Ministry of Health of Ukraine
Ukrainian Medical Stomatological Academy
L.P. Sarychev, S.M. Suprunenko, Y.V.Sarychev
Collection of test tasks on urology to control the level of knowledge of students of the fourth year of the medical faculty
Poltava – 2019
UDC 616.61(075.8)
Authors:
– Leonid P. Sarychev, Doctor of Medical Sciences, Head of Department of Urology with Forensic Medicine, Ukrainian Medical Stomatological Academy;
– Serhiy M. Suprunenko, Ph.D., Assistant Professor, Chair of Urology with Forensic Medicine of Ukrainian Medical Stomatological Academy;
– Yaroslav V. Sarychev, Ph.D., Associate Professor, Chair of Urology with Forensic Medicine of Ukrainian Medical Stomatological Academy.
Reviewers:
– Olexiy O. Lyulko, Doctor of Medical Sciences, Head of Department of Urology, Zaporizhzhya Medical Academy of Postgraduate Education;
– Mykhailo I. Ukhal, Doctor of Medical Sciences, Head of Department of Urology and Nephrology of Odessa National Medical Univercity.
Sarychev L.P., Suprunenko S.N., Sarychev Y.V.. “Collection of test tasks on urology to control the level of knowledge of students of the fourth year of the medical faculty” for students of higher medical educational institutions of the third and fourth levels of accreditation, Poltava, 2018 - 185 p.
The collection of tests discloses modern approaches to the organization of the educational process on the subject of urology, the provision of practical training, and the organization of independent training of students. The collection has a practical direction and is designed for students of higher medical institutions of Ukraine.
Contents
1. Clinical anatomy, physiology of the urinary system and male reproductive
system… ... 5
2. Symptoms of urological diseases ... 17
3. Methods of urological patients examination ... 29
4. Anomalies of the urinary and male reproductive system ………42
5. Acute pyelonephritis ... 55
6. Chronic pyelonephritis ... 69
7. Pyonephrosis, paranephritis ... 84
8. Cystitis, prostatitis, urethritis, cavernitis, epididymitis ... 98
9. Tuberculosis of the urinary and male reproductive systems ... 110
10. Urinary stone disease ...123
11. Traumatic injuries of the urogenital system ... 135
12. Neoplasms of the urinary and male reproductive systems ... 146
13. Acute and chronic renal failure ... 160
14. Urgent care for diseases of the urinary and male reproductive systems ... 173
15. References … ... 185
Topic: Clinical anatomy, physiology of the urinary system and male reproductive system.
Tests for 1st level:
