturition, urgency and pain for more than 1 year. Sometimes the urine is turbid, and the treatment effect of taking a variety of antibiotics is not good. Routine examination of urine: red blood cell 30 ~ 40 / HP, white blood cell and pyocyte full field of vision. Urine pH 5.0, protein (+), the most likely diagnosis is______

A. Chronic cystitis
B. Bladder tumor
C. Acute cystitis
D. Urinary tuberculosis
E. Cystitis glandularis

The patient was a 35 years old female with recurrent hematuria and pyuria for more than 3 years. The long-term use of antibiotics had poor efficacy. She had urine culture for 3 times and no bacterial growth was found. The most valuable auxiliary examination for this disease is______

A. IVP
B. B-ultrasound
C. exfoliative cytology
D. CT
E. uroflowmetry

The patient was a 31 years old male with frequent urination, urgency and pain for more than 1 year. Sometimes the urine was turbid. Taking a variety of antibiotics was ineffective. Urine examination: purulent ball full field of vision, protein (++), the most valuable auxiliary examination for diagnosis is______

A. cystoscopy
B.MRI
C. B-ultrasound of urinary tract
D. IVP and urinary Mycobacterium tuberculosis examination
E. radionuclide renogram

A3-Type (10 questions)

Male, 31 years old, frequent micturition, urgent micturition and painful micturition for more than 1 year. Sometimes the urine is turbid. Taking a variety of antibiotics is ineffective. Urine examination: pyocyte filled the field of vision,Protein (++).

The patient was clinically diagnosed as urinary tuberculosis. In order to further clarify the diagnosis, the first choice is

A. Radionuclide renogram
B. IVP check
C. B-ultrasound of urinary tract
D. renal arteriography

What is most likely to occur in this patient on urography？

A. The development time of renal parenchyma was prolonged during IVP
B. The cancer body presents large soft tissue shadow or calcification shadow
C. The renal pelvis has filling defect or part of the renal calyces is dilated
D. The edge of the kidney is irregular, such as moth like or renal calyceal occlusion and cavity formation
E. Renal angiogram showed irregular deformation, stenosis and elongation

One year after anti tuberculosis treatment, routine urine examination has returned to normal, but the frequency of urination has increased. The most likely reason is

A. Bladder contracture
B. Mental frequent micturition
C. recurrence of urinary tract tuberculosis
D. complicated with prostatitis
E. With chronic cystitis

Female, 24 years old, with a history of frequent micturition, urgent micturition and urinary pain for 3 months, the treatment with a variety of antibiotics did not improve, and there were many red and white blood cells in urine routine. Recently, the patient’s symptoms have worsened, accompanied by urinary incontinence.

Which of the following is the most likely diagnosis?

A. Urinary tuberculosis
B. glandular cystitis
C. interstitial cystitis
D. chronic cystitis
E. acute cystitis

What kind of urinary incontinence does this patient have?

A. True urinary incontinence
B. filling urinary incontinence
C. urgent urinary incontinence
D. stress urinary incontinence
E. mental urinary incontinence

Which of the following tests is not meaningful for diagnosis?

A. CT
B. IVP
C. Cystoscopy
D. Renal radionuclide scanning
E.MRI

Which of the urine test items is not meaningful for diagnosis?

A. Specific gravity of urine
B. Urine pH test
C. PCR detection of tuberculosis in urine
D. Urine microscopy

–

Male, 40 years old, frequent and urgent urination for more than 1 month. Routine urine examination: WBC 30-50/HP, RBC 10-20/HP, trace urinary protein. B-ultrasound showed mild hydronephrosis in the right kidney and no development in the ureter. Cystoscopy: extensive chronic inflammatory changes of bladder mucosa with multiple ulceration, especially near the right ureteral orifice.

The most likely manifestation of this patient on retrograde urography is

A. Right whole kidney calcification
B. The right renal calyce is occluded and forms a cavity.
C. spot calcification shadow in the right kidney.
D. irregular expansion of the right renal calyce and Meng
E. The edge of the right renal calyces is irregular, such as insect erosion

The preferred treatment is

A. Broad spectrum antibiotic therapy
B. Combination therapy of anti tuberculosis drugs and interferon
C. After 2 weeks of anti tuberculosis treatment, the affected side of the kidney was removed
D. After 2 weeks of antituberculous treatment, the lesion of the affected side of the kidney was removed
E. Combined with anti tuberculosis drugs for more than half a year before deciding on further treatment

After the above treatment, the symptoms disappeared and the routine urine examination was basically normal, but there was left hydronephrosis after 3 years. The impossible reason is

A. Decreased bladder volume
B. Increased pressure in the bladder
C. Left ureteral orifice stenosis
D. Reflux of bladder urine to left ureter
E. scar stenosis of bladder neck

A4-Type (5 questions)

Male, 26 years old, frequent micturition, urgent micturition, painful micturition with intermittent terminal hematuria for 2 years, sometimes urine turbidity, general antibiotic treatment is ineffective. Urine examination: 40 ~ 50 pyocytes /HP, 20 ~ 30 red blood cells / HP, protein (+).

In the process of continuing anti tuberculosis treatment after discharge, Which of the following is the most appropriate treatment?

A. Bed rest
B.B-ultrasound and renal function examination of contralateral kidney were performed regularly
C. Epididymal tuberculosis resection
D. regular chest X-ray fluoroscopy
E. regular urine tuberculosis examination

In the process of anti tuberculosis treatment after nephrectomy, if the urine tuberculosis bacteria are negative for many times, the patient’s urine frequency is significantly worse than that before operation, and the urine volume is only tens of milliliters each time.The most likely cause of urine frequency is

A. tuberculosis relapse
B. coli infection
C. mycoplasma infection
D. mental factors
E. Bladder contracture

During the postoperative follow-up, B-ultrasound and intravenous urography showed contralateral hydronephrosis, significant expansion of the full length of the ureter, bladder capacity of about 50ml, accompanied by urethral stricture, negative urinary tuberculosis culture, renal function examination: urea nitrogen 10.5mmol/L, creatinine 162mmol/L. at this time, the most suitable treatment is

A. continue anti tuberculosis treatment
B. Bladder augmentation
C. Ureterostomy
D. Nephrostomy
E. Cystostomy
A 32 years old female patient had repeated frequent urination, urgency and pain for 4 years. Urine examination showed a large number of red blood cells and white blood cells. IVP showed that there was a destructive focus in the lower calyce of the left kidney, forming a whole cavity.

The possible diagnosis is

A. Hydronephrosis
B. Renal cell carcinoma
C. Nephroblastoma
D. Renal tuberculosis
E. Kidney Meng nephritis

Which of the following is the most appropriate treatment？

A. nephrectomy
B. Nephrostomy
C. Partial nephrectomy
D. anti tuberculosis treatment
E. Immunotherapy

B1 5

A. Mycobacterium tuberculosis can be found in urine, and only a small amount of leukocytes can be found
B. Mycobacterium tuberculosis can be found in urine. Urine is acidic and has bladder irritation symptoms
C. secondary to pulmonary tuberculosis
D. symptoms of systemic tuberculosis

Renal cortical tuberculosis is characterized by
Clinical renal tuberculosis is characterized by

A. nausea, edema, anemia, oliguria
B. urgent urinary incontinence
C. fever, night sweat, weight loss and poor appetite
D. Autonephrectomy

The characteristic manifestation of ureteral tuberculosis is
The late manifestation of bladder contracture is
The main manifestation of bilateral renal tuberculosis

Answer

A1-Type

ABDBD DCBAB

A2-Type

CDCDE ACBDA CACDD AD

A3-Type

BDAAC DAECC

A4-Type

BECDD

B1-Type

ABDBA

2. Injury of Urinary System

Fri, 06 Nov 2020 00:00:00 +0000

A1-Type (20 qustions)

Which of the following is the most reliable way to diagnose the type of bladder rupture？

A. Abdominal CT
B. Metal probe
C. Subpubic bladder puncture
D. Cystography

Which of the following is not the clinical manifestation after bladder rupture?

A. Massive chyluria
B. Abdominal pain
C. Shock
D. Dysuria, hematuria

The causes of ureteral injury do not include ________

A. Urethrography
B. Intraluminal instrument operation
C. Radiation therapy
D. Violent trauma

What is the main clinical manifestation of severe kidney injury?

A. Shock
B. Hematuria
C. Pain
D. Mass
E. Fever

5.which organ is the most common injured genitourinary organs in closed injuries?

A. Kidney
B. Bladder
C. Urethra
D. Prostate
E. Testicle

What is the most common site of male urinary system injury?

A. Kidney injury
B. Ureteral injury
C. Bladder injury
D. Urethral injury
E. Penile injury

Which is the most common route of urinary tract infection in women?

A. Descending infection
B. Ascending infection
C. Direct infection
D. Hematogenous infection
E. Lymphatic infection

Which of the following is the mildest type of kidney injury?

A. Renal Contusion
B. Total renal laceration
C. Partial renal laceration <1cm
D. Partial renal laceration >1cm
E. Renal hilar Injury

Which of the following symptoms can be used to distinguish between intraperitoneal bladder rupture and extraperitoneal bladder rupture?

