MSRA Category: Renal Medicine/Urology

MSRA-2458

A 30-year-old female patient presents to the Emergency Department with a 7-day history of lower abdominal pain. She describes the pain as all over the lower abdomen. On further questioning, she reports having noticed a small amount of odorous vaginal discharge, urinary frequency and pain on urination. Her basic observations include heart rate 98 beats/minute, respiratory rate 18 breaths/minute, blood pressure 110/65 mmHg, temperature 38.5 °C. On examination, there is diffuse tenderness of the suprapubic region, right iliac fossa and bilateral lower back.

What is the most likely diagnosis?

MSRA-2441

Which ethnic group has a higher occurrence of prostate cancer?

MSRA-2457

A 52-year-old woman visits her doctor seeking guidance on managing recurrent episodes of urinary incontinence that occur during laughter or coughing. She reports no symptoms of dysuria, frequency, or urgency. Additionally, she has been experiencing night sweats and irregular periods for the past year. The patient’s medical history includes hypertension and depression. A urine dipstick and examination of the vulva/vagina reveal no abnormalities. What is the recommended initial treatment?

MSRA-2442

You are having a conversation with a patient who is 60 years old and has a PSA level of 10.2 ng/ml. What would be the next course of action that the urologist is likely to suggest?

MSRA-2443

A 35-year-old man comes to the clinic complaining of pain and swelling in his right testicle that has been gradually developing over the past two days. He rates the pain as 5/10 on the pain scale. Although he recently returned from a trip to Spain four weeks ago, he denies experiencing any dysuria or urethral discharge. Upon examination, the right testicle is tender and swollen. The patient’s heart rate is 84/min and his temperature is 36.8ºC. Based on these symptoms, what is the most probable underlying diagnosis?

MSRA-2444

A 55-year-old man requests a PSA test due to his father’s recent prostate cancer diagnosis. You perform a digital rectal exam and inform him that his prostate feels normal. After further conversation, you agree to proceed with the test. What is the appropriate timing for PSA testing to ensure accurate results?

MSRA-2445

As a foundation doctor in general practice, you encounter a patient who is fifty-five years old and has a past medical history of prostatitis. He is interested in getting a prostate specific antigen test done due to his family’s history of prostate cancer. What would be an appropriate time to conduct the test?

MSRA-2446

As a foundation doctor in general surgery, you are assisting your consultant in a surgical exploration of a suspected testicular torsion in a patient with a bell clapper deformity. The patient, who is in his early twenties, has been experiencing symptoms for six hours. Upon examination, the surgery confirms the presence of testicular torsion.

What is the appropriate course of action for the surgeon to take in this situation?

MSRA-2447

A 39-year-old female patient arrives at the Emergency Department complaining of intense, stabbing pain in her right flank that spreads to her groin. The pain comes and goes but is excruciating, reaching a severity of 10/10 at its peak. A pregnancy test yields negative results, while a urine dip shows positive for nitrites, leukocytes, and blood.
What test should be conducted to properly diagnose the condition?

MSRA-2448

A 27-year-old woman comes to the clinic complaining of dysuria and frequency, four weeks after giving birth. She exclusively breastfeeds her child and had an uneventful antenatal period and delivery. On examination, her abdomen appears normal and she has no fever. A urine dipstick reveals positive results for blood, protein, leucocytes, and nitrites. What is the best course of action for management?