1. The correct location of the elements of the renal pedicle from front to back:
A. Vein, artery, pelvis.
B. Аrtery, vein, ureter.
C. Аrtery, ureter, vein.
D. Ureter, vein, artery.
E. Vein, ureter, artery.
2. What is attached to the left kidney anteriorly and exteriorly:
A. Spleen and colon B. Spleen
C. Descending colon.
D. Small intestine loops.
E. Pancreas.
3. The renal pelvis is normally located within the range:
A. L1 - L2.
B. Th11 - L1.
C. Th11 - Th12.
D. L2 - L4.
E. L1 - L3.
4. Normally, the kidneys may move:
A. To the height of one vertebra.
B. The left kidney is slightly rotated.
C. Do not move during breath.
D. Lower while exhalation.
E. Angulation 1600.
5. Abdominal kidney system consists of:
A. pelvis, major and minor calyxes.
B. pelvis, major, middle and minor calyxes.
C. pelvis, calyxes and vaults.
D. major, middle and minor calyxes.
E. pelvis, major and minor calyxes and the beginning of the ureter.
6. The kidney forniceal apparatus includes:
A. Part of the minor calyx, its vaults and papilla.
B. Renal pyramid and papilla.
C. Major calyx and minor calyxes.
D. Collector tubules and papilla.
E. Minor calyx and pelvis.
7. What is typical for the kidney anatomical structure (find the false variant):
A. The right kidney is located higher then the left one on one vertebra.
B. The kidney has a fibrous capsule.
C. Renal pelvis is located at the level of L1 -L2.
D. Each major calyx is formed from 2-3 minor calyxes.
E. The physiological mobility of the kidney can be within 1 vertebra.
8. The ureter has a physiological narrowing at the level of (find the false variant):
A. crossing with the testicular vein.
B. intramural segment.
C. juxtavesical segment.
D. intersection with the iliac vessels.
E. ureteropelvic junction.
9. Where is an X-ray projection of the ureters located?
A. on the periphery of transverse processuses of the vertebrae.
B. on the posterior part of axillary furrow.
C. on the periphery of vertebrae.
D. on the periphery of rectum muscles.
E. on the periphery of internal oblique muscle.
10. The right ureter is met with _____ at the terminal line of the pelvis.
A. The external iliac artery.
B. The internal iliac artery.
C. The hypogastric artery.
D. The common iliac artery.
E. The testicular artery.
11. The left ureter is met with _____ at the terminal line of the pelvis.
A. the common iliac artery.
B. the internal iliac artery.
C. the hypogastric artery.
D. the external iliac artery.
E. the obturator artery.
12. Whereis the urinary duct (urachus) with reference to the prostate fascia located?
A. Behind the prostate fascia.
B. Infront of the prostate fascia.
C. In the mass of the prostate fascia.
D. To the side of the prostate fascia.
E. c) and d) are true
13. When can Lieutaud triangle be identified?
A. While cystoscopy.
B. During excretory urography.
C. Under urethroscopy.
D. While cystography.
E. During chromocystoscopy.
14. Lieutaud triangle is formed by..
A. The openings of the ureters and the internal opening of the urethra.
B. The ureteral openings and the fundus of bladder.
C. The kidneys and bladder.
D. The kidneys.
E. The vertebral column and ureters.
15. What numbers of the clock dial does the location of ureteral orifices correspond:
A. 7 right and 5 left.
B. 5 right and 7 left.
C. 9 right and 3 left.
D. 1 right and 11 left.
E. 8 right and 4 left.
16. Where is the external sphincter of the bladder located:
A. In the urogenital diaphragm.
B. In the muscle that elevates the anus of the rectum.
C. At the base of the bladder.
D. In the tendon center of the perineum.
E. B) and D) are true.
17. The basis of the prostate gland is composed of:
A. everything said here below.
B. fundus of urinary bladder.
C. seminal vesicles.
D. ampulla of the deferent duct.
E. c) and d) are true.
18. The urethra perforates the urogenital diaphragm with:
A. The membraniform part.
B. The pars cavernosa.
C. The prostatic and membranous parts.
D. The prostatic part.
E. None of the above-mentioned.
19. The caliber of the male urethra is the shortest and the narrowest:
A. In the area of the membranous part of the urethra.
B. In place of the transfer of the bladder into the urethra.
C. In the area of the external opening of the urethra.
D. In all these places of the urethra narrowing.
E. b) and c) are true.
20. Testicle is covered with:
A. Seven layers of scrotum.
B. Five layers of scrotum.
C. Six layers of scrotum.
D. Four layers of scrotum.
E. Eight layers of scrotum.
21. Serous fluid (hydrocele) can be accumulated under pathological conditions between ________.
A. Parietal and visceral layers of the funicular process of the testicle.
B. External and internal spermatic fascia.
C. External spermatic fascia and dartos.
D. Perididymis and visceral layer of the funicular process of the testicle.
E. Internal spermatic fascia and funicular process of the testicle.
22. The testicles are the main elements of the male reproductive system and they are destined to:
A. all answers are correct.
B. the hormone production.
C. the formation of sperm.
D. the function as separate organs.
E. the procreation.
23. Normally, daily diuresis is up….
A. to 2000 ml.
B. about 500 ml.
C. to 1000 ml.
D. to 3000 ml.
E. to 1200 ml.
24. Oliguria is the medical term for a decreased output of urine that is less than ___.
A. 500 ml.
B. 100 ml.
C. 1000 ml.
D. 300 ml.
E. 50 ml.
25. Anuria is characterized by:
A. Deep deficiency of urine excretion by the kidneys.
B. Sharp lumbar pain.
C. Lack of protein in the urine.
D. Sudden hypotension.
E. Lack of urine excretion from the bladder.
26. Determine, which of the following causes cannot stain urine red?
A. Kidney tumor.
B. Lead poisoning.
C. Intake of rifampicin.
D. Intake of higher doses of sulfonamides.
E. Consumtion of large amounts of beets.
27. Normally, the urine specific gravity is:
A. 1010- 1025.
B. 1002- 1020.
C. 1002- 1012.
D. 1015- 1035.
E. 1010- 1045.
28. Isosthenuria is:
A. The range of specific gravity of urine per day is less than 7-8 units.
B. The high of specific gravity of urine during the day.
C. The range of specific gravity of urine per day is less than 20 units.
D. The range of specific gravity of urine is less than 1003.
E. The low of specific gravity of urine during the day.
29. Hyposthenuria is characterized by?
A. Chronic renal failure.
B. Urolithiasis.
C. Acute glomerulonephritis.
D. Acute cystitis.
E. Interstitial nephritis.
30. Hypostenuria is a decrease in urine specific gravity less than A. 1005.
B. 1020.
C. 1030.
D. 1015.
E. 1010.
31. What is a normal urine reaction?
A. faintly acid.
B. weakly alkaline.
C. acidulous.
D. neutral.
E. alkaline.
32. The concentration of protein in the urine should not outrange ______ in a healthy person.
A. 0,030 g / l.
B. 0,150 g / l.
C. 0,100 g / l.
D. 0,400 g / l.
E. 0,010 g / l.
33. When does extrarenal proteinuria occur?
A. The breakdown of white blood cells and red blood cells..
B. Chronic interstitial urethritis.
C. Disturbance of reabsorption in the glomeruli.
D. Increased secretion in the ureter.
E. Ormond's disease.
34. What is not found in the urine of a healthy person?
A. glucose.
B. protein.
C. creatinine.
D. red blood cells.
E. bacteria.
35. Aspermia is characterized by A. Absence of ejaculate.
B. Lack of live sperm.
C. Lack of sperm.
D. Lack of spermatogenesis cells.
E. Decreased sperm amount.
36. The normal sperm count (in 1 ml of ejaculate) ranges:
A. 60 -120 mln.
B. 20-25 mln.
C. 80 -100 mln.
D. 10- 60 mln.
E. 90 -180 mln.
37. What is a normal renal blood flow in an adult?
A. 1100 mL/min.
B. 1600 mL/min.
C. 800 mL/min.
D. 600 mL/min.
E. 400 mL/min.
38. The renal blood flow stanches when systolic blood pressure decreases at
A. 60-70 mmHg B. 100 mmHg C. 80-90 mmHg D. 40-50 mmHg E. 30-20 mmHg
39. What is the nitrogen balance in the body?
A. The ratio of nitrogen intake and its loss per day.
B. Daily urinary nitrogen loss.
C. Contant of total protein in the blood.
D. Urea is found in the blood.
E. Daily intake of nitrogen in the body with food.
40. Nitrogen balance is a _________ in a healthy person:
A. Neutral.
B. Negative.
C. a) and b) are true.
D. Positive.
E. a) and d) are true.
41. What is the level of potassium in the blood serum, normally?
A. 3.5 mmol/L.
B. 2.25 mmol/L.
C. 3.9 mmol/L.
D. 7.6 mmol/L.
E. 4.5 mmol/L.
42. Serum potassium concentration
A. It is increased in acidosis and decreased in alkalosis.
B. It is not changed.
C. It is decreased in acidosis.
D. It is increased in alkalosis.
E. It is decreased in acidosis and increased in alkalosis.
43. The main clinical manifestations of hypokalemia are:
A. Weakness, muscular weakness, tachypnoea tachypnoea, ECG changes.
B. Muscle weakness.
C. Respiratory disorders.
D. Asthenization.
E. The flattening of the T wave, lengthening of the interval PQ
44. The main clinical manifestations of hyperkalemia are:
A. Arrhythmia, ventricular fibrillation, vomiting and diarrhea.
B. Arrhythmia, gastric rhythm.
C. Cardiac arrest in diastole.
D. Мentricular fibrillation.
E. Vomiting, diarrhea.
45. The subcutaneous (superficial) fascia of the anterolateral abdominal wall consists of:
A. 3 layers.
B. 2 layers.
C. 1.layers.
D. 4 layers.
E. 5 layers.
46. The upper edge of the prevesical fascia reaches to the level of ______ on the anterior abdominal wall
A. Umbilicus.
B. Douglas fold.
C. The upper edge of the pubic symphysis.
D. Mid-height of the pubic symphysis.
E. Behind the pubic joint.
47. Where is the urinary duct (urachus) in relation to the pre-biliary fascia located:
A. Behind the prevesical fascia.
B. In the masses of the prevesical fascia.
C. To the anterior prevesical fascia.
D. Next to the prevesical fascia E. а) and b) are true
48. What is the function of urinary duct (urachus):
A. to discharge the primary urine into the amniotic fluid in the embryonic period
B. to fix the embryo to the uterus.
C. to intake of nutrients into the embryo.
D. to produce hormone.
E. to exchange gas of the embryo and uterus.
49. The cisterna chili of the retroperitoneal space is located at a rate of:
A. 12-th thoracic and 1-st lumbar vertebra B. 10-th thoracic
C. 11-th thoracic vertebra D. 3-rd lumbar vertebra E. 4-th lumbar vertebra
50. What muscle passes through the large sciatic foramen?
A. piriform muscle B. iliac-lumbar muscle C. obturator internus muscle D. elevator muscle of anus E. а) and b) are correct