A. Shock
B. Difficulty urinating and hematuria
C. Pain
D. Urinary fistula
E. Local symptoms

Where is the anterior urethral injury mainly located?

A. Penile urethra
B. Membranous urethra
C. Bulbar urethra
D. Prostatic urethra
E. General urethra

What is the main causes of posterior urethral injury?

A. Iatrogenic injury
B. Violent sex
C. Direct violence in the perineum
D. straddle injury
E. Pelvic fracture

Which of the following is NOT a urinary tract injury?

A. Kidney injury
B. Ureteral injury
C. Testicular injury
D. Urethral injury
E. Bladder injury

Which of the following is the most severe type of kidney injury?

A.Renal Contusion
B. Total renal laceration
C. Partial renal laceration <1cm
D. Partial renal laceration >1cm
E. Renal hilar Injury

What is the most common cause of ureter injury?

A. Spontaneous rupture
B. Pelvic fracture
C. Direct violence injury
D. Latrogenic injury
E. Open injury

Which of the following is NOT an indication for surgical exploration of kidney injury?

A. No improvement in active anti-shock therapy
B. Progressive increase in hematuria
C. Progressive increase in abdominal mass
D. Suspected abdominal organ injuries
E. Obvious pain in waist and abdomen

What is the most common cause of bladder injury?

A. Spontaneous rupture
B. Pelvic fracture
C. Direct violence injury
D. Latrogenic injury
E. Open injury

Where is the posterior urethral injury mainly located?

A. Penile urethra
B. Membranous urethra
C. Bulbar urethra
D. Prostatic urethra
E. General urethra

What is the main causes of anterior urethral injury?

A. Iatrogenic injury
B. Violent sex
C. Direct violence in the perineum
D. Straddle injury
E. Pelvic fracture

Which of the following is not a clinical manifestation of kidney injury?

A．Shock
B．Abdominal mass
C．Hematuria
D．Fever
E. Pusuria

What is the most common treatment for closed renal injury

A．Surgery
B．Drainage
C．Temporary conservative treatment and close observation
D．Nephrectomy
E. Renal repair

A2-Type (14 qustions)

The patient, a 25-year-old male, had dysuria and urethral orifice bleeding 3 days after riding injury. Physical examination: fever, obvious swelling of scrotum and cyanosis. The correct treatment is ________

A. Immediate urethral repair
B. Immediately catheterize with a metal catheter
C. Urethral reunion operation
D. Suprapubic cystostomy and drainage of extravasated urine
E. Subpubic bladder puncture

An athlete has sudden left lumbar colic and hematuria during running. What is his possible disease？

A. Urethral stone
B. Ureter stone
C. Bladder stone
D. Sprain of left waist
E. Left ureteral injury

The patient, a 45 years old male, was hospitalized with hematuria after being injured in his right waist. It is diagnosed as closed renal injury. In order to further understand the degree of injury and observe the patient’s general condition, which of the following judgment values is the least?

A. According to the severity of hematuria
B. Changes in blood pressure and pulse
C. Hemoglobin and hematocrit
D. The patient has fever, and the body temperature reaches 38.5℃
E. Abdominal palpation to understand the expansion of perirenal hematoma

The patient was a 36 years old male who was kicked in the lower abdomen and felt severe pain in the lower abdomen, abdominal distension and obvious tenderness. He was initially diagnosed as closed bladder rupture.Which of the following checks is not normally used？

A. Abdominal plain film
B. Catheterization and bladder leak test
C. B-ultrasound examination of bladder
D. Cystography
E. Cystoscopy

The patient, male, 20 years old, fell from a height of 6m 3 hours ago. Low back pain, hematuria, . Blood pressure: 10 / 6kpa (75 / 45mmHg), pulse: 120 times / min, left lumbar skin abrasion, local slight bulge, positive tenderness, palpable mass in the right upper abdomen, mild muscle tension. B-ultrasound: there is a 3. 0cm×3. 0cm×2. 0cm dark area around the left kidney, the liver and spleen capsule are complete, and the abdominal puncture is negative. The most important treatment should be ________

A. Antibiotic application
B. Hemostatic application
C. Analgesic application
D. Transfusion and rehydration
E. Immediate surgical exploration

The patient was injured in the waist with obvious gross hematuria, tenderness in the waist on the injured side, no muscle tension, no mass, normal pulse and blood pressure. The most likely diagnosis is______

A. Partial renal laceration leading to the renal capsule
B. Renal contusion
C. Renal pedicle injury
D. Partial renal laceration leading to the renal pelvis
E. Full thickness renal laceration

The patient was a 30-year-old male with perineal crush injury for 3 hours. He collided with people on a bicycle 3 hours ago.he was unable to urinate.Blood dripping from the urethral orifice, perineal hematoma such as table tennis, normal blood pressure and pulse; Urethrography showed complete urethral bulbar rupture. At this time, the best treatment for admission is______

A. Try indwelling catheter for continuous drainage
B. Suprapubic cystostomy
C. Transperineal, urethral end-to-end anastomosis
D. Suprapubic cystostomy
E. Urethral realignment reduction and hematoma drainage

An 18-year-old male patient with urethral injury caused by traumatic pelvic fracture was unable to urinate on his own. Physical examination: the general condition is good. The prostate can’t be touched when it moves up. What’s the best treatment for this patient?

A. Urethral intubation and drainage
B. Suprapubic bladder leakage
C. Urethral realignment
D. Urethral anastomosis
E. Suprapubic aspiration

A 30-year-old female patient was treated 1 hour after the impact on her left waist. Physical examination: BP: 120/70 mmHg, Hb: 110 g/L, no muscle tension and tenderness in the abdomen, the left abdomen touches the mass, the range is limited, and there is no mobile voiced sound.The most likely diagnosis is ______

A. Contralateral hydronephrosis
B. Liver rupture
C. Gastric perforation
D. Hydronephrosis after renal trauma
E. Renal trauma, extravasation of renal blood and urine

The patient, a 24-year-old male, was unable to urinate because of the car squeezed the lower abdomen. Physical examination: blood pressure 110/75 mmHg, heart rate 78 beats/min. The X-ray film showed that the pubic branch was fractured and the urinary catheter could not be inserted into the bladder. What is the cause of urethral rupture？

A. The bladder was not emptied at the time of injury
B. Increased abdominal pressure
C. Penile hyperemia and high urethral tension
D. Pelvic fracture tearing membrane urethra
E. Hematoma extrusion and traction

The patient, a 30-year-old male, came to see a doctor urgently because of urethral dripping blood after the perineum rode over a hard object. Physical examination showed that the perineum was swollen. Which of the following is the most appropriate measure?

A. Cystostomy
B. Analgesia
C. Incision and drainage of perineum
D. Urethrography
E. Trial catheterization

The patient was a 26 years old male with open perineal laceration, perineal hematoma, urinary extravasation and blood outflow from the external orifice of the urethra. The first best treatment is ________

A. Debridement, incision and drainage
B. Suprapubic cystostomy
C. Indwelling catheter
D. Debridement urethroplasty
E. Infusion, anti infection

The patient was a 26 years old male with open perineal laceration, perineal hematoma, urinary extravasation and blood outflow from the external orifice of the urethra. The most common complication after repair of urethral injury is______

A. Urethral perineal fistula
B. Prostatitis
C. Wound infection
D. Urethral stricture
E. Urethrorectal fistula

The patient, a 32 years old male, was hospitalized because he was unable to urinate on his own after falling from a high place. Physical examination: the abdomen is soft without tenderness, the round mass can be touched 3cm below the umbilicus, the percussion is voiced, and the pelvic film shows the fracture of the upper and lower limbs of the right pubis. The catheter can be inserted for 20cm, flowing out bright red blood liquid, and no urine is found. Which of the following injuries should be diagnosed?

A. Posterior urethral contusion
B. Extraperitoneal bladder rupture
C. Bulbar urethral rupture
D. Intraperitoneal bladder rupture
E. Posterior urethral rupture

A3-Type (20 qustions)

The patient, a 21-year-old male, continued to overflow light red liquid after being stabbed at the left waist. Physical examination: blood pressure 12 / 9.3kpa (90 / 70mmhg), pulse 120 times / min, tenderness in the left upper abdomen, no muscle tension and rebound pain.

Which of the following is the most likely diagnosis?

A. Kidney injury
B. Gastric perforation
C. Splenic rupture
D. Intestinal rupture
E. Pancreatic injury

What else should be done to clarify the diagnosis?

A. Barium meal radiography
B. Excretory urography
C. Abdominal puncture
D. Barium enema
E. Determination of amylase in wound overflow

The principle of treatment should be

A. Immediate surgical exploration
B. Non-surgical treatment
C. Surgical exploration in case of gross hematuria
D. Surgical exploration in case of shock again
E. Surgical exploration in case of peritonitis

Male, 35, a construction worker on the construction site, was hospitalized with pelvic crush injury before work. Physical examination: Bp 90/50mmhg, P 120 times/min, pale complexion.White, tenderness in the lower abdomen. Hb11 g/dl.X-ray showed linear fracture of iliac bone. After rehydration treatment, the vital signs were stable, but there was still no urine, and the indwelling catheter was only used 50ml urine flowed out at night, light red. Abdominal distension, positive shifting dullness.

