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M1 Urinary Pre-Summative Quiz

Quiz by Jenny Ousley

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8 questions
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  • Q1

    A 22-year-old woman comes to the physician because of intermittent suprapubic pain and urinary frequency for the past 3 months. The pain varies from a 5 to 9 out of 10 without any particular triggers. During a diagnostic cystography, the woman experiences pain on filling of the urinary bladder. A diagnosis of interstitial cystitis is made. What is the location of the neural cell bodies responsible for pain sensation in this patient?

    The sensory ganglia of spinal nerves T5–T9

    The preaortic ganglia at the site of origin of the testicular arteries

    Dorsal root ganglia of spinal levels T10–L2

    Dorsal root ganglia of spinal cord levels S2, S3, and S4

    The intermediolateral cell column of spinal cord levels S2, S3, and S4

    120s
  • Q2

    A 34-year-old woman is brought to the emergency department after falling 1.5 m (5 ft) onto her back during a mountain-climbing expedition. Physical examination shows

    loss of anal tone and perianal numbness. A catheter is inserted to treat her urinary retention. A CT scan shows multiple fractures of her pelvis and her lower lumbar spine. Which of the following nerves was most likely traumatized leading to this patient’s urinary symptoms?

    Pelvic splanchnic

    Superior hypogastric

    Sacral Splanchnic

    Lumbar Splanchnic

    Pudendal

    120s
  • Q3

    A 40-year-old woman comes to the physician to undergo a hysterectomy for leiomyoma uteri. She has extremely heavy periods, which have resulted in a chronic anemia despite the use of iron supplements. In the past month, she has also experienced significant abdominal pain. During surgery, the uterine artery is identified. Which of the following adjacent structures is most susceptible to potential iatrogenic injury during ligation of this artery?

    Internal iliac artery

    Ureter

    Obturator nerve

    Lumbosacral trunk

    Internal iliac lymph nodes

    120s
  • Q4

    A 35-year-old man comes to the emergency department after being kicked in the groin while playing football. Physical examination shows a swollen left scrotum. An MRI shows coagulation of blood in the veins draining the testis. Into which of the following veins would a thrombus most likely pass first from the injured area?

    Left iliac vein

    Left inferior epigastric

    Inferior vena cava

    Left internal pudendal

    Left renal vein

    120s
  • Q5

    A 7-year-old boy is brought to the physician because of an inability to control his urinary bladder, despite being toilet trained at the age of 5. Five months ago, he was treated for a urinary tract infection. Ultrasonography of the abdomen shows a mild dilatation of the left pelvicalyceal system. Diagnostic cystoscopy shows a ureteral orifice inserting directly into the urethra. A diagnosis of ectopic ureter is made. An ureteroureterostomy is performed to correct the defect. Which of the following landmarks is used to identify the position of left ureter during the procedure?

    Anterior to the left gonadal artery

    Medial to the left inferior epigastric artery

    Anterior to the left renal vein

    Anterior to the left common iliac artery

    Anterior to the left inferior epigastric artery

    120s
  • Q6

    A 48-year-old woman undergoes an abdominal hysterectomy for leiomyomata uteri. One day after the procedure, physical examination shows tenderness over the right lower quadrant. She also has a low urine output. A retrograde pyelogram shows contrast material in the left renal pelvis and none in the right, and it is suspected that the right ureter has been damaged. That structure passes inferior to which of the following?

    Ovarian artery

    Uterine artery

    Mesosalpinx

    Round ligament of the uterus

    Ovarian ligament

    120s
  • Q7

    A 45-year-old man is brought to the emergency department after falling 4.5 m (15 ft) during a mountain climbing expedition. Physical examination shows paralysis of the lower limbs bilaterally and a distended urinary bladder. A diagnosis of sacral cord injury is made. During insertion of the catheter to relieve the urinary retention, too much force is used, and the membranous urethra is ruptured. Which of the following structures would most likely be traumatized at this location?

    External urethral sphincter

    Ischiocavernosus muscle

    Bulbospongiosus muscle

    Opening of the bulbourethral duct

    Corpus cavernosus

    120s
  • Q8

    A 52-year-old woman comes to the physician because of difficulty passing urine. Physical examination shows a mass extending through the vaginal orifice past the hymenal ring. A cystogram shows a prolapse of the urinary bladder through the anterior wall of the vagina. Which of the following structures is more than likely defective leading to this problem? 

    Median umbilical ligament

    Levator ani

    Cardinal ligament

    Uterosacral ligament

    Pubovesical and vesicocervical fasciae

    120s

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