NR 509 APEA Exam Urology - Answers with Explanation

Question: 1 In men, painful urination without frequency or urgency suggests: Correct: constipation. Explanation: In men, painful urination without frequency or urgency suggests urethritis. Cystitis presents with frequency and urgency. Constipation usually does not present with urinary tract symptoms. Acute prostatitis presents with frequency, urgency, and dysuria. Question: 2 A 65-year-old woman complains that when she feels the urge to urinate, she has to go immediately or else she urinates "on herself". She has become homebound because she wants to stay close to the bathroom. This condition is termed: Correct: stress incontinence. Explanation: In urge incontinence, (overactive bladder), urgency is followed by immediate involuntary leakage due to uncontrolled detrusor contractions that overcome urethral resistance. Following an urge to void, there is an involuntary loss of urine since the patient cannot get to the toilet quickly enough. Overflow incontinence is associated with a neurological or anatomical obstruction from pelvic organs or the prostate which limits bladder emptying and causes an overdistended bladder. Stress incontinence is commonly seen in women and arises from decreased intraurethral pressure. This condition is generally noted when a patient coughs, sneezes, or laughs. Functional incontinence usually arises from cognitive impairment, musculoskeletal problems, or immobility. Question: 3 Symptoms of proctitis may include all of the following except: Correct: tenesmus. Explanation: Proctitis is inflammation of the lining of the rectum leading to rectal pain, bleeding, and a continuous sensation to defecate (tenesmus). Additional symptoms may also include left-sided abdominal pain, diarrhea, pain with bowel movements, and a feeling of fullness in the rectum. Suprapubic pain is not generally associated with proctitis.