What kind of visceral injury is more likely in the following example?

A. Renal injury
B. Bladder injury
C. Urethral injury
D. Rectal injury
E. Ureteral injury

Which check should I do first?

A. CT
B. B-ultrasound
C. Cystography
D. Urethrography
E. Celiac Arteriography

Which of the following is the correct choice for treatment?

A. Urethral repair
B. Treatment of ascites by abdominal puncture and aspiration
C. Suprapubic cystostomy
D. Laparotomy for bladder repair
E. Continue clinical observation

Male: 39 years old, drunk, fell 1 hour ago, abdominal pain, gross hematuria. Physical examination: bp100/60mmHg, P 100 times/min, pale face, extensive tenderness in the lower abdomen, muscle tension and rebound pain. B-ultrasound showed normal liver and spleen with a small amount of ascites. There is light red liquid on the abdomen. Smooth indwelling of urinary catheter, a small amount of bloody urine outflow, light color. Hb120g/L.

What kind of visceral injury is more likely in this patient?

A. Renal injury
B. Bladder injury
C. ureteral injury
D. rectal injury
E. urethral injury

Which of the following tests is the first choice for the diagnosis of urinary system injury?

A. Celiac Arteriography
B. B-ultrasound
C. CT
D. Contrast radiography
E. Urethrography

Male, 34 years old, unable to urinate due to riding injury of perineum. He developed fever after 3 days of suprapubic cystostomy in a grass-roots hospital, with a body temperature of 38.5. Come to see a doctor. Physical examination: blood pressure 110/75 mmHg, heart rate 78 beats/min, obvious swelling of perineum and scrotum, dark red skin and obvious local tenderness.

Which of the following treatment options is correct

A. Try indwelling catheter again while antibiotic treatment
B. Rethral realignment was performed simultaneously with antibiotic treatment
C. Transperineal urethroplasty was performed at the same time as antibiotic treatment
D. Perineal incision and drainage was performed at the same time as antibiotic treatment
E. The changes of the condition were closely observed

What check should not be done at this time

A. Blood bacterial culture
B. Urine bacterial culture
C. Urethrography to understand the injury
D. B-ultrasound examination of perineum
E. X-ray plain film of pelvis

A 34 years old male was injured in the lower abdomen by a wall fall. Physical examination: blood pressure 110 / 75mmhg, heart rate 78 beats / min, slight tenderness in the lower abdomen, a small amount of bloody urine in catheterization, urine volume only 120ml after 4 hours, light red. The patient’s lower abdominal pain was aggravated, extended to the whole abdomen, and the mobile voiced sound was positive.

The patient’s more likely diagnosis is

A. Urethral bulbar injury
B. Urethral membrane injury
C. Bladder injury
D. Ureteral injury
E. Prostate injury

Which of the following is a simple and effective examination method for clear diagnosis？

A. Abdominal plain film
B. Diuretic test
C. Cystoscopy
D. Intravenous nephrography
E. Bladder water injection test

The preferred treatment for this patient is

A. Emergency surgical exploration
B. Suprapubic cystostomy
c. Drug control of bleeding and infection
D. Indwelling catheterization, anti infection treatment
E. Surgical treatment was performed after comprehensive urinary examination

Female, 55 years old. After urinating in the morning, she wiped it with paper and saw that it was full of blood. The chief complaint was that he felt waist pain after massage in the health salon. Examination: normal blood routine. B-ultrasound showed that the renal enlargement and renal rupture were consistent with CT diagnosis.

Which of the following is the most likely cause of bleeding?

A. Renal cyst
B. Polycystic kidney
C. Renal cell carcinoma
D. Hydronephrosis
E. Renal hamartoma

In order to make a definite diagnosis, which examination should be carried out

A. Urography
B. Puncture biopsy
C. MRI
D. Renal arteriography
E. KUB

The preferred treatment is _____

A. Hematoma removal
B. Partial nephrectomy
C. Nephrectomy
D. Interventional therapy
E. Observe

Male, 35 years old. 2 hours ago, he fell from a height of 3 meters. His right waist hit a hard object. He immediately felt severe pain in the waist, and then he had gross hematuria. Physical examination: P 120 / min, BP 80 / 50mmhg, right waist extravasated blood, obvious tenderness, blood HB 86g / L. B-ultrasound showed enlargement of right renal shadow.

The pathological type of right kidney injury is _______

A. Laceration of renal pelvis
B. Renal laceration
C. Renal contusion
D. Renal pedicle injury
E. Renal subcapsular hematoma

The correct treatment is ______

A. Infusion and blood transfusion to stabilize blood pressure
B. Continue to observe blood pressure and pulse
C. Bed rest
D. Anti inflammatory treatment
E. Anti shock therapy + surgical exploration

Male, 50 years old. Two hours after the traffic accident, he was admitted to the emergency hospital. After rescue, his vital signs were stable and his mind was clear. Now he has lower abdominal pain and can’t urinate for 4 hours. Physical examination: the percussion of the lower abdomen is voiced, the digital rectal examination can touch the front of the rectum, the front of the rectum is full.X-ray showed pelvic fracture (fracture of inferior pubic branch).

The most likely diagnosis is

A. Renal injury
B. Anterior urethral injury
C. Urethral injury
D. Posterior urethral injury
E. Bladder rupture

The most important inspection to be supplemented in the later stage is

A. B-ultrasound
B. Urethrography
C. CT
D. Cystography
E. Intravenous urography

A4-Type (10 qustions)

Male, 22 years old, fell and rode on the cross bar, with swelling and pain in the perineum, ecchymosis and hematoma, bleeding at the urethral orifice, unable to urinate. The No. 14 urinary catheter can be inserted into the bladder to lead out clear urine

The best treatment is _______

A.Incision and drainage of perineum
B. urethra realignment with traction
C. retention of urinary catheter for more than two weeks
D. Perineal incision and urethral repair
E. Pull out the catheter and treat with antibiotics

If the urinary catheter cannot be inserted into the bladder, what examination cannot be performed on the patient?

A. Abdominal plain film
B. IVP examination
C. Urethrography
D. Cystoscopy
E. Digital rectal examination

If the urinary catheter cannot be inserted into the bladder, the treatment method is

A.Incision and drainage of perineum
B. Multiple incision and drainage of perineum
C.Suprapubic cystostomy
D.Perineal urethrostomy
E.Transperineal incision urethroplasty

Male, 36 years old, unable to urinate on his own for 3 hours. Three hours ago, his hip was hit by a car. Physical examination: blood pressure 16 / 9kpa (120 / 70mmhg), body temperature 37.8 ℃. Perineum is swollen and purplish red. Digital rectal examination: soft sensation in front of rectum, floating tip of prostate, catheter can not be inserted into bladder. Pelvic X-ray shows pubic fracture.

Most likely diagnosed is

A. Bladder injury
B. Penile urethral injury
C. prostatic urethral injury
D. bulbar urethral injury
E. Membranous urethral injury

The most appropriate treatment at this time is

A. Bladder repair
B. Suprapubic bladder puncture
C. Two stage urethroplasty with suprapubic fistulation
D. urethral realignment
E. Urethral repair or anastomosis was performed

Male, 38 years old. straddle injury, blood dripping from the external orifice of the urethra, swelling, ecchymosis and butterfly hematoma in the perineum and scrotum.

The site of urinary system injury in this patient is

A. Urethral penis
B. Bulbar urethra
C. Bladder
D. Urethral prostate
E. Urethral membrane

The patient’s most likely diagnosis is

A. Posterior urethral contusion and laceration
B. Bladder rupture
C. Bladder contusion
D. Anterior urethral laceration
E. Anterior urethral contusion

The preferred treatment is

A. Simple hematoma removal
B. Cystostomy
C. Try inserting catheter to drain urine + anti infection treatment
D. urethral realignment
E. Urethral broken end anastomosis

Male, 34 years old, unable to urinate due to riding injury to perineum. At that time, three days after suprapubic cystostomy in a primary hospital, he had a fever and a temperature of 38.5 degrees. He came to see a doctor. Physical examination: blood pressure 110 / 75mmhg, heart rate 78 beats / min, obvious swelling of perineum and scrotum, dark red skin and obvious local tenderness

Which of the following treatment options is correct?

A.Try indwelling the catheter again during antibiotic treatment
B.Urethral rearrangement was performed simultaneously with antibiotic treatment
C.Transperineal urethroplasty was performed simultaneously with antibiotic treatment
D.Episiotomy and drainage were performed simultaneously with antibiotic treatment
E.Closely observe the changes of the disease after antibiotic treatment

What should not be done at this time?

A. Blood bacterial culture
B. Urine bacterial culture
C. Urethrography to understand the injury
D. Perineal B-ultrasonography
E. Pelvic X-ray plain film

X-Type (5 qusiotns)

Common ureteral injuries include____

A. Ureteral injury during radical surgery for endometrial carcinoma
B. Ureteral knife puncture
C. Ureteral occlusion after radiotherapy
D. Severe hydronephrosis due to ureteropelvic junction stenosis

Which of the following statements are correct about the value of excretory urography in the diagnosis of renal injury?

A. It can show renal contusion
B. Contralateral renal function can be displayed
C. It can show the leakage of renal contrast medium on the affected side
D. It can show the deformation of the patient’s renal pelvis and kidney calices

Local treatment after urethral injury includes ______

A. Restore urethral continuity
B. Drainage of bladder urine
C. Complete drainage of urinary extravasation
D. Complete drainage of hematocele
E. Systemic anti-inflammatory therapy

Which of the following are the main pathological manifestations after urinary injury?

A. Bleeding
B. Infection
C. Urinary extravasation
D. Shock
E. Fever

Which of the following are non-surgical measures for renal injury?

A. Bed rest
B. Give hemostatic
C. Control and prevention of infection
D. Observe the development of lumbar mass and hematuria
E. Supplementary blood volume

Answer

A1-Type

DACAA DAACC ECEDE BBDEC

A2-Type

DBDADDECED EDDE

A3-Type

ABABC DBDEC CEAEC DDEDB

A4-Type

CDEED BDCEC

X-Type

ABCD BCD ABCD ABC ABCDE

3. Urinary and male-genital system infection

Fri, 06 Nov 2020 00:00:00 +0000

A1-Type (20 questions)

With regard to renal cortical infection, which of the following statements is wrong？

A. Most of them come from blood infection
B. The development of the lesion may lead to perirenal abscess and psoas major muscle abscess
C. There may be no inflammatory cells in the urine of early lesions
D. Early nephrostomy is beneficial to the treatment

What is the most common infection route of renal tuberculosis？

A. Intestinal tuberculosis spreads to the kidneys
B. Epididymal tuberculosis spreads to the kidney
C. Retrograde infection of bladder tuberculosis to kidney
D. Pulmonary tuberculosis spreads to the kidne

Which of the following is a susceptibility factor for infectious stones？

A. Hypocalcemia
B. Urease producing bacteria
C. Hyperoxalemia
D. Hyperthyroidism of parathyroid gland

Which of the following is common in acute cystitis?

A. Initial hematuria
B. Terminal hematuria
C. Whole course hematuria
D. Hematuria

Which of the following diseases is characterized by hematospermia?

A. Prostatitis
B. Seminal vesiculitis
C. Cystitis
D. Urinary tuberculosis
E. Prostate stones

Which of the following does not belong to the characteristics of prostatitis?

A. No urinary tract infection
B. Negative prostatic fluid bacterial culture
C. White blood cells in prostatic fluid
D. Often accompanied by neurosis
E. More young men

What is the most common route of urinary tract infection in women?

A. Lymphatic infection
B. Direct infection
C. Retrograde infection
D. Descending infection
E. Hematogenous infection

Middle aged female patients have frequent micturition, painful micturition and urgent micturition for more than 3 months, accompanied by urine turbidity. Generally, antibacterial treatment is ineffective. Which examination should be made first in the next step?

A.CT
B. Excretory pyelography
C. Cystoscopy
D. Retrograde pyelography
E. Cystography

Which of the following is the characteristic of urinary pain in urethritis?

A. Pain at the beginning of urination
B. Increased urinary pain at the end of urination
C. Often accompanied by urinary line interruption
D. With suprapubic pain
E. With terminal hematuria

Which of the following is the most common clinical prostatitis?

A. Acute bacterial prostatitis
B. Chronic bacterial prostatitis
C. Chronic nonbacterial prostatitis
D. Asymptomatic inflammatory prostatitis
E. Prostate pain

About hematuria with bladder irritation, which of the following diseases is the most common?

A. Bladder tumor
B. Acute cystitis
C. Acute pyelonephritis
D. Acute prostatitis
E. Acute seminal vesiculitis

What is the main pathogens of specific urinary tract infection?

A. Klebsiella pneumoniae
B. Escherichia coli
C. Mycobacterium tuberculosis
D. Fungi
E. Staphylococcus

What is the main pathogens of non-specific urinary tract infection?

A. Klebsiella pneumoniae
B. Escherichia coli
C. Mycobacterium tuberculosis
D. Fungi
E. Staphylococcus

What is the main infection pathway of urinary tract infection?

A. Ascending infection
B. Bloody infection
C. Lymphatic infection
D. Direct spread infection
E. Indirect spread infection

Which of the following is NOT the main clinical manifestation of lower urinary tract urinary system infection?

A. Frequency of urination
B. Urgency of urination
C. Dysuria
D. Difficulty urinating
E. Low back pain

Male patients with long-term indwelling catheterization may have epididymitis because of______

A. Hematogenous infection
B. Physical weakness
C. Lymphatic infection
D. Drug insensitivity
E. Spread of vas deferens

The incidence rate of cystitis in women is significantly higher than that in men. Which of the following is not the cause?

A. Female urethra is short and straight
B. Anatomical malformation of external urethral orifice
C. There are often infectious lesions near the urethral orifice
D. Infection is often secondary to urinary stone
E. Friction injury during sexual intercourse

Which of the following is the correct basis for the correct medication in acute urinary tract infection？

A. Urine routine
B. Urine bacterial culture
C. Urine bacterial culture + colony count
D. Urine bacterial culture + colony count + drug sensitivity test
E. Cystoscopy and pyelography

Which of the following is wrong about urinary tract infection？

A. The most common routes of infection are ascending infection and hematogenous infection
B. The most common pathogen is Escherichia coli
C. The most common pathogen of renal cortical infection is Staphylococcus aureus
D. Obstruction, foreign body and injury are important factors to promote urinary system infection
E. Men are more common than women

Which of the following is wrong about chronic epididymitis

A. It is often developed from untreated acute epididymitis
B. The epididymis showed thickening and swelling in varying degrees
C. The spermatic cord and vas deferens were thickened evenly
D. Simultaneous infection of both epididymis can affect fertility
E. Epididymis resection was needed

A2-Type （20 questions）

The patient,a 25 years old male, with sudden high fever, chills, urination pain, perineal pain, and discharge of inflammatory secretions at the urethral orifice, was admitted to the hospital with acute prostatitis. Which of the following treatments should be excluded

A. inflammatory secretion culture + drug sensitivity
B. bed rest
C. infusion, intravenous antibiotics
D. prostate massage
E. suprapubic cystostomy if necessary for dysuria

A 30-year-old male patient with right low back pain and fever was hospitalized for 3 days. His body temperature was 39 ~ 40 ℃. There was obvious percussion pain in the right renal area. A small amount of pyocyte could be seen in routine urine. Plain film and excretory urography showed enlarged renal shadow on the affected side and compression of renal calyces. The diagnosis was______

A. pyelonephritis
B. pyonephrosis
C. perinephritis
D. renal tuberculosis
E. kidney stones

The patient, a 40 years old male, came to the emergency department for 2 hours due to paroxysmal colic in the left waist, restlessness, nausea and urination discomfort. He had a similar attack history in the past. Examination: obvious percussion pain in the left renal area, 50 routine red blood cells in urine / HP. Which of the following is the appropriate treatment?

A. perform excretory urography immediately
B. immediate B-ultrasound examination
C. emergency radionuclide renogram
D. take clean middle urine for general culture
E. immediate application of analgesics and antispasmodics

A3-Type （5 questions）

A 20-year-old male patient with frequent and urgent urination for more than one year, accompanied by perineal swelling and pain, aggravated symptoms after drinking, no obvious abnormalities were found in routine urine examination for many times, no abnormalities were found in kidney, bladder and prostate by B-ultrasound, and the anti infection effect was poor.

What should be the next inspection?

A. Then routine urine examination
B. routine examination of prostate fluid
C. CT examination of prostate
D. Cystoscopy
E. Transrectal B-ultrasonography

After examining the prostatic fluid, the above patients found that the lecithin corpuscles in the prostatic fluid decreased significantly, with 15-20 cells /HP. Which of the following is correct?

A. Urinary tract infection
B. Chronic prostatitis
C. Cystitis
D. Prostatic hypertrophy
E. Urinary tuberculosis

Which of the following treatments is most meaningful for these patients?

A. Operation
B. Application of antibiotics
C. Warm water bath or local physiotherapy
D. Traditional Chinese medicine treatment
E. Local radiotherapy
A 33 years old male complained of lumbar and abdominal pain, chills and fever for 3 days without nausea and vomiting. Physical examination: the body temperature is 39°C, the pulse is 104 times / min, the sclera is not yellow, the lung is normal, and the abdomen does not touch the liver, spleen and gallbladder. Deep tenderness in the right upper abdomen, soft abdomen in the rest, negative Murphy sign, tenderness and percussion pain in the right costal ridge angle, flexion of the right aviation joint and inability to straighten. White blood cells 19.6 ×109 / L, neutrophils 0.90. Urine routine was negative. Amylase in blood and urine was normal. X-ray fluoroscopy showed that the heart and lung were normal, the right septal muscle increased and the activity decreased. Type B ultrasound showed that the liver and spleen were normal and the kidney shadow increased. The abdominal plain film showed that there was no stone shadow in the right kidney area and gallbladder area. The spine bends to the left, and the shadow of the right psoas major muscle disappears。

Which of the following is the most likely diagnosis？

A. Acute cholecystitis
B. Liver abscess
C. Swelling around left kidney
D. Acute membranous adenitis
E. Right perirenal cyst

The most unlikely cause is

A. Urinary obstructive disease
B. Rheumatoid arthritis
C. Periodontal swelling
D. Skin suppurative infection
E. Suppurative infection of paranasal sinus

A4-Type (5 questions)

Female, 30 years old, frequent urination, urgent urination and painful urination in recent one week with end macroscopic hematuria, aggravated one day with whole course macroscopic hematuria, and there are many red and white blood cells / HP in urine routine.

