Trauma/Emergency

Question 1

In traumatic rupture of the testicle, resection of devitalized testicular tissue and suture repair of the tunica albuginea is indicated:

A. Always
B. In case of haematocele
C. In case of infertility to prevent generation of spermatic autoantibodies
D. Only in cases of an atrophic or absent contralateral testicle

Answer 1

A. Always

Question 2

Which treatment is recommended for penile fracture?

A. Conservatie management
B. Haematoma drainage and indwelling catheter
C. Delayed surgical intervention after antibiotic treatment
D. Early surgical intervention with closure of the tunica albuginea

Answer 2

D. Early surgical intervention with closure of the tunica albuginea

Question 3

What is the gold standard diagnostic method for the radiographic assesment of stable patients with renal trauma?

A. Intravenous urogram
B. Ultrasonography
C. Magnetic resonance imaging
D. Computerised tomography

Answer 3

D. Computerised tomography

Question 4

Which statement is true regarding blunt bladder rupture injuries?

A. They co-exist with urethral disruption in ±50% of cases
B. They are present in ±90% of patients with pelvic fractures
C. High mortality is primarily related to non-urological comorbidities
D. Extraperitoneal rupture is always amenable to non-operative treatment

Answer 4

C. High mortality is primarily related to non-urological comorbidities

Question 5

When a bladder rupture is treated surgically, the preferred method is:

A. A single-layer vesicorraphy with absorbable sutures
B. A single-layer vesicorraphy with non-absorbable sutures
C. A two-layer esicorraphy with absorbable sutures
D. A two-layer esicorraphy withnon-absorbable sutures

Answer 5

C. A two-layer esicorraphy with absorbable sutures

Question 6

The risk for erectile dysfunction after a traumatic posterior urethral rupture associated with pelvic fracture is:

A. Less than 10%
B. About 25%
C. About 50%
D. Over 75%

Answer 6

C. About 50%

Question 7

3 years ago, a 50-year-old woman underwent abdominal hystero- and bilateral salpingo-oophorectomy, followed by pelvic radiotherapy for carcinoma of the cervix. 3 months ago se presented with a right-sided hydronephrosis and a double-J ureteral stent was placed. Today she presents in the emergency room with anaemia, frank hematuria and is haemodynamic instable. What is the most likely diagnosis?

A. Radiocystitis
B. Uretero-iliacal fistula
C. Vesico-vaginal fistula
D. Bladder invasion of cervical cancer recurrence

Answer 7

B. Uretero-iliacal fistula

Question 8

The imaging tool of choice in evaluation and classification of a blunt renal trauma is:

A. MR urography
B. Ultrasonoghraphy
C. CT-scan with contrast
D. Renographic isotope study

Answer 8

C. CT-scan with contrast

Question 9

What grade of injury is a renal cortical laceration of >1cm without urinary extravasation according to the American Association of the surgery of Trauma (AAST)?

A. Grade 2
B. Grade 3
C. Grade 4
D. Grade 5

Answer 9

B. Grade 3