51. What is involved in the formation of the urogenital diaphragm:
A. deep transverse muscle of perineum B. elevator muscle of anus
C. obturator internus muscle and external obturator muscle D. piriform muscle
E. b) and d) are correct
52. What cellular space of the pelvis does the pus spread from to the thigh and abdominal cavity:
A. Prevesical.
B. Behind rectal.
C. Lateral cellular spaces of the pelvis D. All given above
E. а) and b) are correct
53. Drainage of prevesical cellular tissue space according to the method of Buiallsky-McWarter is performed:
A. From the inner and outer obturator muscles through the obturator membrane.
B. From deep transverse muscle of perineum.
C. From the urogenital diaphragm.
D. From the front of the pelvic and urogenital diaphragm.
E. а) and b) are correct
54. The external sphincter of the bladder is located:
A. In the urogenital diaphragm.
B. In the base of the urinary bladder.
C. In thecentral tendon of perineum.
D. In the elevator muscle of anus.
E. b) and d) are true.
55. Genital region and neurovascular fascicle in the pelvic cavity is located:
A. In the lower area.
B. In the middle area.
C. In the upper area.
D. In all areas.
E. b) and c) are true/
Tests for 2nd level:
1. 14 liters of urine were excreted after taking furosemide during 2 days in a 56- year-old patient. He drank 500 ml of water during the day. Hypokalemia (K- 3.2 mmol/L) was observed during examination. What are the main signs of
hypoglycemia?
A. Constant tiredness, weakness, apathy.
B. Tachypnoe, ECG has changes. Muscle tremors.
C. Asthenization.
D. Alibidemia.
E. Nasal hemorrhage.
2. A 28-year-old patient S. He has been married for 2 years. Sex life has been continued with his wife for 3 years. Pregnancy did not occur. The wife has no gynecological problems. He is asthenic, subcutaneous fatty tissue was developed normally, male-pattern of hair growth was determined during examination. The tightly elastic consistency of testicles (5.0×3.0cm) were detected on palpation of the scrotum, the epididymis is not enlarged. The veins dilation of the spermatic cord to the left was at the 1st degree. Testosterone level was 14 nmol/L. What are the causes of male infertility:
A. Prostatitis, urogenital infections.
B. Grade III Varicocele, decrease in the production of testosterone.
C. Monarchism.
D. Scrotal hydrocele.
E. Epididymis cyst.
3. Hematuria – is:
A. Appearance of blood in the urine B. Erythrocyturia.
C. The presence of blood pigment of hemoglobin in the urine.
D. The presence of porphyrins in the urine.
E. The presence of melanin in the urine.
4. The main function of the testicles are except:
A. Production of erythropoietin.
B. Maintenance of homeostasis.
C. Production of gonadoliberin.
D. Production of sperm.
E. Production of testosterone
5. Prerenal anuria occurs:
A. In heart failure.
B. In shock.
C. In poisoning by toxics and drugs.
D. In blood loss up to 400 ml
E. In obstruction with ureteral stone.
Tests of the 3rd level:
1. Hydrocele of the right testicle was diagnosed in a 34-year-old patient B. The right half of the scrotum was 18×30cm during examination. Positive effect on diaphanoscopy was detected. Where is the fluid accumulated in the scrotum:
A. Parietal and visceral layers of the proper funicular process of the testicle.
B. The outer and inner spermatic fascia.
C. Internal spermatic fascia and the proper funicular process of the testicle.
D. External spermatic fascia and dartos.
E. Perididymis and visceral layer of the proper funicular process of the testicle.
2. A 33-year-old patient appealed to the urologist with complaints of pain in the umbillicus, periodic discharge of mucous nature. His temperature increased to 38C. In childhood he had observed by a surgeon about the nonclosure of the urachus. Specify which disease may be in this patient:
A. Umbilical fistula.
B. Bladder ears.
C. Vesicoumbilical fistula.
D. Urachal cyst.
E. Dermatitis of the anterior abdominal wall.
3. A 20-year-old patient presented with complaints of a small amount of sperm during orgasm. There are two children in the patient’s family. He developed normally. In the childhood patient had suffered from measles, chicken pox, frequent sore throats. Sex life is during 2 years. The patient constantly changes sexual partners. How much sperm is discharged during orgasm:
A. 1,5- 3 ml B. 8 ml C. 12 ml D. 15ml E. 30 ml
4. A 45-year-old patient applied to the family doctor with complaints of lumbar pain, cloudy urine, presence of edema on the lower limbs, weakness. He
suffered from swelling under the eyes in the morning. In past medical history:
kidney disease was about 7 years, folk methods were used to treat. Frequent pathology of ENT organs of the tonsillitis, the outpatient and inpatient treatments were used. Myocarditis was observed by a rheumatologist in the childhood. The kidneys are not palpable on examination. Pasternatsky symptom is weakly positive on both sides. Decreased size of both kidneys 7.0×4.0cm is observed while ultrasound of the kidneys. Parenchyma is 1.1cm.
There is no clear differentiation of the cortical and medulla of the kidneys.
Blood biochemical indicators: creatinine is 250 μc / liter, uric acid is 80 μmol / liter, protein is 56 g / liter. The urine test: the specific gravity is 1009, protein is 2g / l, leukocytes are 4-6 in FOV, and erythrocytes are 3-4. What is the amount of protein excreted by kidneys normally:
A. 0,033 g/l B. 4.0 g/l C. 6.0 g/l D. 1.5 g/l E. 0,9 g/l
5. A 34-year-old patient appealed to the urologist with complaints of lumbar pain on the right side, the rise of temperature to 37.4 ° C, weakness and red urine. The past medical history includes the sore throat 10 days ago, treatment with antibiotics for 3 days and the rinsing of throat with calendula. He constantly works in the supercooling and in the humid environment. The urine tests: the specific gravity is 1010, protein is 0,86 g / liter, changed e. Are on all FOV, leukocytes are 6-8 in FOV, 4-8 of hyaline casts are detected in FOV. of salts, and bacteria are not detected. Specify the normal number of red blood cells in the urine:
A. 0-1 in FOV.
B. 10 in FOV.
C. 10-20 in FOV.
D. Dense on all FOV.
E. On ¼ FOV.
Topic: Symptoms of urological diseases Tests of the 1st level:
1. The mother complains on that her 5-year-old child begins to urinate while sleeping. The pathological changes are not detected during examination in the general analysis of urine. What is called this disease?
