Disorders of the Genitourinary System

Disorders of the Genitourinary System Related

Review Disorders of the Genitourinary System related questions and content

A 55-year-old man is experiencing severe pain of sudden onset in the scrotal area. It is somewhat relieved by elevation. On examination the nurse notices an enlarged, red scrotum that is very tender to palpation. Distinguishing the epididymis from the testis is difficult, and the scrotal skin is thick and edematous. This description is consistent with which of these?

  • A. Varicocele.
  • B. Epididymitis.
  • C. Spermatocele.
  • D. Testicular torsion.
Correct Answer: B

Rationale: The correct answer is B: Epididymitis. The key features that point towards epididymitis in this case include sudden onset severe scrotal pain, tenderness in the scrotal area, difficulty in distinguishing the epididymis from the testis, and thick, edematous scrotal skin. Epididymitis is inflammation of the epididymis typically caused by a bacterial infection. The pain is often relieved by elevation due to reduced pressure. Varicocele (A) is a painless swelling of the veins in the scrotum. Spermatocele (C) is a benign cyst containing sperm that is usually painless. Testicular torsion (D) presents with sudden, severe testicular pain but does not typically involve difficulty in differentiating between the epididymis and testis or edematous scrotal skin.

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The drug of choice for treatment and secondary prophylaxis against * cryptococcal meningitis among AIDS patients is:

  • A. Amphotericin B
  • B. Flucytosine
  • C. Fluconazole
  • D. Ketoconazole
Correct Answer: C

Rationale: The correct answer is C: Fluconazole. Fluconazole is the drug of choice for treating and preventing *cryptococcal meningitis in AIDS patients due to its excellent CNS penetration and efficacy. It is preferred over Amphotericin B due to its better safety profile and tolerability. Flucytosine is not used as monotherapy and is often combined with other antifungals. Ketoconazole is not recommended for cryptococcal meningitis due to poor CNS penetration.

Which hormone does not play a role in regulating fluid and electrolyte balance?

  • A. ADH
  • B. aldosterone
  • C. leptin
  • D. atrial natriuretic peptide
Correct Answer: C

Rationale: Leptin does not play a role in regulating fluid and electrolyte balance because it is primarily involved in regulating energy balance and appetite. ADH (antidiuretic hormone) helps in water reabsorption, aldosterone regulates sodium and potassium levels, and atrial natriuretic peptide promotes sodium excretion. Leptin's main function is to regulate hunger and energy expenditure, making it unrelated to fluid and electrolyte balance regulation.

A patient with suprapubic pain and symptoms of urinary frequency and urgency has two negative urine cultures. What is one assessment finding that would indicate interstitial cystitis?

  • A. Residual urine greater than 200 mL
  • B. A large, atonic bladder on urodynamic testing
  • C. A voiding pattern that indicates psychogenic urinary retention
  • D. Pain with bladder filling that is transiently relieved by urination
Correct Answer: D

Rationale: The correct answer is D. Pain with bladder filling that is transiently relieved by urination is a classic symptom of interstitial cystitis. This pattern of pain is due to inflammation of the bladder lining, which worsens as the bladder fills with urine and improves temporarily after urination. This finding is specific to interstitial cystitis and not typically seen in other conditions.

Choices A, B, and C are incorrect:
A: Residual urine greater than 200 mL is more indicative of bladder outlet obstruction or neurogenic bladder dysfunction, not specifically interstitial cystitis.
B: A large, atonic bladder on urodynamic testing is suggestive of neurogenic bladder or bladder outlet obstruction, not interstitial cystitis.
C: A voiding pattern indicating psychogenic urinary retention is more likely related to psychological factors affecting bladder function, not interstitial cystitis.

When the nurse is performing a genital examination on a male patient, which action is correct?

  • A. Auscultating for the presence of a bruit over the scrotum
  • B. Palpating for the vertical chain of lymph nodes along the groin, inferior to the inguinal ligament
  • C. Palpating the inguinal canal only if a bulge is present in the inguinal region during inspection
  • D. Having the patient shift his weight onto the left (unexamine
Correct Answer: B

Rationale: The correct answer is B: Palpating for the vertical chain of lymph nodes along the groin, inferior to the inguinal ligament. This is the correct action during a male genital examination as it helps assess for any abnormalities or signs of infection in the lymphatic system. Palpating the lymph nodes allows the nurse to identify any swelling, tenderness, or enlargement which could indicate underlying health issues. The other choices are incorrect because:
A: Auscultating for a bruit over the scrotum is not a standard practice during a genital examination and is not relevant to assessing male genital health.
C: Palpating the inguinal canal only if a bulge is present is incorrect as palpating the inguinal canal should be done regardless of the presence of a bulge to check for hernias.
D: Having the patient shift his weight is not a standard procedure during a genital examination and is not relevant to assessing male genital health.

Which of the following drug used in the treatment of filariasis? *

  • A. Diethyl carbamazine
  • B. Albendazole
  • C. Levamisole
  • D. Piperazine
Correct Answer: A

Rationale: Diethyl carbamazine is the correct answer for the treatment of filariasis as it is the drug of choice due to its effectiveness in killing microfilariae and adult worms. Diethyl carbamazine directly targets the parasites responsible for filariasis, leading to their death and eventual elimination from the body. Albendazole, Levamisole, and Piperazine are not commonly used for filariasis treatment and are more commonly used for other parasitic infections. Albendazole is more commonly used for helminthic infections, Levamisole for roundworm infections, and Piperazine for pinworm infections.

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