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As they progress in their training, their results should improve over the years. It also provides insight in areas which need additional study and reading 198. The content of the assessment covers both clinical and basic sciences. The contents of the MCQs do not only refiect current management of specific pathologies, but focus on issues of basic science as well. The purpose is to stimulate participants to study clinical urology and to acquire some insight in the basic research that will form the basis of urological practice in the future. 199, Many of the MCQs are rather specific: they have been included in the EBU Service Assessment but are in general not suitable for the official EBU Examination in Urology (FEBU). The assessment and the examination can therefore not be compared. Questions included in the EBU Examination in Urology are more general in nature and test knowledge and st European urologists should have. Please be aware that if you are reading a booklet that is not current, there may be answers that were correct when the questions were written. Medical knowledge may have changed and some of the answers may no longer be accurate For more information about the annual In-Service Assessment and other ies visit the EBU website at www.ebu.com No par of i booklet may be reproduced in any form without permission of the EBU, Which statem about the drugs used for Cushing's disease is correct? Ketoconazole is not used anymore. ‘Aminoglutethimide does not result in salt wasting, Metyrapone blocks the conversion of cholesterol to pregnenolone. ‘Aminoglutethimide blocks the conversion of cholesterol to pregnenolone Which drug is an inhibitor of the cholinesterase enzyme? a. Imipramine. b. Darifenacin . Piridostigmine d. Chlorpromazine. The Trendelenburg position: Causes reduced venous return. Causes the downward shift of the diaphragm Is used in laparoscopic radical prostatectomy. 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PSA values are relizble indicators of progression in hormone- refractory disease. . E-cadherin expression is inversely correlated with grade, stage and overall survival in prostate cancer. 4. The appearance of PSA-producing cells in the bloodstream is very helpful in dinical decision-making, Since the best way to diagnose prostate cancer in pre-screened Populations is not known, the best solution for the time being seems to be: To use PSA velocity To use an arbitrary PSA cut-off value. To eliminate men with large prostates. To biopsy every man aged 2 55 in order to diagnose all cancers that are 2 Gleason 7, What is not a typical complication after nephron-sparing surgery? a. Urinoma / urine fistula b. Bleeding of tumour bed. © Upper urinary tract obstruction. 4. Deep vein thrombosis / pulmonary embolism. ‘An important or significant upgrading of prostate biopsies is AA biopsy Gleason sum upgrading from 4 toa final pathologic Gleason grade 6. A biopsy Gleason sum upgrading from 5 toa final pathologic Gleason grade 6. ‘A biopsy Gleason sum upgrading from 6 to a final pathologic Gleason grade = 7, ‘A biopsy Gleason sum upgrading from 8 to a final pathologic Gleason grade 29. MISCELLANEOUS, 187, 188, 189, 190. 191 A surrogate endpoint biomarker a. Is used for screening patients to discover cancer at an early stage. b. Is used to substitute for a clinical endpoint or to measure clinical benefit, harm, or a lack of benefit or harm, Can help identity classical histopathological character assessing the presence or absence of cancer. d. Is used to dissect the outcome of patients into different prognostic risk groups thereby allowing individualised management. ics in Which statement about prostate specific antigen (PSA) is not correct? a. PSA\is a serine protease. b, The free form of PSA has a molecular weight of 92 kDa. PSA has a high homology to human glandular kalikrein (hK2) d. PSA can be detected in the serum following radical prostatectomy. ‘What is the common feature of a Hemi-Kock pouch and the Sigma-rectum (Mainz il) pouch diversion? The method of antireflux mechanism, The diversion is a cutaneous continent one. The diversion is a modified uretero-sigmoidostomy. The segment of the intestine used in pouch construction. ‘What is not characteristic of parathormone action on the kidney? a. Enhancement of potassium excretion, b. Enhancement of tubular resorption of Calcium. . Suppression of phosphate tubular re-absorption. 