Clinical Decision Making

Q. What causes the pain associated with a stone in the ureter?

  1. Obstruction of urine flow with distension of the renal capsule

    1. Irritation of the ureteral mucosa by the stone

    2. Excessive ureteral peristalsis in response to the obstructing stone

    3. Irritation of the intramural ureter

    4. Urinary extravasation from a ruptured calyceal fornix

Q. What is the most common cause of gross hematuria in a patient older than 50 years of age?

    1. Renal calculi

    2. Infection

  1. Bladder cancer

    1. Benign Prostatic Hyperplasia

    2. Trauma

Q. What is the most common cause of pain associated with gross hematuria?

    1. Simultaneous passage of a kidney stone

  1. Ureteral obstruction due to blood clots

    1. Urinary tract malignancy

    2. Prostatic inflammation

    3. Prostatic enlargement

Q. All of the following are typical lower urinary tract symptoms associated with benign prostatic hyperplasia EXCEPT:

    1. urgency

    2. frequency

    3. nocturia

  1. dysuria

    1. weak urinary stream

Q. What is the most common cause of continuous incontinence (loss of urine at all times and in all positions)?

    1. Enterovesical fistula

    2. Noncompliant bladder

    3. Detrusor hyperreflexia

  1. Vesicovaginal fistula

    1. Sphincteric incompitence

Q. All of the following are potential causes of anejaculation EXCEPT:

    1. sympathetic denervation

    2. pharmacologic agents

    3. bladder neck & prostatic surgery

    4. androgen deficiency

  1. cerebrovascular accidents

Q. What percentage of patients with multiple sclerosis will present with urinary symptoms as the first manifestation of the disease?

    1. 1%

  1. 5%

    1. 10%

    2. 15%

    3. 20%

Q. What important information is gained from pelvic bimanual examination that cannot be obtained from radiologic evaluation?

    1. Presence of bladder mass

    2. Invasion of bladder cancer into perivesical fat

    3. Presence of bladder calculi

    4. Presence of associated pathologic lesion in female adnexal structures

  1. Mobility/fixation of pelvic organs

Q. With what disease is priapism primarily associated?

    1. Peyronie's disease

  1. Sickle cell anemia

    1. Parkinson's disease

    2. Organic depression

    3. Leukemia

Q. What is the most common cause of cloudy urine?

    1. Bacterial cystitis

    2. Urine overgrowth with yeast

  1. Phosphaturia

    1. Alkaline urine

    2. Significant proteinuria

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