Multiple Choice Questions (MCQ)

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Category: Urology--->Urological Trauma
Page: 3

Question 11# Print Question

A 24-year-old motorcyclist is brought into the Emergency department with a ‘severe’ pelvic fracture following a road traffic accident. Associated injuries mean that monitoring of urine output is required by the trauma team. What factor would immediately raise the suspicion of an associated urethral injury?

A. Blood at the meatus
B. Sleeve haematoma of penis
C. High riding prostate on digital rectal examination
D. Blood on glove following digital rectal examination
E. Butterfly haematoma of perineum

Question 12# Print Question

You are asked by the Gynaecology SPR to see a patient who had an abdominal hysterectomy 48 hours ago. The patient is tachycardic, pyrexial (39.2) and complaining of left flank pain. There is abdominal and left flank tenderness, and drainage of 500 mL of blood stained fluid in the last 12 hours from the pelvic drain. FBC – Hb 10.2, WCC 15.0. Electrolytes are normal. The next step in management is to: 

A. Arrange urgent exploratory laparotomy and repair of suspected ureteric injury
B. Advise nil orally, bed rest, intravenous antibiotics and fluid replacement
C. Request urgent CT urogram after immediate resuscitation
D. Request urgent ultrasound
E. Arrange cystoscopy, retrograde ureteropyelogram and attempt retrograde JJ stenting

Question 13# Print Question

An 18-year-old male is brought in to the Emergency department after being stabbed in the right loin. There is no further history available. The patient’s blood pressure is poorly maintained with intravenous fluids but stabilises with a 2 unit blood transfusion. Contrast CT shows a Grade 4 Right renal injury. There is no suspected intra-abdominal injury. What is the next step in management?

A. Request angioembolisation by experienced interventional radiologist
B. Urgent insertion of JJ stent
C. Urgent percutaneous drainage of peri-renal area
D. Admit for bed rest, regular observations and follow-up bloods
E. Urgent exploratory laparotomy and kidney repair or nephrectomy

Question 14# Print Question

A 39-year-old male is brought to the Emergency Department complaining of severe lower abdominal pain and an inability to void. He had been involved in an altercation following a ‘heavy’ drinking session. He vaguely remembers being punched to the head and lower abdomen. He did not lose consciousness and has been assessed as having only a minor head injury. Examination reveals a stable patient with lower abdominal tenderness, but no obvious palpable bladder. Blood and urine tests are normal. What is the investigation would you consider next?

A. Intravenous urogram with delayed phase
B. Ascending urethrogram and insertion of catheter
C. Stress cystogram with 300 mL of contrast inserted into the bladder
D. Screening cystogram with diluted contrast
E. Ultrasound abdomen and renal tract

Category: Urology--->Urological Trauma
Page: 3 of 3