Which of the following checks is most inappropriate？

A. B-ultrasound examination
B. Catheterization for urine bacterial culture
C. Bacteriological culture
D. Intravenous urography
E. Bacteriological examination of urine sediment smear

Which of the following is not handled properly?

A. Drink more water
B. Reduce activities
C. Light diet
D. Oral broad-spectrum antibiotics
E. Bladder irrigation with catheter to control hematuria
Female, 35 years old, had a sudden urinary frequency, urgency and pain last night, accompanied by lower abdominal pain.
3.The first check to consider is
A. CT
B. Cystoscopy
C. Urine routine examination
D. Catheterization test residual urine
E. excretory urography

Which of the following is the most appropriate treatment?

A. Oral broad-spectrum antibiotic therapy
B. Intravenous antibiotics
C. Antibiotics were given intravenously for 1 day and then orally for 1 week
D. More than two antibiotics must be used in combination
E. Just drink more water and urinate frequently

The above patients found moderate hydronephrosis in the right kidney by B-mode ultrasound. Which of the following tests is the most inappropriate?

A. IVP
B. KUB
C Blood routine
D. Radionuclide renal scan
E. Cystoscopy and right renal retrograde angiography

Answer

A1

DDBBB BCBACBBBAE EDDEE

A2

DBE

A3

BBCEB

A4

BECAE

1. Surgical Examination and Diagnosis of Urinary and Male Reproductive System

Thu, 05 Nov 2020 00:00:00 +0000

A1-Type (25 questions)

Which of the following tests is not helpful to understand the etiology of hydronephrosis？

A. Abdominal CT examination
B. Urodynamic examination
C. Retrograde cystography
D. Cystourethroscope

In the imaging examination of renal injury, _______ can quickly and accurately understand the injury of renal parenchyma, urinary extravasation and perirenal hematoma, and understand the examination of contralateral renal function, liver, spleen, pancreas and great vessels

A. Intravenous pyelography
B. Abdominal ultrasound
C. Abdominal CT Enhanced Scan
D. Abdominal MRI

The key points of differentiation between renal tumors and retroperitoneal extrarenal tumors are _______

A. Palpable mass in the back waist
B. Does not cause hypertension
C. Does not cause renal rotation
D. No deformation of renal calyces

Which of the following is an early detection method for bone metastasis of prostate cancer?

A. MRI
B. B-scan ultrasonography
C. ECT
D. KUB

Which of the following is the most commonly used auxiliary examination of the urinary system

A. B ultrasound
B．CT
C．KUB
D．IVP
E．MRl

Which of the following diseases is characterized by hematospermia?

A. Prostatitis
B. Seminal vesiculitis
C. Cystitis
D. Urinary tuberculosis
E. Prostate stones

Regarding the value of excretory urography in the diagnosis of bladder cancer, which of the following is wrong?

A. Understand dual kidney function
B. Determine whether there is upper urinary tract obstruction caused by bladder tumor
C. Determine whether there is renal pelvis cancer and ureteral cancer
D. Preliminarily estimate the size and location of the tumor according to the filling defect in the bladder
E. Determine the depth of bladder tumor invasion

Which of the following is the best way to diagnose a renal mass

A. B ultrasound
B. CT
C. IVU
D. Abdominal plain film
E. Renogram

Which of the following is not included in the differential diagnosis of BPH？

A. Bladder neck contracture
B. Neurogenic bladder
C. Prostate cancer
D. Bladder diverticulum
E. Urethral stricture

Which of the following is wrong about the criteria for the diagnosis of “nephroptosis”?

A. The standing position of the renal plain film is at least one vertebral body lower than the lying position
B. The kidney B-ultrasound standing position is at least 3cm lower than the lying position
C. Nephroptosis is more common in thin and tall women
D. Bephroptosis is more common on the right side
E. Asymptomatic patients should also undergo surgery

Which of the following are the three typical symptoms of kidney cancer?

A. Hematuria, pain and lumps
B. Hematuria, pain and hypertension
C. Hypercalcemia, pain and hypertension
D. Hypercalcemia, pain and lumps
E. Emaciation, anemia and weakness

Which of the following organ is NOT belong to urinary tract?

A. Kidney
B. Ureter
C. Adrenal
D. Bladder
E. Urethra

Which of the following main symptoms is repeated frequent urination and urgent urination?

A. Kidney stone
B. Renal tuberculosis
C. Renal tumor
D. Nephroptosis
E. Renal edema

Which of the following is the definition of oliguria?

A. 1500 ml/24h
B. <100 ml/24h
C. >3500 ml/24h
D. <400 ml/24h
E. >2500 ml/24h

Which of the following is the definition of anuria?

A. 1500 ml/24h
B. <100 ml/24h
C. >3500 ml/24h
D. <400 ml/24h
E. >2500 ml/24h

Which of the following is the definition of microscopic pyuria under high power field?

A. <3 WBCs/HP
B. >5 WBCs/HP
C. >400 WBCs/HP
D. >3 WBCs/HP
E. >10 WBCs/HP

Which of the following is the definition of polyuria?

A. 1500 ml/24h
B. <100 ml/24h
C. >3500 ml/24h
D. <400 ml/24h
E. >2500 ml/24h

Which group of urologic diseases is often NOT associated with hematuria?

A. Urological tumors
B. Urinary tract infection
C. Primary aldosteronism
D. Urinary stones
E. Urological trauma

In which way is adult polycystic kidney inherited?

A. Autosomal dominant inheritance
B. Autosomal recessive inheritance
C. Sex chromosome dominant inheritance
D. Sex chromosome recessive inheritance
E. Not inherited

What is the most serious harm of cryptorchidism to men?

A. Male infertility
B. Sexual dysfunction
C. Testicular torsion
D. Mental factors
E. Malignant transformation

Which group of urologic diseases is often not associated with hematuria.

A. Urological tumors
B. Urinary tract infection
C. Primary aldosteronism
D. Urinary stones
E. Urological trauma

22.Which of the following is false regarding the characteristics of renal colic?

A. Severe colic is unsettling
B. Often paroxysmal attacks
C. The pain can be radiated to the lower abdomen
D. Pain may be severe enough to cause deficiency
E. No nausea or vomiting

What is the first choice examination for renal injury?

A. Ultrasound
B. X-ray
C. CT
D. MRI
E. Angiography C

Which of the following is the definition of microscopic hematuria under high power field?

A. <3 RBCs/HP
B. >5 RBCs/HP
C. >400 RBCs/HP
D. >3 RBCs /HP
E. >10 RBCs/HP

In which way is infantile polycystic kidney inherited?

A. Autosomal dominant inheritance
B. Autosomal recessive inheritance
C. Sex chromosome dominant inheritance
D. Sex chromosome recessive inheritance
E. Not inherited

A2-Type (25 qustions)

The patient was a 45 years old female with asymptomatic gross hematuria for 2 weeks. Cystoscopy showed that the left wall of bladder was 0.8 cm×1.2cm cauliflower tumor with unclear tumor pedicle and congestion of bladder mucosa around the tumor. The best treatment should be ________

A. Intracavitary chemotherapy
B. Radiotherapy + immunotherapy
C. Electrocautery or laser treatment of bladder tumors
D. Partial cystectomy
E. Total cystectomy

The patient, a 40 years old male, has gross hematuria. In order to determine the diagnosis, the most important examination is？

A. Urine routine
B. Urine exfoliated cell test
C. Excretory urography
D. Ultrasonic
E. Cystoscopy, retrograde pyelography

The patient is a young woman. After marriage, she has symptoms such as frequent urination, urgent urination and painful urination. The first examination to consider is ________

A. Cystoscopy
B. Urine exfoliative cell test
C. Urine three cup test
D. Renal function
E. Urine routine and urine culture

The patient was a 50 years old male with intermittent painless whole course hematuria for 2 months. B-ultrasound showed a 2cmx1cm tumor in the bladder. According to the medical history and examination, the most important test is _______

A. Urine routine
B. Urine exfoliative cell test
C. Cystoscopy
D. KUB and IVU
E. Enhanced CT

The patient was a 50 years old male with right lumbar pain, hematuria and low fever for 3 months. Physical examination: anemia, abdominal hypertrophy, no palpable mass, grade Ⅲ right varicocele, no varicocele on the left. ESR is fast. Which of the following is the most likely diagnosis?

A. Varicocele
B. Nephroblastoma
C. bladder cancer
D. Renal cell carcinoma
E. Renal pelvis tumor

The patient was a young male with sudden epigastric pain, nausea and vomiting. Routine urine examination showed that the field of vision was full of red blood cells, 5-10 white blood cells / HP, and the blood routine was normal. Considering the right ureteral stone, the most appropriate emergency treatment method was ________

A. drink plenty of water
B. oral antibiotics
C. anti inflammatory, antispasmodic and analgesic
D.ESWL
E. surgical exploration

The patient had painless gross hematuria and cancer cells were detected in the urine. Which of the following tests is most meaningful for further diagnosis?