4. Stimulation of the production of 1.25-dihydroxy vitamin D. Vascular endothelial growth factor (VEGF) is mainly a modulator of: Apoptosis only in prostate cancer tissue. Angiogenesis only in prostate cancer tissue, Angiogenesis in both prostate cancer and BPH tissue ‘tromal-epithelial interaction into the prostate gland.ypr6u os *P qpyBu oe > piu si °G ‘prou s> “e sonenses MW warp qwernfpy —p ‘Adesaunowayp ueanipy "> ‘Aderayjorpes weAnipy °q dn-mojjos © | quawa6euew ayeudoidde ysow ays, ‘anssy}|2292iN-!8d aU} JO UOISEAL! 2U0}}-pe01g YIM eWOUDIED [J@> jeyjayyoun sjeanas Woda, ABo|oyied ‘up "fusoras=}2un-ouydau [e>ypes luaMapUN OyM quaned & UL #58 P %59 > Go SZ e ‘Aarewsnoidde 5} 9 5 J0 2103s uosea/9 pue vauipeds fusor>ayerso1d yeDIpel ul SuIBseW annisod yum J02Ue> ajeisoud 4o Uo|sUayx= de-Ps1x@ 104 S1eaK / 18 [enIAINS Bauj-UoIss@s50xd Jo A}qeqoId SYL ‘ayeysoid 2612) Kian, 6 91095 Uosea|) 1 aby ehuopareysoig Jeauuag je>Ipey 0} uone>;pureniuod 2 palapisuod TOU s! YAN za UL suo) ua6oxphH “Pp. ‘wnisaubey 2 ‘ayeydsoyd “q ‘winpos JFHEDKS ‘ajnqmy ap jo uorydau aut Aq Bu 10rd ayy s 6 saynjos Buy 4 yo ays au ‘BL3 14, 7, Which metabolites are increased in prostate cancer at magnetic resonance spectroscopic analysis (MRSI)? a. Citrate. b. Polyamine and citrate. Choline and Polyamine d. Choline and creatine/citrate ratio, The half-life of PSA is between a. 1-2 days b. 2-3 days 4-5 days. d. 1 week HPCI (for Hereditary Prostate Cancer is a specific gene that predisposes men to develop prostate cancer which has been located in a. Chromosome 1 b. Chromosome 8 Chromosome 15. d. Chromosome 16. Which methods are needed to correctly stage patients with rnon-seminomatous testicular cancer? PET. PLAP levels MRI of abdomen, CT scan of abdomen and chest, Which statement is correct? a. Testis cancer is the most common solid cancer in young men b. Seminoma is often metastatic, even if diagnostic delay is short ©. Testicular self-examination is recommended monthly for all adult men. 4. The incidence of testis cancer is stable in the majority of 181 182, 183 184. 185, Delayed graft function due to acute tubular necrosis following renal ‘cadaver donor transplantation is seen in approximately a. 1% of all transplants. b. 5% of all transplants. © 30% of all transplants, 4. 50% of all transplants Risk factors for ureteral stenosis in renal transplantation do not include Delayed graft function. Multiple arteries in the graft. Cytomegalovirus (CMV) infection. Female donor graft in a male recipient, Contraindications for kidney transplantation include: History of neoplasia. Obesity with BMI >35. Short life expectancy. Bilateral iliac artery atherosclerosis, Which of the following is a rare cause of renal induced haematuria? Polyartritis nodosa. Henoch-Schénlein purpura ‘Wegeners’ granulomatosus. 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For which patients is cryoablation best indicated? 50-year-old healthy man with 2.5 cm exophytic lower pole mass, 60-year-old woman with 6 cm renal mass with tumour extension into the renal vein, ©. 65-year-old man with 3 cm left renal mass and multiple pulmonary and liver lesions positive for malignancy on biopsy. 4. 