Genitourinary Surgery Multiple Choice Questions
1. Antibiotic prophylaxis for a major operation is best
A. Administered 1 hr. before surgery incision
B. Administered the night before surgery
C. Administered following incision
D. Administered immediately after completing surgery
Answer: A
2. Technetium 99 m (99m Te) Dimercapto Succinic Acid (DMSA) is taken up by which renal cell
A. Glomerulus
B. Proximal tubule
C. Distal tubule
D. Collecting tubule
Answer: B
3. The fetal kidney develops from
A. Paraxial mesoderm
B. Intermediate mesoderm
C. Lateral mesoderm
D. Neural tube
Answer: B
4. Regarding sipuleucel T vaccine, all the follwing are true, EXCEPT
A. It is a treatment option for patients with minimally or asymptomatic prostate cancer
B. Sipuleucel-T causes marked symptomatic relief in patients with bone pains
C. The drug was approved based onthe survival benefit compared to place bo
D. Sipuleucel-T will not cause any meaningful PSA decline
Answer: B
5. The non steroidal antiandrogen associated with interstitial pneumonetis and delayed adaption to darkness after exposure to bright illumination
A. Bicalutamide
B. Nilutamide
C. Flutamide
D. Cyproterone acetate
Answer: B
6. The most common malignant tumor associated with bladder diverticula is
A. Urothelial carcinoma
B. Adeno carcinoma
C. Squamous cell carcinoma
D. Sarcoma
Answer: A
7. Which of the biomarkers has the greatest specificity for the presence of prostate cancer in patients with elivated PSA ?
A. PCA 3
B. TMPRSS 2 : ERG
C. F-PSA
D. 4 Kscore
Answer: B
8. A fourtyeight years old women who had abdominal hysterotomy 2 months back presents for evaluation of clear vaginal discharge since surgery. Following oval intake of pyridium, her pads continue to have clear watery discharge. The most likely diagnosis is
A. Vesico vaginal fistula
B. Uretero vaginal fistula
C. Peritoneo vaginal fistula
D. Vesico uterine fistula
Answer: C
9. The key elements of abdominal sacrocolpopexy do NOT include
A. use of permanent monofilamentmesh
B. Secure fixation to the sacral promontory
C. Secure fixation to the vaginal cuff
D. Use of a biologic graft
Answer: D
10. The consistent advantage of laperoscopic/robotic prostatectomy over open prostatectomy is
A. Less bleeding
B. Less urinary incontinence
C. Preservation of erectle function
D. Less post operative pain
Answer: A
11. Cause of congenital pelvi-urteric function obstruction include
A. Presence of an a peristalitic segment of ureter similar to that found in primary obstructive mega ureter
B. True ureteral stricture at PUJ, that is congenital
C. Kinks or valves produced by unfolding of ureteral mucosa and musculature
D. All of the above
Answer: D
12. Which of the following is typically associated with organic E. D. in contrast with psychogenic E.D. ?
A. Sudden loss of erections
B. Gradual decline in erectile ability
C. Situational erectile difficulty
D. Erection responses on awakening
Answer: B
13. The structure not located in retro peritoneum is
A. Asending color
B. Adrenal
C. Transverse color
D. Second part of duodenum
Answer: C
14. All the following are true regarding Germ Cell Tumor (GCT) EXCEPT
A. It occures bilaterally approximately 15% of the time
B. Cryptorchidisism is associated with increased risk for GCT
C. Intratubular Germ Cell Neoplasia (ITGCN) is associated with high risk for GCT
D. GCT incidence may be high when there is a family history of Testicular cancer
Answer: A
15. For minimising the gap between healthy urethral margins before anastamosis in pelvic fracture urethral injuries, all the following procedures are useful, EXCEPT
