KMU Past Paper Practice

A 31-year-old man undergoes semen analysis during evaluation of infertility. The report shows reduced sperm concentration and motility. He has no major abnormality on examination. Which step is most appropriate before classifying the abnormality as persistent male-factor infertility?

A man with hypogonadotropic hypogonadism receives hCG therapy. His testosterone improves, but spermatogenesis remains inadequate. Which additional treatment most directly supports Sertoli-cell function?

An adolescent with an untreated undescended inguinal testis develops sudden severe groin pain and vomiting. The affected testis is extremely tender. Which complication should be suspected?

A 45-year-old man develops painless scrotal enlargement several weeks after treatment for epididymo-orchitis. Ultrasound shows fluid surrounding a structurally normal testis. How should this swelling be classified?

A 52-year-old man has a large hydrocele causing persistent heaviness and difficulty with daily activities. Ultrasound shows no underlying testicular lesion. Which management principle is most appropriate?

A 27-year-old man undergoing infertility assessment has a clinically significant left varicocele and impaired semen parameters. Which physiological disturbance contributes most directly to reduced sperm production?

A 30-year-old man has a palpable varicocele, infertility and repeatedly abnormal semen parameters. He and his partner wish to conceive. Which management approach is most appropriate?

Histopathology of a testicular mass demonstrates separate areas of embryonal carcinoma, teratoma and yolk-sac differentiation within the same lesion. Which classification is most appropriate?

A patient with a marker-producing testicular germ-cell tumor undergoes definitive treatment. Serial serum marker levels subsequently begin to rise after an initial decline. What is the most important interpretation?

Two men have malignant germ-cell tumors of the testis. One has localized disease with a favorable tumor type and low marker burden, while the other has widespread disease with a high marker burden. Which factor combination best explains the difference in expected outcome?

A 46-year-old man presents with high fever, dysuria, perineal pain and a markedly tender swollen prostate. Which examination maneuver should be avoided because it may promote systemic spread of infection?

A 71-year-old man has longstanding bladder-outlet obstruction from benign prostatic hyperplasia. Cystoscopy shows a thickened, trabeculated bladder wall. Which process best explains this change?

A 73-year-old man with known benign prostatic hyperplasia has repeated episodes of acute urinary retention despite appropriate medical therapy. Which next management principle is most appropriate?

A 69-year-old man with urinary symptoms has a moderately raised PSA. Examination suggests benign enlargement, and he recently had prostatic inflammation. Which interpretation of the PSA result is most appropriate?

A 76-year-old man is diagnosed with a small localized low-grade prostatic adenocarcinoma. He has no symptoms from the tumor and no evidence of metastasis. Which management option may be appropriate when immediate curative treatment is not required?

Two patients have prostatic adenocarcinoma. One has organ-confined low-grade disease, whereas the other has high-grade cancer with distant spread. Which feature combination is most important for estimating prognosis?

Testosterone enters an androgen-responsive cell and produces a sustained change in protein synthesis. Which intracellular event most directly mediates this effect?

A man with androgen deficiency receives an intramuscular testosterone ester that produces a prolonged therapeutic effect compared with unmodified testosterone. Which pharmacokinetic feature explains this difference?

A patient with androgen-dependent prostate carcinoma is prescribed bicalutamide as part of androgen blockade. Which pharmacological class best describes this drug?

During development of a non-hormonal male contraceptive, gossypol produces substantial suppression of fertility. Further use is limited because some men develop an electrolyte abnormality and prolonged failure of sperm production. Which pair best represents these concerns?