70-year-old woman with 2.8 cm endophytic anterior renal mass with a history of diabetes, renal insufficiency and peripheral vascular disease 24. Which statement is incorrect? a, Advanced RCC is routinely treated with cytotoxic chemotherapy. . Cytokines such as high-dose IL-2 can be associated with high oxicity. . Patients with mRCC and poor prognosis derive little benefit from cytokine therapy. d. A'small proportion of patients with mRCC are able to achieve long-lasting responses to cytokines, 25. Key molecules in the hypoxia-inducible pathway that are potential prognostic molecular markers in RCC include p53, Kio7. cAIX, PTEN. What is the most frequent cause of penile fracture? Masturbation, Sexual intercourse. Sports-related trauma, Self-inflicted bending of the penis, Post-obstructive diuresis should be managed by: Replacement of all measurable urine. Fluid replacement always given parenterally. Replacement of all measurable urine plus 30 mL per hour. Replacement of all measurable urine plus 1 litre every 12 hours-Awoypayersoid je>ypes BuIMto|jo} vs4 alqemseaw fuy “Pp ‘PAULO aq PINOUS Y>IYrA "Uy/BU g°0 30 asu y > PAULO 2g PINOYs LDR “WyEUZ'O Jo ast y “@ “peu ayy anoge Juy6u z yo asu ye | Awoy>a.2}soud jenjpes Jaye aan of ‘Aderayowayp [e2'sanextul “Pp ‘uov@saiut je2tsaneniul “> ‘5g [easanentul °G Rusoyraysh “2 ruownean, papuaunorss a snow jensin Jo a>uasqe au UI Mis ul eWOURIeD jo aouasaid aig atexisuowap saisdoig wopued pue sja2 queubyeU £9 smoys ABojouf> aun 19 SYUOW! xs "sURe|NSU! 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NOW JeINDASA pastes YA Pa}EDOSEE S13) > ‘frabuns e10.0s fouaBsewa paau siuaned °q tuoisio} sejnansai Aq pasne> Aljensn sti] °e 109 jejnansoy jeiuawubas 0) spueBai ym AWAIEIS LPIYM “OL31 32, 33, 34 ‘A prognostic factor for a beneficial outcome of salvage radiotherapy following radical prostatectomy is: PSA doubling time less than 10 months. Start of radiotherapy when PSA < 1.5 ng/ml. Margin positivity only in radical prostatectomy specimen Absence of Gleason grade 4 in radical prostatectomy specimen. Transient elevation of testosterone may occur in LHRH agonist treatment: Never. At each re-injection Oniy after the first injection of agonist LHRH Consistently at the frst injection and in 10% of the re-injections. In addition to lifestyle modifications and the administration of ‘amin D and calcium supplements, which of the following can increase bone mineral density in patients undergoing androgen deprivation therapy? ‘a. Radionuclides. b. Selenium intake. etary counselling. d. Intravenous bisphosphonate therapy. ‘Which statement is correct concerning the indication for perfor prostate biopsies? 2. APSA cut-off level of 4 ng/ml is accepted as a universal PSA, threshold, b. APSA cutoff level of 2.5 ng/ml is accepted as a universal PSA threshold. APSA cut-off level between 4-10 ng/mL is accepted as a universal PSA threshold, d. There is no real PSA threshold, 166. 167, 168. 169, Which imaging technique is most useful for detecting suspected ureteral injuries after a trauma? a. Diuresis renography. Intravenous pyelography. ©. CT with contrast agent, obtained 20 minutes after injection of the contrast agent. d. CT with contrast agent, obtained immediately after injection of the contrast agent. Which method is used to perform a “one shot" intra-operative ravenous urogram (IVU) in a 50 kg woman with a grade V injury of left kidney? ct a 100 mL bolus of intravenous contrast followed by a single of the abdomen at 10 minutes us of intravenous contrast followed by a single at 20 minutes . Inject a 50 mL bolus of intravenous contrast followed by a full series to evaluate the urinary tract, including the ureters. d. Determine the patient's serum creatinine and adjust the dose accordingly to make sure she will not develop renal failure as a result of reaction to the contrast agent. What is correct for bladder rupture associated with blunt abdominal trauma? a. It should be treated surgi b. It coexists in 50% of cases with urethral disruption. . Itis in 90% of cases associated with a pelvic fracture. d._ The mortality is dependent on non-urological comorbidity. in most cases. What is correct for testis rupture due to blunt trauma? It usually involves both testes. 