A. Excesion of Bucks Facia from corpus spongiosum
B. Mobilising the corpus spongiosum off the corpora cavernosa up to the corona of the glans
C. Dissection of intracrural space down to the pubis
D. Periosteal elevations infra pubectomy
Answer: B
16. The nerve likely to be injured is Psoas hitch is
A. Obturator nerve
B. Ilio hypogastric nerve
C. Genitofemoral nerve
D. Lio inguinal nerve
Answer: C
17. Indication for radiologic imaging in urologic trauma include all EXCEPT
A. All penetrating trauma
B. High impact rapid deceleration trauma
C. Adult patients with microscopic hematuria without shock
D. All pediatric patients with microscopic hematuria
Answer: C
18. The stone most unlikely to be fragmented with ESWL
A. Calcium oxalate dehydrate
B. Calcium oxalate monohydrate
C. Struvite
D. Uric acid
Answer: B
19. The most appropriate treatment for patients with renal tubular acidosis include
A. Thiazides
B. Sodium alkali
C. Potassium alkali
D. Aceto hydroxamic acid
Answer: C
20. The preferred site of puncture in to the collecting system for PCNL is
A. Upper pole calyx
B. Posterior lower pole calyx
C. Anterior lower pole calyx
D. Upper pole infendibulum
Answer: B
21. The best treatment option for a 9 year old female with right 2 cm renal pelvicstone and cystinuria is
A. Extracorporeal Shock Wave Lithotripsy (ESWL)
B. Ureteroscopy with laser Lithotripsy and stone basketing
C. PCNL
D. Anatrophic nephrolithotomy
Answer: C
22. Which of the following statements is true regarding children with non-neurogenic neurogenic bladder ?
A. Constriction of urinary sphincter occures during voiding in a voluntary form of detrusor sphincter dyssyenergia
B. Gradual bladder de-compensation and myogenic failure result from incomplete emptying
C. Gradual bladder de-commpensation and myogenic failure result from increasing amounts of residual urine
D. All of the above
Answer: D
23. The estimated prevalence of vesico ureteric reflux in children with Urinary Tract Infection (UTI) is
A. 3%
B. 5%
C. 10%
D. 30%
Answer: D
24. The most useful study for the detection of phychonephritis and cortical renal scarring is
A. DTPA scan
B. DMSA scan
C. MAG-3 scan
D. CT urogram
Answer: B
25. Which of the following is NOT considered a urachal anomaly ?
A. Patent urachus
B. Urachal cyst
C. Urethral-urachus fistual
D. Umbulical urachal sinus
Answer: C
26. Most common intra abdominal injury associated with laperoscopic surgery is
A. Bowel injury
B. Liver injury
C. Vascular injury
D. Bladder injury
Answer: C
27. Accessory pudental artery usually arise from
A. Obturator artery
B. External liac artery
C. Superior vesical artery
D. Femoral artery
Answer: A
28. The mycobacteria which does not cause tuberculosis (TB)
A. Mycobacterium bovis
B. Mycobacterium microti
C. Mycobacterium africanum
D. Mucobacterium avium intracellulare
Answer: D
29. The effect of testosteron includes all the following EXCEPT
A. enhances sexual interest
B. increase frequency of sexual act
C. increases frequency of noct.erections
D. enhances fantasy induced or visually stimulated erections
Answer: D
30. The gold standard in measuring renal function in children with myelodisplasia is
A. Serum creationine
B. GFR as estimated by the Modification of Diet in Renal Risease (MDRD) equation
C. Serum cystatin
D. Nuclear renography
Answer: D
31. The siglemost important prognostic factor for RCC is
A. Tumor stage
B. Tumor grade
C. Tumor size
D. Histologic subtype
Answer: A
32. Struvite stones (infection stones) can be produced by all the organisms EXCEPT
A. Proteus
B. Klebsiella
C. E-Coli
D. Staphylococcus
Answer: C
33. Para neoplastia syndromes in RCC include all the following EXCEPT
A. Hypertension
B. Polycythemia
C. Hepatic dysfunction
D. Hypothyroidism
Answer: D
34. Most accurate examination to document the presence of bladder stone is
A. Ultrasonography
B. Excretory urography
C. Computed tomography
D. Cystoscopy
Answer: D
35. Which among the following has best prognosis among renal tumors ?
A. Sarcoma
B. Carcinoid
C. Small cell
D. Adult Wilms tomor
Answer: B
36. Pre-ureteral venacava occurs due to the persistance of
A. subcardinal vein
B. supracardinal vein
C. posterior cardinal vein
D. inferior vitelline vein
Answer: A
37. Regarding ask-upmark kidney, all are ture EXCEPT
A. it is always associated with renal artery intimal disease
