Exam 11: Genitourinary System

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?

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:

The most common complication of an untreated urinary obstruction due to a ureteral calculus is:

Calculation of prostate specific antigen (PSA) velocity provides a more specific measure of prostate cancer risk. An increased risk of prostate cancer is indicated when the PSA rises more than:

A major reason for the atrophic changes that occur in the pelvic floor muscles of the elderly woman is:

Your 77-year-old patient complains of frequent urination, hesitation in getting the stream started, and nocturnal frequency of urination that is bothersome. On digital rectal exam there is an enlarged, firm, nontender, smooth prostate. The clinician should recognize these as symptoms of:

Which of the following disorders can cause urinary incontinence?

A 15-year-old female patient presents with complaints of constant thirst, urination up to 20 times a day, and recent unintentional weight loss of 10 pounds over the last month. It is important for the clinician to recognize these symptoms as those of:

When performing a dipstick test on a patient's urine sample, a positive leukocyte esterase and nitrite is indicative of:

A 27-year-old male comes in to the clinic for symptoms of dysuria and 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:

An 18-year-old female patient presents with repeated urinary tract infections. She has no risk factors in her history, and her physical examination is unremarkable. She also has a normal pelvic examination. Which of the following should be obtained if anatomical abnormalities are suspected?

A 33-year-old female patient visits the clinic multiple times over the last year complaining of dysuria, frequency, urgency, suprapubic pain, and dyspareunia. Her physical examination, including a pelvic examination, is normal. Urinalysis and urine culture is repeatedly negative. Her IV pyelogram is also normal. The clinician should recognize that this presentation is consistent with symptoms of:

An IV pyelogram should not be performed if serum creatinine is:

Your 66-year-old patient complains of frequency of urination and hesitancy of the urine stream. On digital rectal exam there is a hard, nodular, enlarged, nontender prostate. The clinician should recognize these as symptoms of:

On digital rectal exam, you note that a 45-year-old patient has a firm, smooth, nontender but asymmetrically shaped prostate. The patient has no symptoms and a normal urinalysis. The patient's prostate specific antigen is within normal limits for the patient's age. The clinician should:

When conducting an initial evaluation of incontinence, which of the following is not indicated?

A 65-year-old male patient complains of frequency, urgency, hesitancy, and weak urine stream. Physical examination is unremarkable, except digital rectal exam reveals an enlarged, firm, nontender prostate gland. Urine culture reveals 100 bacteria CFU/mL. The clinician should suspect:

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 77-year-old male patient with a history of benign prostatic hyperplasia treated with finasteride has routine laboratory revealing a prostate specific antigen (PSA) of 7.5 ng/mL. Which of the following must be considered in interpreting this finding?

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 a 102°F fever, tachycardia, and right costovertebral angle tenderness to percussion. The most likely condition is: