Multiple Choice
Identify the choice that best completes the statement or answers the question.
1. When performing a dipstick test on a patient’s urine sample, a positive leukocyte esterase and
nitrite is indicative of:
A. Microscopic hematuria
B. Urinary tract infection
C. Calculi in the urine
D. Possible bladder tumor
2. An intravenous pyelogram should not be performed if serum creatinine is:
A. Less than 1.5
B. Greater than 1.0
C. Greater than 1.6
D. Less than 1.0
3. Your 55-year-old male patient presents to the emergency department with complaints of sudden
development of severe right-sided, colicky lower abdominal pain. He cannot sit still on the
examining table. The patient has previously been in good health. On physical examination, there
are no signs of peritoneal inflammation. A urine sample reveals hematuria and crystalluria. Which
is the next diagnostic test that should be done immediately?
A. Ultrasound of the abdomen
B. Abdominal x-ray
C. Digital rectal examination
D. Spiral CT scan
4. The most common complication of an untreated urinary obstruction due to a ureteral calculus is:
A. Hydronephrosis
B. Renal artery stenosis
C. Ureteral rupture
D. Kidney mass
5. A 43-year-old male patient complains of right-sided abdominal and pain in the back in the right
costovertebral angle region, fever, chills, dysuria, and nausea. On physical examination, there is
102 degree fever, tachycardia, and right costovertebral angle tenderness to percussion. The most
likely condition is:
A. Lower urinary tract infection
B. Pyelonephritis
C. Nephrolithiasis
D. Hydronephrosis
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, 6. On a physical examination for employment, a 45-year-old male shows no significant findings and
takes no medications. Past medical history and surgery are unremarkable. On urinalysis, hematuria
is present. The urinalysis is repeated on another day and still reveals microscopic hematuria. It is
important to recognize that painless hematuria can be diagnostic of:
A. Urinary tract infection
B. Bladder cancer
C. Nephrolithiasis
D. Pyelonephritis
7. On DRE, you note that a 45- year-old patient has a firm, smooth, non-tender but asymmetrically
shaped prostate. The patient has no symptoms and has a normal urinalysis. The patient’s PSA is
within normal limits for the patient’s age. The clinician should:
A. Refer the patient for transrectal ultrasound guided prostate biopsy
B. Obtain an abdominal x-ray of kidneys, ureter, and bladder
C. Recognize this as a normal finding that requires periodic follow-up
D. Obtain urine culture and sensitivity for prostatitis
8. Your 77-year-old patient complains of frequent urination, hesitation in getting the stream started,
and nocturnal frequency of urination that is bothersome. On DRE, there is an enlarged, firm, non-
tender, smooth prostate. The clinician should recognize these as symptoms of:
A. Prostatitis
B. Prostate cancer
C. Urethritis
D. Benign prostatic hyperplasia
9. Your 66-year-old patient complains of frequency of urination and hesitancy of the urine stream. On
DRE, there is a hard, nodular, enlarged, non-tender prostate. The clinician should recognize these
as symptoms of:
A. Prostatitis
B. Prostate cancer
C. Urethritis
D. Benign prostatic hyperplasia
10. A 27-year-old male comes in to the clinic for symptoms of dysuria, urinary frequency, as well as
urgency and perineal pain. Transrectal palpation of the prostate reveals a very tender, boggy,
swollen prostate. The clinician should recognize these as signs of:
A. Prostatitis
B. Prostate cancer
C. Urethritis
D. Benign prostatic hyperplasia
11. Your 24-year-old female patient complains of dysuria as well as frequency and urgency of
urination that develops the day after she uses her diaphragm. Urine culture reveals a bacterial
count of 100 CFU/mL. These signs and symptoms indicate:
A. Upper urinary tract infection
B. Lower urinary tract infection
C. Normal bacteriuria
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