A. Enuresis
B. Nocturia.
C. Nycturia.
D. Incontinence of urine.
E. Hyperactive bladder.
2. Acute urinary retention was diagnosed in the patient. What kind of urination disorder does this indicate?
A. The impossibility of natural urination when there is the urine presence in the bladder.
B. The presence of urinary retention up to 24 hours.
C. The presence of residual urine in the bladder after urination.
D. The impossibility of natural urination when the urine is absent in the bladder.
E. Difficult urination is accompanied by a sharp pain.
3. What is the pain nature when the stone is into the intramural part of ureter:
A. Paroxysmal and acute pain.
B. Dull pain.
C. Acute pain.
D. Tender pain.
E. Gnawing pain.
4. What is the localization and irradiation of pain when the stone of the intramural ureter can disturb urodynamics:
A. The lumbar region with radiation to the inguinal region, the inner surface of the thigh and the genitals.
B. Subcostal space with irradiation under the scapula.
C. Lateral abdomen with radiation to the lumbar region.
D. Inguinal area with radiation to the thigh.
E. Lumbar region without irradiation.
5. What is the kind of pain in acute prostatitis:
A. Gnawing, occasionally pulsating pain.
B. Paroxismally C. Periodic D. Dull E. Acute
6. Where is the pain localized in acute parenchymal prostatitis:
A. Over the pubic, perineum and sacrum.
B. In the lumbar region.
C. In the lumbar sacral spine.
D. In the rectum.
E. In the perineum.
7. Dysuria – is:
A. Frequent difficulty and painful urination.
B. Frequent, painful urination.
C. Difficult urination.
D. Painful urination.
E. All answers are true.
8. Dysuria occurs in all of these diseases, except:
A. Tuberculosis kidney tumors.
B. BPH.
C. Tuberculosis.
D. Cystitis.
E. Acute prostatitis.
9. Dysuria occurs in all diseases given below, except:
A. Orchitis.
B. Bladder tumor.
C. Bladder stone.
D. Cystitis.
E. Ureteral stone.
10. Stranguria is:
A. Difficult urination, which is accompanied by pain..
B. Pain during urination.
C. Frequent urination.
D. The presence of clots in the urine.
E. B) and C).
11. Stranguria occurs in all diseases given below, except:
A. Ureteral calculus.
B. Bladder stone.
C. Foreign body of urethra.
D. Acute prostatitis.
E. Prostatic hyperplasia
12. Stranguria is found:
A. In all of given below cases.
B. In interstitial cystitis.
C. In severe phimosis.
D. In partial damage of the urethra.
E. In prostate cancer.
13. Nycturia is:
A. Frequent urination.
B. Increased diuresis.
C. Movement of the main diuresis from day to night D. Dayly oliguria.
E. A) and D).
14. Nycturia occurs in all of the listed diseases, except for:
A. Diabetes Mellitus.
B. Cardiac failure.
C. Chronic renal failure.
D. Chronic glomerulonephritis.
E. Prostatic hyperplasia.
15. Pollakiuria is:
A. Increased urination during day and night.
B. Increased diuresis.
C. Frequent urination at night.
D. Frequent daily urination.
E. Increased night-time diuresis.
16. Pollakiuria does not occur:
A. When the stones are located in the upper third of the ureter.
B. With cystocele.
C. With neurasthenia.
D. With hysteria.
E. With phimosis.
17. Oliguria is:
A. Low output of urine.
B. Rare urination.
C. Slow urinatiom.
D. Large amount of urine.
E. Low amount of urine to 600ml.
18. Oliguria does not occur:
A. With Diabetes Mellitus.
B. With the disturb of the vegetative centers of water-salt metabolism C. With acute pyelonephritis
D. With chronic pyelonephritis E. With heart failure.
Tests of the 2nd level:
1. The urinary retention is:
A. Lack of nature urination B. Urination drop by drop.
C. The impossibility of urination in the presence of strangers.
D. Lack of urine in the bladder.
E. Discontinuation of urine filtration by the kidneys.
2. What are the causes of urinary incontinence in male?
A. The result of prostate cancer surgical teatment.
B. Neurological disorders, Parkinson's disease. Spinal cord injury.
C. Intoxication, alcohol poisoning.
D. Hypnosis. Intake of small doses of tranquilizers.
E. Chronic prostatitis.
F. Diseases of the rectum.
3. All of the reactions given below are possible during the introduction of radiopaque substances, except:
A. Macrohaematuria.
B. Severe dysuria.
C. Dizziness and fever sensation.
D. Drop in blood pressure below 60 MmHg.
E. Skin rash.
4. What should be applied for instant diagnosis of closed kidney injury:
A. Computed tomography of the kidneys.
B. Excretory urography and ultrasound of the kidneys.
C. Plan radiography of the kidneys and urinary tract.
D. Radioisotope renography and abdominal aortography.
E. Chromocystoscopy.
5. Prerenal anuria does not occur:
A. In case of poisoning with toxins (chlorine, sublimate, phosphorus, aniline dyes).
B. Obstruction with ureteral calculus.
C. With blood loss up to1000ml.
D. With thromboembolism of the renal vessels.
E. With heart failure.
Tests of the 3rd level:
1. A 74-year-old patient has been suffering from difficulties in urination with strain, interrupted weak urine stream for two years. The urinary incontinence, constant bursting pains over the pubis with pushing out, and the upper edge of which contours at the level of the navel are noted during hospitalization. The dullness is determined by percussion in this area. Urine constantly without control has been excreting drops for several days. What is the kind of the urination disorder in the patient?
A. Incontience with overflow.
B. Acute retention of urine.
C. Chronic retention of urine.
D. Stranguria.
E. Incontinence of urine.
2. A 69-year-old patient S. complains of frequent, difficult, painful urination, the presence of blood in the urine. The patient has the dullness of percussion sound above pubis after urination. Pasternatsky's symptom is negative. The urination is 4 times at night. What is the kind of the urination disorder in the patient?
A. Stranguria.
B. Pollakiuria
C. Hematuria
D. Nycturia.
E. Polyuria.
3. A 70-year-old patient complains of frequent, difficult, painful urination, 3-4 times at night. The patient has the dullness of percussion sound above pubis after urination. Pasternatsky's symptom is negative. What is the cause of the dullness of percussion sound above the pubis:
A. Chronic retention of urine.
B. Acute retention of urine.
C. Anuria.
D. Nycturia.
E. Pollakiuria.
4. A 52-year-old female patient has admitted to the urology department with complaints of back pain on the left, lack of urine during two days. From the anamnesis: she has been suffering from urolithiasis for 12 years. Three years ago she underwent nephrectomy on the right. What is the preliminary diagnosis:
A. Postrenal anuria.
B. Prerenal anuria.
C. Arenal anuria.
D. Renal anuria.
E. Acute retention of urine.
5. A 48-year-old female patient complains of the loss of urine under any tension such as the coughing or lifting weights. She does not have other urination disorders. Determine the cause of this disorder.
A. Stress incontinence of urine.
B. Pollakiuria.
C. Hyperactive bladder
D. Dysuria.
E. Stranguria.
6. A 36-year-old female patient was admitted to the hospital with complaints of pain in the right lumbar region, the appearance of blood in the urine after the attack of pain. The kidneys are not palpable. Pasternatsky's symptom on the right is positive. The red urine and uraturia are identified during examination. The function of the right kidney is absent on the excretory urogram. Determine the cause of this disorder.
A. Ureteral colic.
B. Anuria.
C. Myoglobinuria.
D. Hematuria.
E. Uraturia.
7. An 18-year-old male patient had sudden pain in the left lumbar region. He is single. The body temperature is normal. The nausea and vomiturition are detected.
The urination is not disturbed. The pain on the left increases (the palpation of the kidney is painless on the right) during bimanual palpation. The kidneys are not palpable. Determine the disease.