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Allelic losses of 17p have prognostic value in clear cell carcinoma. b. The age at diagnosis is an important prognosticator in renal cell carcinoma Microvascular invasion is of prognostic significance in ‘organ-confined renal cell carcinoma. d. Grading, nuclear morphometry and DNA content are well established prognosticators in clinical decision-making for renal cell carcinoma Sunitin is a HIF Inhibitor. m Tor Inhibitor. Anti VEGF Antibody. Tyrosine Kinase itor. Laparoscopic partial nephrectomy isa challenging technique because a, It generally requires retroperitoneal access. ». Itdoes not duplicate the surgical steps of open partial nephrectomy. Ithas a longer operative time compared to open partial nephrectomy. 4. Tumour resection and parenchymal suturing must be completed within 30 minutes. Partial nephrectomy is standard treatment for small renal masses because: a. Many small renal masses can be benign b. Laparoscopic radical nephrectomy is too morbid, Single and multi-centre published experience has proven its safety and efficacy. d. Randomised trials have shown equivalent results compared to radical nephrectomy. 158. 159, 160. ‘A couple has visited the outpatient clinic for primary infertility for 3 years. What is their chance of spontaneous conception in the following year? Approximately: a. 5%. b. 15% c. 25%, d. 35%, Regarding the surgical management of ischaemic priapism, which procedure is the “T-shunt technique” (Winter shunt)? Deep dorsal vein shunt. Open distal shunt between corpora cavernosa and glans. Percutaneous distal shunt between corpora cavernosa and glans. 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S|“ ‘euytoun oyeysod ays ul valuas JO UoRIsodap ay; se PAUYap s| "> \WseBJ0 JO UONRSLAS e JO aduAsqe ayy ul iN>D0 yOUUe) °q ‘SapISAA [2UlUUAS AY) JO UONIDeIUOD o3 anp Ajs6.e} 5] “2 tuoneinoef 9st ssi sl48. 49, 50. 51 What is the frequency of bladder urothelial cell carcinoma after treatment of a primary upper urinary tract urothelial cell carcinoma? a. 510%. b. 15-50% ©. 60-75%, d, 80-90%. The most common symptom in patients with non-muscle invasive bladder cancer is: a. Haematuria b. Weight loss . Lower abdominal pain. d. Dysuria and frequency. Currently, the advice for a high risk non-muscle invasive bladder cancer (NMIBC) patient failing BCG, is treatment with: a. Radical cystectomy. b. Thermochemotherepy. . Photodynamic therapy (PDT). 4. Electromotive drug administration with a chemotherapeutic drug (EMA). Clinical studies comparing fluorescence-guided transurethral resection and conventional TUR using white light cystoscopy show that: a. PDD is less effective than white light cystoscopy in detecting carcinoma in situ b. The number of tumours detected at a second-look TUR is reduced in patients following fluorescence-guided resection, The specificity of fluorescence-guided cystoscopy is better than the specificity of standard white light cystoscopy. 4d. Fluorescence-assisted TUR decreases recurrence-free survival of patients suffering from non-muscle invasive urothelial carcinoma. 149 150. 151 152. Emission and ejaculation are under the control of: Sympathetic nervous system. Sympathetic and pudendal system, Parasympathetic nervous system, Parasympathetic and pudendal system, Most of the peri blood supply comes from the: Gluteal artery, Obturator artery Internal pudendal artery. Inferior epigastric artery. If transrectal ultrasound reveals dilated seminal vesicles associated with a midline cyst in a man with obstructive azoospermia, which is the subsequent procedure? Vasovasostomy, Classic end-to-side vasoepididymostomy. ‘Transurethral resection of ejaculatory ducts. End-to-side intussusception of both seminal vesicles. Which parameter generally correlates with impaired spermatogenesis? Low FSH Low FSH ~ Low LH. Normal