A. Cystoscopy
B. X-ray abdominal plain film
C. Intravenous pyelography
D. Renal arteriography
E. Cystoscopy + retrograde pyelography

The patient was male, 40 years old. He came to the hospital for emergency treatment for 2 hours due to paroxysmal colic in the left waist, restlessness, nausea and urination discomfort. He had a similar attack history in the past. Examination: obvious percussion pain in the left renal area, routine urine red blood cells 50 / HP. Which of the following is the most appropriate treatment？

A. Perform excretory urography immediately
B. Immediate B-ultrasound examination
C. Emergency radionuclide renogram
D. Take clean middle urine for general culture
E. Immediate application of analgesics and antispasmodics

A 29 years old male patient underwent left kidney and left ureterectomy for tuberculosis of the left kidney, left ureter and bladder one year ago. After the operation, he was treated with anti tuberculosis for 8 months. At present, the routine urine examination of the patient is negative. IVP shows mild hydronephrosis in the right kidney, but the symptoms of frequent urination are significantly aggravated. The reason is ________

A. Urethral syndrome caused by tuberculosis
B. Failure to control bladder tuberculosis
C. Tuberculosis recurrence
D. Complicated with urinary system infection
E. Bladder contracture

The patient is a 72 years old male with painless gross hematuria for more than 1 week. The physical examination found that the left varicocele did not disappear when lying on his back. The first diagnosis to consider is ________

A. Renal cancer
B. Ureteral cancer
C. Prostate cancer
D. Carcinoma of the renal pelvis
E. Bladder cancer

The patient, a 29 years old female, was treated for 3 months due to blunt pain in the left waist. After B-ultrasound and KUB + IVP examination, it was found that there was a 2.0cm×3.0cm stone in the left renal pelvis, left hydronephrosis, left ureter and right kidney and ureter were normal. The preferred treatment for the patient was _______

A. Traditional Chinese medicine stone removal
B. Temporary observation
C. Endoscopic lithotripsy
D. Open surgery
E. Extracorporeal shock wave lithotripsy (ESWL)

The patient was male, 67 years old. B-ultrasound found that the diameter of bladder stones was 1.5cm, combined with bladder diverticulum. Which of the following treatments is most appropriate？

A. ESWL
B. Traditional Chinese medicine stone removal
C. Self dumping
D. Cystoscopic mechanical lithotripsy
E. Cystolithotomy

13.The patient was a 20-year-old male. Physical examination showed that there was a cyst in the groin or above the testis. The light transmission test was positive. There was a clear boundary between the cyst and the testis. Which of the following is the most likely diagnosis?

A. Testicular hydrocele
B. Hydrocele of spermatic cord
C. Communicating hydrocele
D. Testicular tumors
E. Semen cyst

The patient is a 48 years old female with frequent urination, urgency and pain, accompanied by blood dripping after urination for 4 days. Urine routine shows many red and white blood cells /HP. Which of the following tests is incorrect?

A. IVP
B. Cytological culture
C. Urine culture
D. Cystoscopy
E. B-ultrasound examination of urinary system

The patient, a 42 years old female, had recurrent left low back pain with hematuria for 5 years and no urine for 3 days. The right kidney was removed 2 years ago, and physical examination showed that the blood pressure was 27 / 13 kPa.The general condition is poor, the whole body is swollen, the percussion pain in the left renal area is positive, and the blood creatinine is 618.8 μmmol/L (7mg%), a 0.6cm×0.7cm high-density shadow can be seen on the lower edge of the left sacroiliac joint. Which of the following tests should be selected for clear diagnosis?

A. Routine excretory urography
B. Isotopic renogram
C. Selective renal arteriography
D. Left ureteral intubation and retrograde radiography
E. CT examination

The patient, male, 30 years old, had right low back pain with fever for 15 days, up to 40 ℃, mild anemia and normal urine routine. In the following cases, the least likely for this patient is ________

A. ESR may be fast
B. WBC may be high in blood
C. may be associated with staphylococcal infection
D. may be associated with E. coli infection
E. CT may show space occupying lesions

The patient, a 24-year-old male, has a mass in the left scrotum in the past 3 months, which has gradually enlarged, no pain, no fever, punctured and purulent one month ago, and there is no significant improvement in anti infection treatment. The following most likely diagnosis is ________

A. Filariasis in scrotum
B. Testicular tumors
C. Acute epididymitis
D. Acute orchitis
E. Epididymal tuberculosis

The patient was a 68 years old female with intermittent painless gross hematuria for 1 month. B-ultrasound showed left renal space occupying lesion, IVP: renal pelvis and calyces were compressed, urine cytology (-), cystoscopy showed left ureteral orifice bleeding, and the most likely diagnosis was?

A. Left renal pelvis tumor
B. Left nephroblastoma
C. Left kidney stone
D. Left renal cyst
E. Left renal cell carcinoma

The patient, a 60 years old male, had a 1.0 cm induration on his prostate. Two rectal biopsy reports showed benign prostatic hypertrophy. What should be done next?

A. Repeat intrarectal biopsy
B. Simple prostatectomy
C. Radical prostatectomy
D. Transurethral resection for biopsy
E. Transrectal B-ultrasound biopsy

Middle aged female patients have frequent micturition, painful micturition and urgent micturition for more than 3 months, accompanied by urine turbidity. Generally, antibacterial treatment is ineffective. Which examination should be made first ?

A. CT
B. Excretory pyelography
C. Cystoscopy
D. Retrograde pyelography
E. Cystography

The patient was a 32 years old male with recurrent left lumbar pain and microscopic hematuria for 1 year. He had no urine for nearly 3 days and his right kidney had been removed. Physical examination: hazy mind, systemic edema, blood pressure 180 / 100mmhg, percussion pain in the left renal area, blood urea nitrogen 53.6mmol/l, and a 1.0cm×0.8cm high-density shadow can be seen on the lower edge of the left sacroiliac joint on the abdominal plain film. What kind of examination should be done to clarify the diagnosis?

A. B ultrasound
B. Left ureteral intubation and retrograde angiography via cystoscope
C. Radionuclide renogram
D. Routine excretory urography
E. CT

The patient was a 36 years old male who was kicked in the lower abdomen and felt severe pain in the lower abdomen, abdominal distension and obvious tenderness. He was initially diagnosed as closed bladder rupture.Which of the following checks is not normally used？

A. Abdominal plain film
B. Catheterization and bladder leak test
C. B-ultrasound examination of bladder
D. Cystography
E. Cystoscopy

The patient, male, 35 years old, is a migrant worker. In February 2000, he began to have frequent urination, urgent urination and urination pain, lower abdominal discomfort, irregular use of norfloxacin, no significant improvement in symptoms, and the frequent urination, urgent urination and urination pain became more and more serious. The most likely diagnosis is

A. Renal tuberculosis
B. Chronic prostatitis
C. Bladder stones
D. Bladder triangle tumor
E. Bladder cancer

The patient was a 60 years old male with intermittent micturition interruption for 5 days. The abdominal plain film showed that there was an oval shadow with a diameter of 2.5cm in the bladder area.After questioning the medical history, he had frequent micturition and dysuria for 4 years. The most reliable diagnostic method for the patient is ________

A. IVP
B. Standing abdominal plain film
C. Lateral abdominal plain film
D. Cystoscopy
E. CT

The 68 years old female had intermittent painless gross hematuria for 1 month. Physical examination: the lower pole of the left kidney is accessible. B-ultrasound showed left renal space occupying lesion, IVP: renal pelvis and calyces were compressed. Urine cytology (-). Cystoscopy showed white ejection from the left ureter. The most likely disease to be diagnosed is ________

A. Left renal cell carcinoma
B. Left nephroblastoma
C. Left renal cyst
D. Left renal pelvis tumor
E. Left kidney stone

A3-Type (25 qustions)

Male, 44 years old, suffered from recurrent right renal colic for 1 year. In the past two years, he often ate meat, especially animal viscera, with red, swollen, hot and painful bilateral toe joints. No abnormality was found in the plain film examination of urinary system.

1.1. Which of the following examinations should be performed for the patient to make a definite diagnosis？
A. X-ray examination of bilateral toes
B. Urine erythrocyte phase examination
C. 24-hour urine calcium and phosphorus test
D. B-ultrasound examination of kidney, ureter and bladder
E. After cleaning and intestinal lavage, the urinary system was rechecked by plain film
1.2. Which of the following urine routine results has diagnostic value for the disease？
A. Low specific gravity urine
B. High specific gravity urine
C. Urinary pH increased
D. Urinary pH decreased
E. Urinary calcium increased
1.3. Which of the following measures is not appropriate for the patient to prevent recurrence of the disease？
A. Drink more water
B. Properly increase the intake of salt
C. Drink less milk
D. Eat less animal protein
E. Eat more foods rich in cellulose
1.4. The patient’s preferred drug treatment for the prevention of disease recurrence is
A. Sodium bicarbonate tablets
B. Uranium bicarbonate solution
C. Chlorinated bait solution
D. Chlorinated forged tablets
E. Liquor potassii citratis

Male, 66 years old, frequent urination, progressive dysuria for more than 10 years, aggravated for 3 months. Now it is difficult to urinate, unable to control urination and frequent urinary incontinence. Past history of pulmonary tuberculosis. Physical examination: the two fingers under the umbilicus can reach the swollen bladder, and the lower limbs are slightly swollen. Prostate II degree increased, medium and smooth. Laboratory examination: Hb10.8g/dL, many red and white blood cells / HP in routine urine, BUN:12.1 µmol/L, Cr: 279 µmol/L.