A. Ureteral colic.
B. Acute pyelonephritis.
C. Acute cholecystitis.
D. Radiculitis.
E. Pneumonia.
8. A 34-year-old male patient complains of acute pain in the perinum region, the pain shoots up the sacrum above the pubis. The body temperature is 38.3 C. He fell sick two days ago and he had difficulties with urination along with pain. Which of the following urination disorder does the patient have?
A. Stranguria.
B. Dysuria.
C. Nocturia.
D. Acute retention of urine
E. Chronic retention of urine.
9. A 44-year-old male patient suffers from the sharp pain in the perineum above the pubis and uresiesthesia. The body temperature is 38.7 C. The patient felt sick two days ago: difficulty urination appeared at the same time as pain, fever. The impossibility of voiding is noticed this morning. Determine the urination disorder of the patient.
A. Acute retention of urine
B. Anuria.
C. Stranguria.
D. Nocturia.
E. Chronic retention of urine.
10. An 18-year-old young man was admitted to the emergency department with complaints of pain in the right half of the abdomen with irradiation to the scrotum, nausea and vomiting. This was the first acute attack. The muscle tension in the right half of the abdomen was revealed by palpation. Blumberg's sign is doubtful.
The CVA Tenderness is weakly positive on the right. The temperature is 37, 7 С.
The number of leukocytes is 8.0 × 109·/ l. The red blood cells are 3-5 in FOV in urine analysis. Make the diagnosis.
A. Ureteral colic.
B. Intestinal obstruction.
C. Acute appendicitis.
D. Acute cholecystitis.
E. Ruptured ulcer of duodenum.
11. A 42-year-old patient was brought to the emergency department with a diagnosis of renal colic. Which of the following signs is most likely for the patient?
A. Hematuria.
B. Leukocytosis
C. The presence of sugar in the urine.
D. Bilirubinemia.
E. Decrease of red blood counts.
12. A 36-year-old female patient complains of severe pain in the left lumbar region, left hypochondrium, frequent urination, and bloody tap in the urine. She has been sickfor the day. The complaints were noted after the harsh riding. The abdomen is soft and sensitive in the left hypochondrium. Pasternatsky's symptom is positive on the left. What is your preliminary diagnosis:
A. Ureteral colic.
B. Acute pyelonephritis.
C. Hematuria.
D. Acute cholecystitis
E. Biliary colic.
13. A 56-year-old male patient was diagnosed with occlusion of the middle third of the right ureter with stone. What area of pain radiation should be in the patient?
A. In pelvic area.
B. In the hypochondrium.
C. In genital organs.
D. Under the scapula.
E. In the thoracic cage.
14. A 26-year-old patient was diagnosed with occlusion of the upper third of the left ureter with stone. What area of pain radiation should be in the patient?
A. In subcostal area.
B. In genital organs.
C. In pelvic area.
D. Under the scapula.
E. In the thoracic cage.
15. A 52-year-old patient was diagnosed with occlusion of the lower third of the ureter by stone. What area of pain radiation should be in the patient?
A. In genitals.
B. In the thoracic cage.
C. In pelvic area.
D. Under the scapula.
E. In subcostal area.
16. A 48-year-old male patient after hypothermia had bloody tap in the urine without urination disorders. Macrohaematuria disappeared after 12 hours. Which of the following recommendations is the most useful?
A. Perform special studies focused on determination the source of hematuria.
B. Prescribe hemostatic therapy for preventative measures.
C. Perform complex laboratory tests to determine further treatment.
D. Apply for examination during recurrent hematuria.
E. Consultation of the nephrologist.
17. A 30-year-old patient applied to the doctor with complaint of the presence of blood in the urine. This sign arose after the sharp pain in the right lumbar region.
What is the possible cause of hematuria:
A. Stone of the right ureter.
B. Appendicitis.
C. Tumor of kidney.
D. Acute cystitis.
E. Acute glomerulonephritis.
18. A 52-year-old patient complains of intense pain in the right lumbar and iliac regions, frequent urination, nausea and vomiting. The body temperature is 37,20С.
There is a pain along the right ureter. Pasternatsky's symptom is positive on the right. The suspicious shadows for calculus were found on the observational urogram. Your preliminary diagnosis is:
A. Right renal colic.
B. Acute appendicitis.
C. Hepatic colic.
D. Acute pyelonephritis.
E. Intestinal obstruction.
19. A 34-year-old patient was hit by a car. The pelvic fracture was diagnosed at the emergency room. The blood is released from the urethra. How is this symptom called?
A. Urethremorrhagia
B. Hemospermia
C. Hematuria
D. Stranguria.
E. Incontinence of urine
20. A 42-year-old female patient was admitted to the urology department with complaints of sharp paroxysmal pain in the left lumbar region; the pain does not depend on the change of body position, nausea, periodic vomiting, red urine, and frequent urination. She has been sickacutely a few hours ago, after the car driving.
After taking bath the pain slightly diminished, but after a few hours it sharply increased again. The sharp pain is objectively determined by palpation in the left kidney, CVA Tenderness is positive on the left. Make the diagnosis.
A. Right renal colic.
B. Addison's disease.
C. Ureterocele, hydroureteronephrosis.
D. Polycystic kidney disease, exacerbation of chronic pyelonephritis.
E. Acute pyelonephritis, renal abscess.
21. A 65-year-old patient has suffered from the difficulty, painless urination with weak urine stream, periodic sensation of incomplete bladder emptying for 6 months. The patient has 3-4 urination at night. 100 ml of urine is determined after urination in the bladder by the ultrasound. How is this condition called?
A. Chronic retention of urine.
B. Nycturia
C. Oliguria
D. Opsiuria
E. Stranguria.
22. The episode of sharp, stabbing pain in the lumbar region on the left, radiating to the genitals and the inner surface of the thigh was suddenly developed in a 58- year-old patient a day ago. It was accompanied by nausea, vomiting and urination.
He did not urinate from the beginning of the attack. The aplasia of the right kidney is in past medical history. Costovertebral angle tenderness is sharply positive on the left and it is negative on the right. The rounded clear shadow of 12x15 mm in the projection of the left pelvis is detected by the KUB X-ray. The left kidney function is absent.
What is your preliminary diagnosis?
A. Urolithiasis, single left kidney stone, post-renal anuria.
B. Urolithiasis, single left kidney stone, acute urinary retention.
C. Echinococcal cyst of the left kidney, acute renal failure, anuria.
D. Urolithiasis, acute renal failure.
E. Acute interstitial nephritis, obstructive anuria.
23. A 34-year-old patient has brought to the emergency department with complaints of pain in the lumbar region on both sides, lack of natural urination for 8 hours. Urolithiasis and stones of both kidneys 0.5-0.6 cm were diagnosed a year ago. The urine is not received during the catheterization of the bladder. The bilateral expansion of the pelvicalyceal system is detectedby ultrasound data. What is the preliminary diagnosis:
A. Postrenal anuria
B. Acute urinary retention.
C. Chronic pyelonephritis.
D. Secretory anuria.
E. Chronic renal failure.
24. A 68-year-old male patient applied to the urology department with signs of acute urinary retention. Prescribe the priority of proper treatment:
A. Urinary catheterization
B. Antimicrobial therapy.
C. KUB X-ray.
D. Introduction of spasmolysant.
E. Prescription of alpha-blockers.
25. A 50-year-old female patient brought to the clinic with acute renal failure. This disorder has occured in the postoperative period. It is known that the uterus with appendages in the result of malignant lesions was removed. The expansion of the pelvicalyceal system of both kidneys is observed by the ultrasound. Specify the kind of ARF in this case.
