UTI & Pyelonephritis MCQ Quiz | Renal & Genitourinary

Welcome to the UTI & Pyelonephritis MCQ Quiz, specifically designed for MBBS students navigating the Renal & Genitourinary module. This quiz features 25 high-yield, case-oriented multiple-choice questions that cover the essential aspects of urinary tract infections, from uncomplicated cystitis to severe pyelonephritis. Test your knowledge on etiology, pathophysiology, clinical presentation, diagnostic criteria, and current management guidelines. Each question is crafted to reflect the level of detail required for your professional exams. After submitting your answers, you’ll receive your score and a detailed review of the correct and incorrect responses. For your convenience and future revision, a complete list of all questions with their correct answers is available for download as a PDF.

1. What is the most common causative organism for uncomplicated urinary tract infections (UTIs)?

2. Which finding in a urinalysis is most specific for a UTI caused by gram-negative bacteria?

3. The classic clinical triad of acute pyelonephritis consists of fever, flank pain, and:

4. A 45-year-old male with uncontrolled diabetes mellitus presents with fever, flank pain, and gas bubbles seen in the renal parenchyma on a CT scan. What is the most likely diagnosis?

5. In which of the following patient populations is treatment of asymptomatic bacteriuria mandatory?

6. The presence of white blood cell (WBC) casts in urine sediment is most indicative of:

7. Which pathogen is classically associated with struvite (staghorn) calculi and an alkaline urine pH?

8. A 22-year-old sexually active female presents with dysuria, frequency, and urgency. Besides E. coli, which organism is a common cause of UTI in this demographic?

9. What defines a “complicated” UTI?

10. Which of the following is considered a first-line treatment for uncomplicated cystitis in a non-pregnant woman in an area with low TMP-SMX resistance?

11. A UTI that occurs after successful treatment, caused by the exact same initial organism, is known as:

12. The gold standard for the diagnosis of a UTI is:

13. Xanthogranulomatous pyelonephritis (XGP) is a rare, severe form of chronic pyelonephritis often associated with a non-functioning kidney. It is most commonly linked to:

14. Which antibiotic class is generally contraindicated for treating UTIs in pregnant women due to concerns about cartilage damage in the fetus?

15. The “bear paw” sign on imaging is characteristic of which condition?

16. Pyonephrosis is best described as:

17. Which is the most common route for bacteria to infect the urinary tract?

18. For a patient with uncomplicated outpatient pyelonephritis in a region with >10% fluoroquinolone resistance, what is a recommended initial treatment strategy?

19. What is the standard definition of significant bacteriuria from a midstream clean-catch urine sample in a symptomatic female?

20. Fosfomycin is a useful single-dose agent for uncomplicated cystitis. What is its mechanism of action?

21. What key clinical feature helps distinguish acute pyelonephritis from uncomplicated cystitis?

22. Which imaging modality is the initial choice for evaluating a patient with suspected pyelonephritis complicated by urinary obstruction?

23. A patient with a neurogenic bladder and a long-term indwelling urinary catheter is at highest risk for what type of UTI?

24. In a urine dipstick, a positive leukocyte esterase test indicates the presence of:

25. Which of the following risk factors is most significantly associated with recurrent UTIs in young women?