2.1. Which of the following diagnoses is most likely to be correct?
A. Advanced prostate cancer with renal insufficiency
B. Benign prostatic hyperplasia, chronic urinary leakage with urinary tract infection, renal insufficiency
C. Enlarged prostate with urinary tuberculosis
D. BPH with bladder stones
E. BPH with tumor
2.2.Which of the following treatment is incorrect?
A. Immediate indwelling of urinary catheter
B. appropriate use of diuretics
C. antibiotics to control infection
D. Suprapubic cystostomy
E. Emergency prostatectomy to relieve obstruction

Female, 34 years old, with a history of frequent urination and urgent urination for more than 3 years, with repeated symptoms, sometimes heavy and sometimes light. A variety of antibiotic treatment did not improve. A small amount of red and white blood cells /HP were occasionally seen in routine urine examination for many times. Recently, the symptoms of urinary urgency were aggravated and urinary incontinence occurred occasionally.

3.1. The patient’s most likely diagnosis is?
A. Acute cystitis
B. Chronic cystitis
C. Overactive bladder
D. Interstitial cystitis
E. Urinary tuberculosis
3.2.What kind of urinary incontinence does this patient have?
A. Mental incontinence
B. Stress incontinence
C. Urgent incontinence
D. Filling incontinence
E. True incontinence

Female, 45 years old, painless gross hematuria for 1 month, with occasional blood clots in the urine,also accompanied by bladder irritation sign. B-ultrasound showed a 1cm x 2cm soft tissue shadow with pedicle on the right wall of bladder.

4.1. Which of the following is the most likely diagnosis?
A. Bladder stone
B. Acute cystitis
C. Bladder foreign body
D. Bladder diverticulum
E. Bladder tumor
4.2. In order to make a definite diagnosis, the most valuable examination method is
A. Urine cytology
B. Pelvic MRI
C. Pelvic CT
D. Cystography
E. Cystoscopy + biopsy

Male, 75 years old. Dysuria lasted for 3 years and worsened for 2 weeks. Digital rectal examination revealed prostatic nodules with hard texture. Serum PSA 30ng /ml.

5.1. For a definite diagnosis,The most important examination is
A. Prostate biopsy
B. Prostate MRI
C. Cystourethroscopy
D. Enhanced CT of prostate
E. Transrectal prostate ultrasound
5.2. Which of the following tests is of little significance in assessing a patient’s condition?
A. Prostate MRI
B. B-ultrasound of urinary system
C. Radionuclide bone imaging
D. X-ray chest film
E. Cystourethrography

Male, 35 years old. Frequent micturition, urgent micturition, urinary pain and swelling and pain of the right scrotum for 6 months. Past history of pulmonary tuberculosis. Physical examination: the right epididymis tail is swollen and hard.

6.1. Which of the following is the most likely diagnosis?
A. Acute epididymitis,
B. Chronic epididymitis
C. Renal tuberculosis
D. Cystitis
E. Epididymal tuberculosis
6.2. The most valuable examination for systemic lesions is
A. B-ultrasound of urinary system
B. MRI
C. Ureteroscopy
D. Intravenous urography
E. Urine routine

The patient, male, 67 years old, repeatedly urinated at night for more than half a year and had difficulty urinating for 2 months. No space occupying lesions were found in both kidneys by B-ultrasound. The bladder was well filled and the size of prostate was 4.5cm × 4cm × 3cm . Residual urine volume 120 ml.

7.1. The most likely diagnosis of these patients is
A. Neurogenic bladder
B. Overactive bladder
C. Benign prostatic hyperplasia
D. Bladder tumor
E. Urethral stricture
7.2. Which inspection should be done next?
A. CT
B. MRI
C. Transrectal B-ultrasound
D. Urodynamics
E. abdominal plain film

The patient was a thirty-five years old female. Last night, she had a sudden urination frequency, urgency and pain, accompanied by lower abdominal pain.

-8.1. What checks should be considered first?

A. CT
B. Cystoscopy
C. Urine routine examination
D. Catheterization test residual urine
E. Excretory urography

-8.2. How should be treated at this time?

A. Oral broad-spectrum antibiotic therapy
B. Intravenous antibiotics
C. First intravenous infusion of antibiotics one Change to oral antibiotics after days one week
D. must two Combination of more than antibiotics
E. Just drink more water and urinate frequently

-8.3. The patients was treated by B-ultrasound examination found moderate hydronephrosis in the right kidney. Which of the following examinations is the most inappropriate ?

A. IVP
B. KUB
C. Routine blood test
D. Radionuclide renal scan
E. Cystoscopy right renal retrograde angiography

The patient, a 45 years old male, had intermittent gross hematuria for more than 3 months. IVP showed irregular filling defect in the left renal pelvis, and cystoscopy showed blood ejection from the left ureteral orifice.

9.1. According to the above examination, what disease should be considered first?
A. Renal tuberculosis
B. Renal cell carcinoma
C. Renal stone
D. carcinoma of renal pelvis E nephritis
9.2. What treatment measures should be taken?
A. Surgery
B. Antibiotics
C. Hemostatic drugs
D. Chemotherapy
E. All the above are right
9.3. One year after operation, the patient had chest pain and cough. Chest X-ray examination showed scattered small nodules in the lung. What disease should be considered?
A. Pneumonia
B. Tuberculosis
C. Lung cancer
D. Lung metastasis of renal cell carcinoma
E. All the above are right

Patient, male, 45 years old. Two days ago, painless gross hematuria suddenly appeared, mild discomfort in the right waist, no previous history of hematuria, and the clinical preliminary diagnosis was “renal tumor”.

10.1. The preferred inspection method at this time is
A .X-ray
B. Renal arteriography
C. Excretory urography
D. B-ultrasonic examination
E. Isotope renal scan
10.2. What other diseases need to be diagnosed?
A. Kidney stones
B. Renal cell carcinoma
C. Renal cyst
D. Renal tuberculosis
E. All the above are right
10.3. The patient found a solid space occupying lesion in the right kidney. The proposed operation method is _____?
A. Right nephrectomy
B. Partial resection of right kidney
C. Intraoperative frozen preparation for right nephrectomy
D. Ureteral transplantation
E. Renal transplantation

A4-Type (25 qustions)

A 62-year-old African American male attorney presents to a prostate-screening clinic, he has noted slight urgency of urination, frequency nocturia, and a decrease in the force of micturition.

1.1. Which of the following blood tests does he need to do?
A. Carcinoembryonic antigen (CEA)
B. Prostatic acid phosphatase
C. Alkaline phosphatase
D. Prostate-specific antigen (PSA)
E. Lactic dehydrogenase (LDH)
1.2. Arectal examination reveals hemorrhoids and a left-sided irregular mass in the prostat- E. Following normal blood tests, he should have which of the following?
A. Computed tomography (CT) scan of the pelvis
B. Magnetic resonance image (MRI) of the prostate
C. Colonoscopy and biopsy of the prostate under general anesthetic
D. Biopsy of the nodule
E. Bone scan

A 62-year-old postal officer develops minimal urinary symptoms. His PSA level is elevated and continues to increase during a 6-month period of observation. Transrectal ultrasound (TRUS) prostate biopsy were positive for adenocarcinoma of prostate.

2.1. Which of the following is the most reasonable treatment？
A. Refer to oncologist for chemotherapy
B. Metastatic evaluation including CT and bone scans
C. Repeat PSA and biospy
D. Evaluation by radiation oncologist
E. Start hormonal ablation treatment
2.2. Because of positive biopsy findings, he undergoes a radical prostatectomy. The pathology report reveals Gleason score 9/10 and involvement of several pelvic lymph nodes.Which is the most likely site for prostatic cancer metastasis?
A. Liver
B. Kidney
C. Lung
D. Bone
E. Brain
2.3. Metastatic disease from prostatic cancer is confirmed. What is the treatment offered initially to most patients with metastatic prostatic cancer?
A. Cortisone and pituitary ablation
B. Radical prostatectomy
C. Luteinizing releasing hormone (LRH) agonist (Leuprolide)
D. Local irradiation and testosterone
E. Hyperthermia

The patient was a 20-year-old male with right lumbar impact injury for 2 hours, with right lumbar pain, palpable mass and gross hematuria. Admission physical examination status: BP80/40 mmHg. CT and B-ultrasound showed rupture of right kidney, hematocele in renal pelvis and normal left kidney.