A. Postrenal.
B. Prerenal
C. Renal.
D. Arenal.
E. Reflecting.
26. The urinary retention suddenly developed in 6-year-old boy with chronic kidney disease. Prescribe proper treatment to perform the differential diagnosis between anuria and acute urinary retention.
A. Urinary catheterization.
B. Nephrosonography.
C. Intravenous ureography.
D. Cystoscopy.
E. Cystography.
27. A 35-year-old patient was delivered to the sanitary inspection room with complaints of acute lumbar pain on the right and right side of the abdomen. The irradiation of pain is in the right groin and testicle. The nausea, vomiting and frequent urination are observed. Hematuria is in the analysis of urine. The most accurate diagnosis:
A. Ureteral colic.
B. Acute appendicitis.
C. Acute orchiepididymitis.
D. Right kidney tumor.
E. Acute pyelonephritis.
28. A 48-year-old K. patient came stroke day ago, the natural urination was absent. 500 ml of clear urine was introduced by the catheter. The blood test: leuk.
are 7.4 × 109 /l, ESR are 15 mm /h., er. are 3.9 × 109 / l. The urine test: protein is 0.066 g / l, leuk. are 10-15 × 109 /l, er. are 3-4 in FOV. The blood glucose is 6.2 mmol /L. Make the diagnosis:
A. Neurogenic urinary bladder.
B. Urethral stricture.
C. Prostate carcinoma.
D. Benign prostatic hyperplasia.
E. Oliguria.
29. A 23-year-old M. patient has the burning sensation along the urethra, frequent urination, significant turbidity of the first portion of urine due to the foreign matters of leukocytes and bacteria. What is the diagnosis?
A. Acute urethritis.
B. Acute cystitis.
C. Acute pyelonephritis.
D. Abscess of prostate gland.
E. Acute prostatitis.
30. Paradoxical ischuria was diagnosed. What does this disturbance of urination involve?
A. The combination of urinary retention and urinary incontinence.
B. Incontinence of urine
C. Urinary retention.
D. Impossibility of natural urination.
E. Chronical incontinence of urine
31. The patient complains of blood in the urine. The total hematuria is in urine tests. Where is the area of the pathological process localization?
A. Bladder, ureter, kidney.
B. Bladder, urethra.
C. Urethra, bladder.
D. Bladder neck, prostatic urethra.
E. Bladder, ureter.
32. A 57-year-old patient has complaints of frequent, difficult, painful urination, weak urine flow. What disease can be the cause of this irregular urination?
A. All of given above.
B. Prostate carcinoma.
C. Partial urethral damage.
D. Severe phimosis.
E. Chronic interstitial cystitis.
33. A 54-year-old K. patient suffers from polycystic kidney disease. The daily amount of urine is 2.7 liters. Ranges of the urine specific gravity according to the Zimnitskiy's test are 1005-1012. The blood urea is 12.8 mmol / l. What is the cause of this condition:
F. Chronic renal failure.
G. Acute renal failure.
H. Diabetes Mellitus
I. Canal nephropathy.
J. Excessive fluid intake.
Topic: Methods of urological patients examination Tests of the 1st level:
1. What combination of investigation methods will allow more accurate to differentiate nephroptosis from kidney dystopia?
1) excretory urography 2) retrograde pyeloureterography 3) radioisotope
renography 4) aortography 5) chromocytoscopy. Choose the right combination of answers.
A. 1, 2, 4.
B. 1, 3, 5.
C. 2, 3, 4.
D. 2, 3, 5.
E. 3, 5.
2. The weight loss, appetite loss, thirst are observed while examination. The relative density is 1035 in the general urine analysis; the other indicators are without deviations. What medical test should be primarily performed for the patient?
A. Determination of blood glucose level.
B. Zimnitskiy's test.
C. Blood extraction ratio based on endogenous creatinine.
D. Determination of blood creatinine.
E. Test for rarefaction.
3. The patient was taken to the hospital with complaints of nausea, weight loss, lack of appetite and skin itching. The patient has been suffering from chronic pyelonephritis for 7 years. Which of the following medical studies is the most informative to determine the functional state of the kidneys?
A. Blood extraction ratio based on endogenous creatinine.
B. Determination of total nitrogen.
C. Determination of blood creatinine.
D. Determination of blood urea.
E. Zimnitskiy's test.
4. The patient has total hematuria. The worm-like blood clots are in the urine.
What medical test can help to establish the diagnosis?
A. Excretory urography.
B. Pneumopyelography.
C. Radiorenography.
D. Urethroscopy.
E. Cystography.
5. The patient complains of the absence of urine during the day. What is performed with the purpose for differential diagnosis:
A. Ultrasound examination of the kidneys and bladder.
B. Retrograde pyelography.
C. Computer tomography.
D. Radiorenography E. Excretory urography.
6. The contraindications to catheterization of the bladder are:
A. Acute urethritis, prostatitis and epididymitis.
B. Chronic prostatitis.
C. Intra-abdominal rupture of the urinary bladder.
D. Recent injury of urethra.
E. A) and D) are true.
7. The indications for ureteral catheterization are all of listed above, except for:
A. Secretory anuria.
B. Conduction retrograde pyelography and ureterography.
C. Obstructive anuria.
D. Differential diagnosis of secretory and obstructive anuria.
E. Separate receive of urine from each kidney.
8. The contraindications to ureteral catheterization are all listed, except for:
A. Chronic pyelonephritis.
B. Acute pyelonephritis.
C. Acute urethritis and prostatitis.
D. Acute epididymitis.
E. Bladder capacity is less than 75 ml.
9. The complications of ureteral catheterization are:
A. Perforation of the ureter, perforation of the pelvis, bleeding, exacerbation of urinary infection.
B. Perforation of the pelvis
C. Exacerbation of urinary infection.
D. Damage of the bladder.
E. Absent.
10.The complications of the urethral dilation are all of the above, except::
A. Fornical bleeding.
B. Acute prostatitis and epididymitis.
C. Urethrorrhagia.
D. Catheter fever.
E. The formation of a false path.
11.The contraindications to the dilation of the urethra are all listed, except for:
A. Chronic prostatitis and cystitis.
B. Acute epididymitis.
C. Acute cystitis and prostatitis.
D. Benign prostatic hyperplasia.
E. Acute urethritis.
12. What are required for cystoscopy:
A. All of the following.
B. Bladder capacity is more than 75 ml.
C. Transparent space in the cavity of the urinary bladder.
D. Urethral patency.
E. 2 and 3 are true.
13. The indications for urethroscopy are:
A. All listed below.
B. Chronic inflammatory diseases of the urethra.
C. Tumors of the urethra.
D. Colliculitis.
E. А) and В) are true.
14.The dry urethroscopy is used for inspection of:
A. The anterior and posterior of the urethra, seminal crest B. The posterior of the urethra
C. Seminal crest
D. А) and В) are correct E. Urinary bladder.
15.The irrigation of urethroscopy is used to examine.