FSH — Elevated LH Elevated FSH. Erectile dysfunction (ED) and coronary artery disease (CAD) are closely related. Which of the following is correct? a. ED prevalence is related to the extent of CAD. '. Multivessel (2 or 3 Vessel Disease) involvement becomes clinically evident at the same time of ED presence. . Almost one out of five men presenting ED as the first clinical nanifestation may have asymptomatic CAD. 4d. In one out of three of men with CAD, symptoms of ED have started before the symptoms of CAD (mean 39 months).wiatp $0 3UON “P. ‘ewourie> euoAiquy > eWOUIWIaS “q ‘euiojelal “e jana] JO ueW sy UO paseq apnpxe am ueD adfy jeriGojorsiy UDIYM "W/M £81 $1 SDH 40 jana} ayy 429429 40} AwsODapIYP.O Jo auIN BYE IY ‘ewoUDIED \euoKiqua °P unOWITY PES 3}OA > eWOUIWaS “a ewowesal esunpe Ut sadue> seynonsar yo adh je2\Gojo3siy qwuanbaxy 1soU Au SI YM “japued Jejnoqser eWOUIWUAS-UOU Ul pareRafe si ely adAIgns aYL “P ‘BuOUUOU J99URD SASSI Ul 103324 IUEJOAU Ue st} > uaping snowy aly URIM SareS10> |2A2] YL“ ‘SeWOUIWUAS UI paleAafe aq Ue? 1] "2 daseuabosphyap ayeyne| auwzua ayy Suipse6a1 13209 TOU si quawarers YUM ‘%0P-0E 'P %SI-0L > 87 “A ELE {sewoy/20wo.poayd Buowe Arueubijew Jo aBeyUaDVed ap S! 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S34 21UOUD > Aayqeyen20q pasea.sul 0} spea| moj, pooja produ “q won DIsUODOseA 0 550} S2aUeyUD Upiyan wianshs 618UaIpe ALN JO U pue aseajai apo (aue) si asn souqiyu Gadd Ajep 40 si2ay0 jer>yauaq ayp 40} (sjuoneue|dxe queuILOpaid ay. bl wl ‘PL spl57 58 59, 60, What is the hal life time of alpha-fetoprotein (AFP)? 1-2 days, 5-7 days. 14-16 days, 30 days. a b. ‘ 4. What is the most frequent genetic alteration in testicular cancer? itp. 7q 10} 19p LOH. 3925-26 LOH, CD 31 immunhistology helps to identify a. Vascular invasion, . Choriocarcinoma component. . Embryonal carcinoma component 4. Testicular intraepithelial neoplasia. ‘Which statement is correct in a case-control study with prostate cancer death as endpoint? a. A case isa subject who was diagnosed with prostate cancer and stil alive b. A-case is a subject who was diagnosed with prostate cancer and died from lung cancer © Accontrol is @ subject who was diagnosed with prostate cancer before his matched case and died from prostate cancer. 4. A control is a subject without prostate cancer before the date of diagnosis of his matched case and s ANDROLOGY/INFERTILITY 142, 143 144, Which statement regarding penile anatomy is not correct? a. The efferent innervation of the penis originates from the pudendal nerve. . Buck's fascia covers both corpora cavernosum and corpus spongiosum ©. The superficial vein system may be connected to the deep dorsai vein network 4d. The efferent innervation of the penis derives from the frst, second and third sacral roots. ‘The most appropriate first-line therapy for a patie emission after retroperitoneal lymph nade dissection wi a. Ephedrine sulphate at a dose of 25 mg four times dai , Micro-epididymal sperm aspiration and intracytoplasmic sperm injection, ©. Assingle dose ephedrine sulphate of 25 mg one hour before intercourse. d. Sperm retrieval from a posteja insemination of his partner. lation urine sample and intrauterine A positive post-coi | testis present: 2. If there isa normozoospermia in the ejaculate. b. If intercourse is observed soontaneously during ovulation, C. Ifafter intercourse motile sperms are demonstrable in the cervical mucus d. If after intercourse motile sperms are demonstrable in the posterior vaginaerpue2hyper pue uossuaiedy hq pasar2eveu> s| “p ‘Buneams pue vossuersadhy Ag pasvairesey> S| > uosuarodAy hq pare>icwwo> eq few eysauyseeue Buunp 4n320 hey, °e .erayausfp 2WOUOINY uonejnsela (ewiouge 40 ¥si Joreai6 & yum payeDosse ave Usopols pue UISOINSWEL “P ‘won>uny apoase uo yoayo [PD YaUaG jews e aney UD sIEY0;0-UdIY > ‘pig uo e2uanyu! anneGau e ancy siePoKq-eydly “a uoneinefe jewouge asne> siaypo|q-eudy “e (HsTOsU st uon>uny jenxas pue