3.1 The measure to be taken is
A. Oral antibiotics – hospitalized to observe the changes of the patient’s condition
B. You can go home and stay in bed to closely observe the changes of your condition
C. Supplement blood volume by blood transfusion and infusion
D. Surgical exploration
E. Look at the bladder first
3.2 During the operation, it was found that the renal arteries and veins on the affected side were obviously damaged. The measure to be taken is _____
A. Nephrectomy
B. Vascular repair
C. Partial nephrectomy
D. Wound suture hemostasis
E. None of the above is correct
3.3. On the third day after operation, the patient had systemic edema and decreased urine volume. The examination to be performed was _____
A. Contralateral renal function
B. Blood cell analysis
C. Urinalysis
D. Renal CT
E. Renal MRI

The patient was a 36 years old female. A week ago, she underwent total hysterectomy due to endometrial cancer. There was more bleeding during the operation. Now there was continuous clear liquid outflow from the vagina. After the solution was injected into the bladder, the vaginal outflow was still clear.

4.1. What is the first diagnosis to consider?
A. Renal injury
B. Ureteral injury
C. Bladder injury
D. Anterior urethral injury
E. Posterior urethral injury
4.2 What treatment is required?
A. Continue observation
B. Indwelling catheter
C. Cystoscopy
D. Contrast
E. All the above are right
4.3. If ureteral injury is indicated by angiography, the treatment measure to be taken is___
A. Ureteral transplantation
B. Open ureter
C. Ureteral stent
D. Temporary observation E end to end ureterostomy
4.4 How long is the retention time of ureteral stent placed during operation?
A. 7 days
B. 14 days
C. 30 days
D. 60 days
E. 6 months

The patient, an 18-year-old male, was kicked in the perineum for 6 hours. The perineum was painful, slightly swollen, poor urination, and the pain was aggravated during urination, but he could urinate. There were no special signs during physical examination.

5.1. What is the most likely diagnosis?
A. Urethral rupture
B. Urethral contusion
C. Soft tissue contusion
D. Prostatitis
E. Urethritis
5.2 The most appropriate treatment is
A. Urethral reduction
B. Cystostomy
C. Open surgical repair of bladder
D. Antibiotic treatment to observe the changes of the disease
E. Indwelling catheter for urine drainage
5.2. How long does the catheter stay?
A. 3 days
B. 7 days
C. 14 days
D. 30 days
E. 3 months
5.3. Turbid liquid can be seen in the urinary catheter on the fifth day. What should be considered at this time?
A. Urinary tract infection
B. Dehydration
C. Nephritis
D. Urinary stone
E. All of the above are possible

The patient, a 22-year-old female, had sudden frequent micturition, urgent micturition, urinary pain, incomplete micturition, accompanied by low fever, increased leukocytes and a little red blood cells in routine urine examination.

6.1. What should be further checked?
A. Urine bacteria culture
B. Abdominal ultrasound
C. Blood routine
D. Abdominal CT
E. None of the above is correct
6.2. If it is confirmed to be urinary infection by bacterial culture, the most likely route of infection is___
A. Direct infection
B. Blood borne infection
C. Lymphatic infection
D. Retrograde infection
E. Seminal tract infection
6.3. According to the above culture results, What is the preferred treatment?
A. Oral quinolones
B. Vancomycin static point
C. Catheterization
D. Bladder irrigation
E. All the above are right

The patient, male, aged 75, had a urinary retention before March. He had frequent micturition, dysuria, and acute myocardial infarction five years ago. The heart condition is relatively stable.

7.1. What tests should the patient undergo?
A. Urodynamic examination
B. Prostate B-ultrasound
C. Urography
D. Routine urine test
E. Urine bacteria culture
7.2 Ultrasound examination showed benign prostatic hyperplasia, and the first choice of treatment was
A. Drug treatment, such as hormone α Receptor blocker
B. Catheterization
C. Prostatectomy or transurethral resection of the prostate
D. Cystostomy
E. Antibiotics
7.3. On the first day of prostatectomy, the patient’s urine was pale blood. What treatment does the patient need?
A. Indwelling catheter
B. Application of hemostatic drugs
C. Antibiotic
D. Diuretic drugs
E. No special treatment
7.4. Turbid liquid can be seen in the urinary catheter on the fifth day after operation. What complications should be considered at this time?
A. Urinary tract infection
B. Dehydration
C. Nephritis
D. Urinary stone
E. The above are possible

Male, 35 years old, severe pain in the left waist, accompanied by nausea, vomiting and anuria for 3 days. Nephrectomy was performed for right hydronephrosis 5 years ago. Physical examination: left renal percussion pain, blood urea nitrogen 50.6mmol/l, KUB showed a 0.8cm high-density shadow at the left sacroiliac joint

8.1. The most valuable auxiliary examination for diagnosis is ______
A. Ultrasonic examination
B. Excretory urography
C. Radionuclide renogram
D. CT
E. ureteral intubation and retrograde radiography
8.2 The first choice for emergency treatment is ______
A. Ureterolithotomy
B. Ureteral intubation and drainage
C. Ureteral catheter lithotomy
D. Chtaneous ureterostomy
E. Treatment with integrated traditional Chinese and Western medicine

B1-Type (15 qustions)

A. Hematuria characteristics of renal tuberculosis
B. Hematuria characteristics of renal tumors
C. Hematuria characteristics of renal stone
D. Hematuria characteristics of pyelonephritis
E. Characteristics of hematuria in cystitis

Terminal hematuria with frequent urination, urgency and pain.
Painless gross hematuria.
Gross hematuria with renal colic.

A. Stress urinary incontinence
B. True urinary incontinence
C. Filling incontinence
D. Pseudourinary incontinence
E. Urgent urinary incontinence

A 28 years old female had frequent urination, urgency and pain for 5 days, with occasional symptoms of urinary incontinene.
Women aged 67 often have urinary incontinence symptoms in the past three years, which often worsen when they feel cough. No urinary tract rritation.
A 76 years old male had progressive dysuria for more than 10 years. Recently, his symptoms became worse after suffering from pneumonia. He had micturition drip and urinary incontinence.
A 71 years old man underwent transurethral prostatectomy for benign prostatic hyperplasia. He was unable to urinate normally after the operation. His urine flowed out involuntarily.

A. Varicocele
B. Hydrocele of tunica vaginalis
C. Hematocele vaginalis
D. Testicular tumor
E. Epididymitis

Which of the above is often caused by tuberculosis
Which of the above often occurs on the left
Which of the above is related to cryptorchidism
Which of the above is secondary to trauma
Which of the above light transmission tests is positive

A. Squamous cell carcinoma
B. Adenocarcinoma
C. Clear cell carcinoma
D. Transitional cell carcinoma
E. Seminoma

The most common form of penile cancer is
Testicular cancer is the most common
What is the most common form of prostate cancer

X-Type (10 qustions)

Meaningful tests for the diagnosis of prostate cancer include _______

A. Transrectal B-scan ultrasonography
B. Digital rectal examination(DRE)
C. Excretory urography
D. Serum PSA test

Which of the following test to confirm whether there is residual urine and determine the residual amount is wrong?

A. Indwelling catheter after urination
B. Percussion of bladder area after urination
C. Digital rectal examination
D. KUB examination of urinary system after micturition

The diagnostic basis of renal tuberculosis includes _______

A. X-ray radiography showed destruction or calcification
B. Irritation sign of bladder
C. Acid fast bacilli found in urine
D. Pyuria and hematuria

Which of the following statements about hematuria are correct？

A. Red urine is hematuria
B. Generally, when 1000 ml urine contains 1ml blood, it is gross hematuria
C. When there are more than 3 red blood cells in each high power field of centrifuged urine, it has pathological significance
D. The degree of hematuria is directly proportional to the severity of the disease

Which of the following are contraindications for retrograde angiography?

A. Lower urinary tract infection
B. Urinary stone
C. Urethral stricture
D. Bladder tumor
E. Urinary tuberculosis

Which of the following are common symptoms in patients with prostatitis?

A. Abnormal urination such as frequent urination and urgent urination
B. Renal colic
C. Sexual function change
D. Perineal pain or discomfort
E. Weakness and weakness of limbs

The physical examination of Urology specialty should include ________

A. Examination of renal area
B. Ureteral examination
C. Bladder examination
D. Examination of external genitalia
E. Examination of prostate and seminal vesicle

Which of the following are the diagnostic methods of bladder stones？

A. X-ray plain film
B. B-ultrasound
C. Cystoscopy
D. Digit
E. Renal arteriography

Which of the following are the main uses of renal arteriography?

A. For diagnosis
B. For the treatment of embolism
C. Intraluminal vasodilation
D. Used to determine the function of the kidney
E. Used to define the scope of the tumor

Which of the following diseases can cause urinary tract obstruction in its development?

A. Pelvic tumor
B. Varicocele
C. Prostate disease
D. Epididymal cyst
E. Urinary tuberculosis

Answer

A1-Type

ACDCA BEBDE ACBDB DECAE CECBB

A2-Type

DEECD CEEEA CEBDD EEEEB BAADA

A3-Type

DDBEB ECCEE AEEDC DCAED ADDEC

A4-Type

DDBDC DAABD ABBEB AAEAB CAAEB

B1-Type

ABCEA CBEAD CBAEB

X-Type

ABD CD ABCD BC AC ACD ABCDE ABCD ABC ACE