Genitourinary System (Male and Female) Practice Questions

1) A 55-year-old postmenopausal woman complains of vaginal dryness, dyspareunia, and increased frequency of urinary tract infections. Physical examination shows atrophic changes of the vaginal mucosa. Which of the following is the most appropriate treatment to relieve her symptoms?

2) A 58-year-old male complains of difficulty maintaining an erection. He has hypertension and is on a beta-blocker. He denies morning erections. Which of the following medications is commonly used as a first-line treatment for erectile dysfunction?

3) Which of the following medications is used to treat urinary incontinence?

4) A 25-year-old male presents to the emergency room with severe pain in the right flank that radiates to the groin, nausea, and vomiting. Examination reveals a well-developed male in acute distress, with tachycardia and CVA tenderness. He does not have rebound or guarding. Rectal examination is negative for occult blood. Urinalysis reveals 3+ blood. What is the most likely diagnosis?

5) A 21-year-old female presents with fever, flank pain, and costovertebral angle tenderness on the right side. She has nausea and vomiting. Urinalysis reveals white blood cell casts. Which of the following is the most likely diagnosis?

6) A 19-year-old male presents to the emergency department with acute, severe left testicular pain that started 2 hours ago while he was playing sports. On examination, the left testis is exquisitely tender, with a high-riding position in the scrotum, and the cremasteric reflex is absent on the left side. Which of the following is the most likely diagnosis?

7) A 35-year-old female presents with an uncomplicated urinary tract infection. What is the most likely etiologic agent?

8) A 32-year-old woman has had repeated urinary tract infections over the past year. She describes involuntary loss of urine with coughing and sneezing. On pelvic exam, there is mild cystocele noted, but no significant uterine prolapse. Which of the following best describes this patient’s incontinence?

9) A 27-year-old female with obesity and hirsutism has irregular menstrual cycles every 2 to 3 months. On pelvic ultrasound, her ovaries appear enlarged with multiple peripheral cysts. Which of the following laboratory findings is most characteristic of her condition?

10) A 60-year-old female complains of urinary urgency, frequency, and nocturia without dysuria or infections. Urodynamic studies confirm detrusor overactivity. Which of the following medications is most appropriate for long-term management?

11) A 72-year-old male presents for a routine check-up. He has mild lower urinary tract symptoms but is otherwise asymptomatic. His PSA level is mildly elevated. On digital rectal exam, the prostate feels hard and nodular. Which of the following is the most likely diagnosis?

12) A 25-year-old sexually active male presents with scrotal swelling and pain that began gradually over the past 2 days. He also has dysuria and discharge. Physical exam reveals tenderness mostly localized to the posterior aspect of the testis, and the Prehn sign (relief of pain with elevation) is positive. Which of the following is the most likely diagnosis?

13) A 29-year-old female complains of burning sensation during urination and urinary frequency for three days. She denies flank pain or fever. Urinalysis shows positive nitrites and leukocyte esterase. Which of the following is the most common causative organism?

14) A 50-year-old male with poorly controlled diabetes complains of painful ejaculation, perineal discomfort, and difficulty urinating for several weeks. He has a mild fever. Rectal exam reveals a boggy, tender prostate. Which of the following is the most likely diagnosis?

15) A 54-year-old male presents with difficulty initiating urination, nocturia, and a weak urinary stream for the past year. On digital rectal exam, his prostate is symmetrically enlarged, smooth, and rubbery. Which of the following is the most likely diagnosis?

16) A 48-year-old premenopausal female presents with increasing pelvic pressure, a sensation of heaviness, and incomplete emptying of her bladder. Physical exam reveals a protrusion of the bladder into the anterior vaginal wall when she bears down. Which of the following is the most likely diagnosis?

17) A 35-year-old female has heavy and prolonged menstrual bleeding for the past six months. She denies intermenstrual bleeding. Ultrasound of the pelvis reveals multiple well-defined solid masses within the uterine wall. Which of the following is the most likely diagnosis?

18) A 55-year-old female presents to the emergency room complaining of fever, chills, and pain in the right flank. She was treated two weeks ago for a urinary tract infection with three days of Bactrim. Examination reveals a temperature of 38.7°C. She is tachycardic and has CVA tenderness on the right side. Urinalysis reveals 3+ Leukocytes, 3+ blood, and 1+ protein. What is the most likely diagnosis?

19) A 23-year-old female presents with left lower abdominal pain and vaginal bleeding. Her last menstrual period was 7 weeks ago. Serum beta-hCG is positive. A transvaginal ultrasound shows no intrauterine gestational sac but reveals a left adnexal mass and free fluid in the pelvis. Which of the following is the most likely diagnosis?

20) A 42-year-old male presents to his PCP with complaints of urinary frequency for about two weeks. He also notes a low-grade fever and pain in the perineum. He is married and denies any extramarital affairs. Examination reveals an enlarged boggy prostate. Urinalysis is negative. What is the most likely diagnosis?