siaxpo(9-2ydje Buipsebos UAWeTeLs YDIUN go? fq vonuaias A.euyn aynde Jo ¥su xp dnp SIByPOIG-1 UCI ‘uunjon ateisoud uo aUapuadap si SM] UO 13849 122091 Udy -%0 Ka BUINjOA a.eISO1d Jo LOIN! e o} pea} 51=2010-1 CU) “yS4 wru9s uo J2aYje TUERaIaN OU BAEY| SYPOIC-| UY p 2 ‘9 e aapauie> 'S_SLET yw Uaw Ayaple Ut si2%P0)9-(eUdIe ynoge wuaWAIeIS UKM (@uaunuos Aveuun paxius) Bouauquoou! a6in ym pSvIaWOd Ajensn S| “P ‘po sieaf og uawiom ul Aquanbayy B10W INQ > ‘uawor pa6e-ajppu ut Auanbeu} 1SOW S4M220 G ‘UWOM JO 941 AjaIeWIKOIdde SIDYY "e ‘apuauqjuoru AZeULN $s9.35 v9 9 7 19 SDNINLLNODNI/Hd/1YNOLLINN vuondaju! en Aeuun addy p ‘ssouydauosayainoupéH > xnjjad esalaINOD'saA “q ‘isouydauasphH “2 ‘6g paypeye aq ue> SING YUM ueDs Jeajanu [euai e JO UORELasdiayU SUL Wt65, 66. 67. 68 The strongest indication for surgical treatment of LUTS due to bladder outflow obstruction is: a. Nocturia b, Bladder diverticulum, First episode of urinary retention. d. Recurrent urinary tract infections Side effects of alpha blockers might include: a. Dry mouth. b. Vasoconstriction. . Floppy irs syndrome. d._ Risk of glaucoma deterioration. The most common histological change, which was reported in the experimental studies on the use of Botulinumtoxin-A in animal prostates, was, proliferation. Reduction of androgen receptors Reduction of alpha-t-adrenergic receptors. Which statement regarding the side-effects of medical therapy for LUTS in elderly men is correct? a. Plant extracts are generally well tolerated. b. Tamsulosin has a negative effect on erectile function but not on ejaculation. The intraoperative floppy iris syndrome has recently been described in patients taking finasteride / dutasteride. 4. Combination therapy (alpha 1-blocker/SARi) does not lead to a higher rate of side effects compared to the respective monotherapy. 136 137, 139, 140, Structures developing from Wolffian duct are: Epididymis, seminal vesicles, and testes. Seminal vesicles, epididymis, and prostate Vas deferens, prostate, and seminal vesicles. Epididymis, vas deferens, and seminal vesicles. Torsion of the testicle in the pubertal - adolescent period is: a. An extra-epididymal process. . An intravaginal process (tunica vaginalis). An extravaginal process (tunica vaginalis) 4d. A combined intra- and extravaginal process (tunica vaginalis). The most common testicular tumour in prepubertal children is at a. Yolk sac. b. Teratoma . Embryonal d. Teratocarcinoma, ‘The optimal age for surgical treatment of a child with an undescended testis is considered to be: <6 months of age. 10 - 18 months of age 24 - 36 months of age, 60-72 months of age. na child with a complete renal duplication, the most common situation is the following There is no obstruction and no reflux. ‘The upper and lower poles both demonstrate reflux The upper pole demonstrates obstruction and the lower pole reflux. The upper pole demonstrates reflux and the lower pole obstruction, ee ae ea HETtuwunngkxo “p ‘auanido.g > posayol “a uinidsouy “e gsuonumy>iu Jo Jaquinu uerpaw ay} Gubnpal ye 1S9q si Grup aseajas papuarxe WPIYAA, 452 £q {ua6ins 10} paau ‘yp pue uonuatas Aueuun aynbe Jo ¥Su au) aonpay sPenxe eld “P uonsnnsqo ‘moypyno seppeiq uo 12eduu! anysod punoyoud e aney s}2eNK@IUE\s > sen auios Jo} paywawunoop uaag sey suioyduiAS uo 1>3}}9 annisod y °q 9662-07 Aq auinjon aieIsoid ayy a>npal SI>eN)x9 WEI “e 222809 51 s}>eNxe yue|d Jo /oeDyye a4) BuIpseGaL AWSTErS LPIYAA ‘anoge aun jolly > ‘awn uoResualayie> Y0Ys pue fers jeudsoy UOYS “> ‘papjone si punoms je>i6ung “q ‘321 UONEDGUUOD MOT *e ‘apnppur Aworr=rers010 Uuado Jano (g7T0H) Awsoy2ayersoud J2se] winwwsjoy Jo sabeLuENpe By. wsiueypeus jeoiGojouped Aue ur panjonu Ou S| “P suo! 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[edajasn jeD/Ouns se yaDUJS se S19} °q ‘sugey jomog pue Bulpior sarouduut osje ye ey) 5} uoR>alu! jeza¥2sn (es1Ut JoyDUE gns) >Ido>sopua jo aBeyueNpe ay. % Ol< % OB % LS % EL esqueyul jeu wuat-ny Jo abequaniad yeyn ul sinav0 ajaase1 papusrsepuN vel 61 TEL LetB. 74 75. 