A. The posterior of the urethra B. The anterior of the urethra.
C. Seminal crest
D. а) and b) are correct.
E. Urinary bladder.
16.The contraindications to chromocystoscopy are:
A. Acute cystitis, urethritis, shock, acute prostatitis, collapse.
B. Collapse.
C. Shock.
D. Acute prostatitis.
E. Retention of urine.
17.The chromocystoscopy contraindications are:
A. Bladder capacity is less than 50 ml..
B. Chronic prostatitis.
C. CKD.
D. Renal hepatic failure.
E. High blood pressure.
Tests of the 2nd level:
1. What kind of contrast media x-ray is necessary to use for medical study of the urinary tract:
A. Triombrast.
B. Iodamide C. Omnipaque D. Barium.
E. Iopagnost
2. What are the complications of intravenous administration of contrast agents?
A. Hives.
B. Anaphylactic shock.
C. Bronchospasm.
D. Diarrhea
E. Acute coronary syndrome.
3. What can incorrectly detected during diagnosis of urine stones of the excretory system for their presence:
A. Stones of the gallbladder.
B. Pancreatic stones.
C. Dehydrated cysts, vessels.
D. Fecal stones.
E. Hydrocalix.
4. Specify the tools that are necessary for retrograde pyelography::
A. Catheter cystoscope.
B. Set of ureteral catheters C. Syringe and contrast agent D. Nephroscope.
E. Indigo carmine.
5. What is the purpose of retrograde pyelography, except for:
A. Arresting of renal colic.
B. Taking urine separately from each kidney.
C. Identificatiom of the destructive process in calyxes with tuberculosis.
D. Identification of pelvis tumor, ureter.
6. What does the ultrasound of the kidney allow us to identify.
Conditions of the pelvic-ureteric segment and nephrolithiasis:
A. Sizes of the kidneys.
B. Thickness of the parenchyma.
C. The presence of stones and tumors.
D. Location.
E. Kidney function.
Tests of the 3rd level:
1. A 23-year-old N. patient has markedly turbidity of urine due to the foreign matter of leukocytes and bacteria. However, the localization of the
inflammatory process is unknown. Which medical method of examination should be used?
A. Three-glass test.
B. Two-glass test.
C. Zimnitsky test of urine.
D. Nechiporenko test of urine.
E. Urine culture.
2. A 52-year-old female patient was admitted to the urological department with complaints of severe lumbar pain to the left, without the urine for two days.
From the anamnesis: she has suffered from urolithiasis for 12 years. The patient had a right-sided nephrectomy three years ago. What medical test should be performed to differentiate acute urinary retention from anuria?
A. Ultrasound.
B. Computed tomography.
C. To perform the catheterization of the bladder.
D. Intravenous ureography.
E. Cystography.
3. A 36-year-old B. patient was admitted to the clinic with complaints of pain in the right lumbar region, the appearance of blood in the urine after the pain attack.
The kidneys are not palpable. Pasternatsky's symptom is positive to right.
Microhematuria and uraturia were revealed in the urine test. What medical method of examination is most appropriate in this case?
A. Ultrasound.
B. Intravenous ureography.
C. Computed tomography.
D. Urine test.
E. Retrograde ureteropyelography.
4. A 25-year-old patient has severe pain in the left lumbar region, frequent urination and nausea. He felt sick 2 days ago after the long hard work. The
abdomen is soft and painful in the left hypochondrium. Pasternatsky's symptom is positive on the left. What should be done to clarify the diagnosis?
A. Ultrasound.
B. KUB X-ray.
C. Computed tomography.
D. Chromocystoscopy.
E. Intravenous ureography.
5. A 68-year-old patient addressed to the urology department with acute urinary retention. Specify the priority medical test:
A. Catheterization of the bladder.
B. KUB X-ray.
C. Introduction of antispasmodics.
D. Antibacterial therapy.
E. Prescription of alpha-adrenoblocker.
6. The natural urination is absent for 3 days after drinking alcohol in 71-year-old patient. Significant desire to urinate is not noted. The patient has suffered from stranguria and nocturia for 3 years. The patient has hypertrophy. The bladder is not clearly defined by palpation. What medical method is most appropriate for determination of the existing pathology nature?
A. Ultrasound.
B. KUB X-ray.
C. Determination of the urea level and blood creatinine.
D. Intravenous ureography.
E. Catheterization of the bladder.
7. A 52-year-old patient complains of intense pain in the right lumbar and iliac regions and frequent urination. The pain is noted along the right ureter.
Pasternatsky's symptom is positive to the right. The shadows for suspicious calculus are found on the KUB X-ray. What should be done to clarify the diagnosis?
A. Ultrasound.
B. Intravenous ureography.
C. Urine and blood tests.
D. Retrograde ureteropyelography.
E. Computed tomography.
8. A 34-year-old patient was hit by a car. The pelvic fracture was diagnosed in the emergency room. The blood is released from the urethra. What examination must be performed to clarify the diagnosis?
A. Retrograde ureteropyelography.
B. Voiding urethrography.
C. Ultrasound of the bladder.
D. Computed tomography.
E. Intravenous ureography with descending cystography.
9. A 60-year-old patient was admitted to the clinic with total painless macrohaematuria with clots on the background of subfebrile in the last two months. What medical methods must be performed urgently:
A. Cystoscopy and excretory urography.
B. Chromocytoscopy and Nechiporenko test of urine.
C. UFM and microscopic sediment examination.
D. Bladder catheterization and microscopic sediment examination.
E. Retrograde urethrocystography and blood urea concentration test.
10. Total painless hematuria was diagnosed in the patient of the emergency department. What the tactics should be performed?
A. Ultrasound.
B. Excretory urography.
C. Cystoscopy D. Angiography.
E. Retrograde ureteropyelography.
11. A 23-year-old patint has dysuria and marked turbidity of the first portion of urine due to foreign substances of leukocytes and bacteria. What is the
preliminary diagnosis?
A. Acute prostatitis.
B. Acute cystitis.
C. Acute urethritis.
D. Acute pyelonephritis.
E. Abscess of prostate gland.
12. A 21-year-old female patient complains of pain in the left half of the abdomen during the physical exertion. The smooth, nonmobile and painless mass is determined by the palpation at the level of the umbillicus. This
formation is the kidney, the ureter according to the excretory urography. It is not clearly visualized. The right kidney is located normally, its function is
satisfactory. What medical method will allow us to accurately establish the anomaly of the kidney in a patient?
