MCQ 4th week of July, 2015



  1. A 65 year old man has AUA symptoms score of 25 and a bother score of 5. He has no history of urinary retention, infection or stones. With Normal renal function. DRE shows a 25 gm benign prostate. The next step is :                                                                                                                


a.     Alpha blocker
b.    Photovaporization.
c.     5- alpha reductase inhibitor.
d.    Observation.
e.     Combined alpha blocker and 5. Alpha reductase inhibitor.


  1. A 47 year old obese man has hypertention, new onset diabetes and general weakness. 24 hours urine collections show elevated cortisol levels. The next step is:
a.     Abdominal CT scan.
b.    Low dose dexamethasone test.
c.     Metyrapone test.
d.    High dose dexamethasone test.
e.     Late afternoon plasma corticotrophin and cortisol measurement.


  1. A 35 year old man with a T10 spinal cord injury has chronic bacteruria unresponsive to antimicrobial therapy. He is managed by CIC obtaining volume of 400 ml. Cystometry shows detrusor areflexia with high bladder compliance. A renal Ultrasound is normal except for 4 mm left renal stone. The best management is:
a.     Sphincterotomy and condom catheter drainage.
b.    Reassurance.
c.     ESWL.
d.    Urine Culture.
e.     Urinary acidification.


  1. A 28 year old man with poor frequency and quality of erection since a radical orchiectomy for a stage A seminoma six months ago. He received XRT to periaortic nodes. The last treatment was two months after the orchiectomy. His Chest X ray and the serum markers, glucose and testosterone are normal. The next step is:


a.     Testosteron patch.
b.    Intracavernosal injection therapy.
c.     Nacturnal penile tumescence studies.
d.    Sexual dysfunction counseling.
e.     Intraurethral alprostadil.


  1. A 42 year old man with spina befida undergoes ileovesicostomy and bladder neck closure with omental flap interposition for sever incontinence. Thee months later he develops recurrent incontinence from a vesicourethral fistula. The next step is:
a.     Ileal conduit.
b.    Tube vesicostomy.
c.     Repeat bladder neck closure with rectus flap interposition.
d.    Permanent nephrostomy tube.
e.     Repeat bladder neck closure with omental interposition.



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