76 7. \When considering solfenacine as frontline therapy for overactive bladder treatment, it must be known, comparing i to other anticholinergic drugs, tat its 2, Inferior and causes more side effects. b. Non-inferior to tolterodine extended release. . Less effective, but has a lower adverse event rate, d. More effective, but has a higher adverse event rate, ‘Among the different formulations and dosages of oxybutinin, which has the lowest adverse events? a, Transdermal formulation b. Extended release formulation €. Immediate release 2.5 mg tid. d. Immediate release 2.5 mg as needed. Which drug is not available as immediate or extended release formulation for overactive bladder? Urispas. Trospium, Tolterodin Oxybutinin, ‘What is the advised treatment in a 60-year-old man with lower urinary tract symptoms due to BPH and IPSS = 7 without nocturnal polyuria? b. itor + a-1 blocker. c. Desmopressin with or without Education Lifestyle Advice. 4, Watchful waiting with or without Education-tifestyle Advice. ‘Which statement is correct concerning uroflowmetry? Itis an invasive measurement. 50 mL voided urine is enough for exact interpretation. Decreased maximal flow raie indicates lower urinary obstruction. Normal maximal flow rate does not exclude lower urinary obstruction. 128, 129, 130, ‘Aten-year-old git! with 2 normal voiding pattern has continuous urina kidney, no left ki The test most long incontinence. An ultrasound shows a normal right ey is identified ly to prove diagnostic is: IP, DMSA scan, Urodynamics. Cystoscopy and retrograde pyelography. A five-year-old gil has persistent daytime incontinence and is wet every night. Physical examination reveals a low, short gluteal cleft with a flattened buttock. Her urinalysis is negative and a renal sonogram is normal, The next step is: Spinal MRI Spinal utrasound. Urodynamic study. Timed voiding and voiding diary The diagnostic work-up in an eleven-year-old boy revealed a symptomatic left-sided uretera-pelvic junction obstruction (UPIO) with vesico-ureteric reflux grade 3 on the same side. ‘The most appropriate surgical treatment of his UPIO is: Foley Y-V pyeloplasty. Ureteroscopic endopyelotomy. Anderson-Hynes dismembered pyeloplasty. Culp and de Weerd’s spiral pelvic flap pyeloplast, ‘A newborn boy has penoscrotal hypospadias and bilateral «ryptorchidism. Karyotype reveals a point mutation on chromosome 11p13. At the age of one he develops renal failure. Renal biopsy reveals diffuse mesangial sclerosis. He is started on dialysis. At the age of two, an ultrasound reveals a 3 cm solid mass in the lower pole of the right kidney. The next step is: Open renal biopsy. Bilateral nephrectomy. Right radical nephrectomy. Repeat uitrasound in 3 months.aouayadwonu1 sa1suiyds “uoRInAsgo 19e2 Aieuuin Jamo} ‘ou ‘suonse UO Josns.ap AseqUnjonUt‘ounssaid Josn.Aap pases!oul “P noNASgo 13eN KseuLN 49M0} jeuoNDUNL ‘uondemuoD sosninap Avewunjonut ‘aunssaid Josnujap paseaL: ‘@ouaunUODU! SsaNis ‘uoNUaal KJeuLiN ‘Aun 2enuODOdAY JOsNARBd “g ‘aduaUnUODU! 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Which statement is not correct regarding desmopressin treatment for nocturia due to nocturnal polyuria in adults? a. The risk of hyponatrem b. Serum sodium concentra regularly, «. The risk of hyponatremia increases with lower serum sodium concentration at start of treatment. 4. The risk of hyponatremia increases with higher basal 24-hour urine volume per bodyweight. increases with age. does not need to be monitored 83. Which statement is correct when considering the genetic and far factors about BPH? a. There is no relation between BPH and genetic/fami b. Segregation analysis showed that the results were most consistent with a single gene defect. . Segregation analysis showed that the results were most consistent with an autosomal recessive inheritance pattern. 