A. Renal angiography.
B. Cystography.
C. Radioisotope renography.
D. Chromocystoscopy.
E. Ultrasound.
13. A 40-year-old patint was delivered to the emergency department. Acute
pyelonephritis on the left and stone of the left ureter were diagnosed. Which of the following methods will confirm or exclude the disturbance of the passage of urine from the left kidney?
A. Chromocystoscopy.
B. Bladder catheterization.
C. Plain urography.
D. UFM.
E. Radioisotopic .
14. A 29-year-old V. patient was hospitalized with complaints of dysuria and subfebrile body temperature. The leukocytes cover the entire field of view in the general urine test. What test will be appropriate for verification of the
leukocyturia source?
A. Three-glass test.
B. Nechiporenko's test.
C. Rehberg's test.
D. Amburzhe's test.
E. Zimnitskiy's test.
15. A 32-year-old patient was admitted to the hospital with complaints of fever to 39. 60C. The patient's condition is severe. The sharp pain during extension is noted in the position when the patient leads up to the abdomen by the hip. The bulging in the lumbar region and hyperemia on the right, pain in the lumbar region, especially in the right costovertebral angle, protective contraction of the lumbar muscle during mild palpation, scoliosis of the lumbar spine are
observed. What emergency examination is necessary for the patient to establish the diagnosis?
A. Plain urography and intravenous ureography.
B. Chromocytoscopy.
C. UFM.
D. Radioisotope renography.
E. Retrograde ureteropyelography.
16. A 45-year-old female patient suffered from the general weakness, fatigue, dry mouth and thirst. The skin is pale. AP is 170/105 MmHg. Then tuberous kidneys are enlarged during palpation. The collective current of residual
nitrogen is 100 mmol /l. Daily variation is 1010-1012 in relativeto the specific gravity of urine. It is known that the grandmother of the patient died at the age of 43 from the unknown kidney disease. Which of the following method is the most informative to confirm the diagnosis?
A. Sonography of the kidneys.
B. Excretory urography.
C. Chromocytoscopy.
D. Dynamic scintigraphy.
E. Radioisotope renography.
17. A 55-year-old patient with total monosymptomatic macrohaematuria was delivered to the emergency department. It is appeared at first. The general condition of the patient is satisfactory. The pathological changes were not identified during examination. Which of the following methods must be urgently performed?
A. Echo scan.
B. Cystography.
C. Cystoscopy.
D. Catheterization of the bladder.
E. Bougienage.
18. Urgently woman applied with intense pain in the right hypochondrium and lumbar region, nausea, vomiting. Temperature is 37.50 C. The urine analysis includes such indicators such as the amount of leukocytes is10-12 FOV and the dose of erythrocytes is 15-20 in FOV. What method is the appropriate for the differential diagnosis of renal and hepatic colic?
A. Chromocytoscopy.
B. Identification of blood creatinine.
C. Nechiporenko's test.
D. Plain urography E. Zimnitskiy's test.
19. A 62-year-old F. patient has acute disorder of cerebral circulation, the urination is absent for 28 hours. The bladder is on 2 cm below the umbilicus.
Which of the following catheter should be used for prolonged urine release?
A. Indwelling catheter.
B. Metal bougie.
C. Metallic male catheter.
D. Thiemann's catheter.
E. Pezzer's catheter.
20. A 68-year-old L. patient has pain in the abdomen after frequent micturate urge to urinate. The urine retention is suddenly developed. Specify the
emergency management.
A. Catheterization of the bladder.
B. Catheterization of the bladder.
C. Paracentetic cystostomy.
D. Introduction of antispasmodics.
E. Introduction of alpha-adrenoblocker.
21. A 68-year-old patient has lower abdominal pain after frequent micturate urge to urinate. The urine retention is suddenly developed. What else should be done to clarify the diagnosis?
A. Ultrasound of the urinary system.
B. Cystoscopy.
C. Cystography.
D. Urethrography.
E. Excretory urography.
22. A 3-year-old boy was taken to the hospital with complaints of pain in the left lumbar region. The pain occurs during urination. What method will be appropriate in the diagnosis of this disease?
A. Micturating cystography B. Excretory urography.
C. Cystoscopy.
D. Urethrography.
E. Renography.
23. The patient was brought to the hospital with urethral surgery that occurred after the perineal injury. Which of the following method is contraindicated in this case?
A. Urethralcystoscopy.
B. Cystoscopy.
C. Excretory urography.
D. Ultrasound of the kidneys and bladder.
E. Isotopic renography.
24. A 40-year-old woman has the typical picture of renal colic, paroxysmal pain during the week, temperature is 38.60 C. The shadow suspicious for calculus (0.5
× 0.8 cm) near the bladder is noted on the observational urogram. Antispasmodic injections and novocaine blockades give the temporary effect. What kind of manipulation can help for the patient?
A. Ureteral catheterization.
B. Antibiotics.
C. Repeated blockade of the round ligament of uterus.
D. IV introduction of the mixture (with morphine).
E. Physiotherapy.
25. A 34-year-old man complained of frequent and painful urination. He had the operation about the trauma of urethra year ago. He has difficulty urination with weak stream during last 3-4 months. What tool can help in
A. Uroflow meter.
B. Indwelling catheter.
C. Cystoscopy.
D. Echo scan.
E. Bougienage.
26. The man brought to the hospital with acute urinary retention, which
developed on the background of benign prostatic hyperplasia. What catheter is most likely and atraumatic to release urine of the patient?
A. Thiemann's plastic curved elastic catheter.
B. Metallic male catheter.
C. Nelaton's catheter.
D. Pezzer's catheter.
E. Three-way elastic catheter with balloon.
27. A 29-year-old patient has complained of the body temperature to 38°C, pain in the right lumbar region and nausea. He has been sickfor 12 hours. Leucocyturia is absent, but bacteriuria occurs in the number more than 100 thousand of the microbial bodies in the general urine test. Is it possible to exclude the presence of acute pyelonephritis?
A. No.
B. Yes, but only after ultrasound.
C. Yes, but only after Amburge's test.
D. Yes.
E. Yes, but only after Nechiporenko's test.
28. A 50-year-old female patient was hospitalized with complaints of the blood urine. She felt sick for the first time. The abdomen is soft and painless.
Pasternatsky's symptom is negative on both sides. The kidneys are located in the typical places, calculi in the projection of the kidneys; ureters and bladder are not detected on the observational Rо-gram. 8'-15 'PCS was filled from two sides; the kidney function is not impaired on the excretory urogram. The filling corporal with dimensions of 0.4 × 0.4 cm in the area of the pelvis is observed on the right side. What research is necessary to determine the source of bleeding?
A. Computed tomography with intravenous enhancement.
B. X-ray.
C. Retrograde ureteropyelography.
D. Nephroscopy.
E. Ureteronephroscopy.
29. The cloudy urine is excreted in 3-year-old child.Leukocyturia and bacteriuria are revealed by the laboratory test. The child holds his hand on the lumbar
region on the right side during urination. What medical method is most appropriate to confirm the cholecystic -renal reflux?
A. Excretory urography.
B. Dynamic scintigraphy.
