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

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

Last updated on Nov 6, 2022