4, Segregation analysis showed that the results were most consistent with an autosomal dominant inheritance pattern, 84. In autonomic dysreffexia a. Bradycardia and flushing are caused by vasoconstriction b. Hypertension is rarely life-threatening, but tachycardia is. ¢. The uninhibited thoracic spinal cord drives the distal sympathetic nervous system 4d. The uninhibited thoracic spinal cord drives the distal parasympathetic nervous syster 85. _ Symptom reduction by finasteride depends on inital prostate size and may not be more efficacious than placebo in patients with prostates srraller than: 40m. 0m. om. 100ml. 121 122, ‘What is the most common indica for open surgery in stone disease? Staghorn calculus. A paediatric patient. Non-functioning part of kidney. Patients that are allergic to iodine-contai ng contrast. What is the advised treatment in a case of sepsis associated with an obstructing stone? . URS with antibiotic cover. PCNL with antibiotic cover. Drainage of the system and a delayed approach.Buyjqqup uonumsiwasod “p ‘apuauquoDU} > AOUEYSEH “G ‘fousbin A! 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Functional urinary tract obstruction from organic obstruction, ©. Detrusor denervation from muscular integrity in case of acontractile detrusor. 4. Infrapontine upper motorneurone lesion from suprapontine upper motomeurone lesion, nent of choice if the prostate 12, 113. 14. 15. AA 75-year old male presented with painful mictu temperatures. Urinalyss shows pyuria and urine This disease pattern most likely represents: ion and subfet iture is negative le a, Prostate cancer. b. Prostate tuberculosis, . Chiamycial prostatitis. 4. Gonococcal prostatitis What is not an important factor for successful stone disintegration after ESWL? Kidney function The rate of shockwaves. Abdominal compression. Coupling of the ESWL device with skin ‘What is not usually a cause of urethritis? Mycoplasma hominis, Trichomonas vaginalis. Chlamydia trachomatis. Mycoplasma genitalium. Which test result is most supportive of the diagnosis of urethritis? a. A negative leukocyte esterase test b. 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Myocardial infarction Choose the right order according to resistance to ESWL (most resistant stone first) ite, struvite, Weddel fe, Whewellte, uric acid, struvite. te, struvite, Whewellite, uric a struvite, Weddelite a b. d When a patient presents with fever, flank pain and renal obstruction from a small calculus impacted in the pelvic ureter, the situation is best managed by: a. Immediate ureteroscopic extraction of the stone. b. Retrograde stenting of the ureter and administering antibiotics, Administering antibiotics and delaying ureteroscopy until the urine is sterile d. Immediate percutaneous nephrostomy, antibiotics and ureteroscopic stone removal after all signs of infection have disappeared. During @ percutaneous nephrolithottipsy serious bleeding is encountered. What is the appropriate immediate action? Nephrectomy, Blood transfusion and wait Arteriography with embolisation Clamping the nephrostomy tube. ‘When hypercalciuria is found in a case of urolithiasis: Calcium restriction is mandatory. educe hypercalciuria, excretion is not related to calcium excretion lopurinol and a reduced oxalate intake must be prescribed 102, 103, 104. 105, 106. a. Citrate. b. Allopurinol. ¢. Thiazide diuretics. 4. Cellulose phosphate. In cystinuria the inherited defect in renal tubular reabsorption affects: Cystine alone. Cystine and ornithine, Gystine, lysine and arginine, Gystine, omichine, lysine and arginine. ‘What is often fcund in alkaline urine? Cystine stones, Uric acid stones. Calcium oxalate stones. Magnesium-ammonia-phosphate stones. Urinary tract stones originate from the: Ureter. Renal pelvis. Renal calices Collecting ducts of the kidney, Which drug can be useful in post-menopausal recurrent urinary tract infections? a. Oestriol b. Tamoxifen © Testosterone, G. Progesterone,