A 33-year-old female patient visits the clinic multiple times over the last year complaining of dysuria, frequency, urgency, suprapubic pain, and dyspareunia. Her physical examination, including a pelvic exam, is normal.
Urinalysis and urine culture is repeatedly negative. Her intravenous pyelogram is also normal. The clinician should recognize that this presentation is consistent with symptoms of:
A. Asymptomatic bacteriuria
B. Upper urinary tract infection
C. Interstitial cystitis
D. Polycystic kidneys
Question 2A 65-year-old male patient complains of frequency, urgency, hesitancy, and weak urine stream. Physical examination is unremarkable except DRE reveals an enlarged, firm, non-tender prostate gland. Urine culture reveals 100 bacteria CFU/mL.
The clinician should suspect:
A. Lower urinary tract infection due to benign prostatic hyperplasia
B. Bacteriuria due to prostatitis
C. Obstructive uropathy due to prostate cancer
D. Upper urinary tract infection due to benign prostatic hyperplasia
Question 3A 27-year-old male comes in to the clinic for symptoms of dysuria, urinary frequency, as well as urgency and perineal pain. Transrectal palpation of the prostate reveals a very tender, boggy, swollen prostate.
The clinician should recognize these as signs of:
A. Prostatitis
B. Prostate cancer
C. Urethritis
D. Benign prostatic hyperplasia
Question 4Your 77-year-old patient complains of frequent urination, hesitation in getting the stream started, and nocturnal frequency of urination that is bothersome. On DRE, there is an enlarged, firm, non-tender, smooth prostate.
The clinician should recognize these as symptoms of:
A. Prostatitis
B. Prostate cancer
C. Urethritis
D. Benign prostatic hyperplasia
Question 5Your 66-year-old patient complains of frequency of urination and hesitancy of the urine stream. On DRE, there is a hard, nodular, enlarged, non-tender prostate. The clinician should recognize these as symptoms of:
A. Prostatitis
B. Prostate cancer
C. Urethritis
D. Benign prostatic hyperplasia
Question 6A 43-year-old male patient complains of right-sided abdominal and pain in the back in the right costovertebral angle region, fever, chills, dysuria, and nausea.
On physical examination, there is 102 degree fever, tachycardia, and right costovertebral angle tenderness to percussion. The most likely condition is:
A. Lower urinary tract infection
B. Pyelonephritis
C. Nephrolithiasis
D. Hydronephrosis
Question 7On a physical examination for employment, a 45-year-old male shows no significant findings and takes no medications. Past medical history and surgery are unremarkable. On urinalysis, hematuria is present.
The urinalysis is repeated on another day and still reveals microscopic hematuria. It is important to recognize that painless hematuria can be diagnostic of:
A. Urinary tract infection
B. Bladder cancer
C. Nephrolithiasis
D. Pyelonephritis
Question 8On DRE, you note that a 45-year-old patient has a firm, smooth, non-tender but asymmetrically shaped prostate. The patient has no symptoms and has a normal urinalysis. The patient's PSA is within normal limits for the patient's age.
The clinician should:
A. Refer the patient for transrectal ultrasound guided prostate biopsy
B. Obtain an abdominal x-ray of kidneys, ureter, and bladder
C. Recognize this as a normal finding that requires periodic follow-up
D. Obtain urine culture and sensitivity for prostatitis
Question 9The most common complication of an untreated urinary obstruction due to a ureteral calculus is:
A. Hydronephrosis
B. Renal artery stenosis
C. Ureteral rupture
D. Kidney mass
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