B. hypertension and its sequelae like encephalopathy, retinopathy etc are commonest mainfestations
C. segmental vascular anomalies have been cited as the possible cause of hypertension
D. disease is primarily seen in young women and girls
Answer: A
38. Hypercalcimia in Renal Cell Carcinoma(RCC) can be due to all the following EXCEPT
A. osteolytic metastalic involvement of the bone
B. production of parathyroid hormone like peptide by tumor
C. excessive tubular re-absorption of calcium
D. action of tumor derived 1,25-dihydroxyvitamine `D_(3)` and prostaglandins
Answer: C
39. Drugs used for intravesical instillation in carcinoma urinary bladder include all the following Except
A. Bacille Clamette-Guerin (BCG)
B. Cisplatin
C. Mitomycin-C
D. Thiotepa
Answer: B
40. Bacteriuria without pyuria is indicative of
A. Infection
B. Colonisation
C. Tuberculosis
D. Stones
Answer: B
41. Regarding Bladder Pain Syndrome (BPS)/Interstitial Cystitis all the statements are true EXCEPT
A. A childhood presentation is extremely rare. The average age of onset is 40 years
B. Patients with BPS have a 10 fold higher incidence of childhood voiding problems than do patients without the syndrome
C. Bladder compliance in patients with interstitial cystitis is always abnormal
D. Urine Anti Proliferative Factor (APF) appears to have the highest sensitivity and specificity among the markers studied
Answer: C
42. Cancer occuring in urinary intestinal diversion is most likely to occure in
A. Uretero sigmoidostomies
B. Ileal conduits
C. Colon conduits
D. Sigmoid conduits
Answer: A
43. Which of the following is NOT a contra indication for Testosterone supplementation therapy ?
A. Cogestive heart failure
B. Polycythemia
C. Breast Cancer
D. Angina pectoris
Answer: D
44. Health related quality of life is best assesed by
A. Patient themselves
B. Sponses or immediate family members
C. Specialist caring for the patient
D. Specially trained examiners
Answer: A
45. Transuretero-ureterostomy is contraindicated in
A. Retroperitoneal fibrosis
B. Urothelial malignancy
C. Nephrolithiasis
D. All of the above
Answer: D
46. Hyper calciuria in sarcoidosis is
A. Absorptive hypercalciuria
B. Renal hypercalciuria
C. Recorptive hypercalciuria
D. None of the above
Answer: A
47. Most sigfnificant complication of PCNL is
A. Incomplete stone removal
B. Extravesation of irrigation fluid
C. Urinary tract infection
D. Hemorrage
Answer: D
48. A characteristic finding in angiomyolipoma is
A. Positive staining for vimentin
B. Unique cytokeratin expression pattern
C. Positive staining for Human Melanoma Black-45 (HMB-45)
D. Occasional aneuploidy
Answer: C
49. Most common cancer after kidney transplantation
A. Skin
B. Cervix
C. Kaposi sarcoma
D. Thyroid
Answer: A
50. The ideal site of meision in endo pyelotomy is
A. Anterior
B. Posterior
C. Medial
D. Lateral
Answer: D
51. Blood volume in children is estimated as
A. 55 ml/kg
B. 25 to 50 ml/kg
C. 70-80 ml/kg
D. 65-70 ml/kg
Answer: C
52. Which of the following groups of antibiotics include the best choice for treating an infected renal cyst in a patient with ADPKD ?
A. Trimethoprim-sulphamethoxazole, chloromphenicol, fluroquinolones
B. Cephalosporins, trimethoprim-sulpha methoxazole doxycycline
C. Gentamycin, cephalosporins, vancomycin
D. Doxycycline, amoxicillin, gentamicin
Answer: A
53. Which of the following is confirmatory in the diagnosis of tuberous sclerosis ?
A. Renal angio myolipoma and multiple renal cysts
B. Hamartomatous rectal polyp and facial adenoma sebaceum
C. Renal angiomyolipoma and cardiac rhabdomyoma
D. Mitral valve prolapse, renal angiolipoma and gingival fibromas
Answer: C
54. The most common type of retroperitoneal soft tissue sarcoma is
A. Liposarcoma
B. Leiomyosarcoma
C. Malignant fibrous histiocytoma
D. Adrenal myelolipoma
Answer: A
55. A 24 Fresh (Fr) Foley balloon catheter
A. Measures 24 cm long
B. Measures 8 mm in outer diameter
C. Measures 8 mm in inner diameter
D. Can hold 24 ml of fluid in the balloon
Answer: B
56. The normal baseline or resting ureteral pressure is
A. 0-5 cm `H_(2)O`
B. 5-10 cm `H_(2)O`
C. 10-15 cm `H_(2)O`
D. 15-20 cm `H_(2)O`
Answer: A
57. The feature associated with worst survival in children with wilms tumor is
A. diffuse tumor spill
B. diffuse anaplasia
C. incomplete tumor resection
D. lung metastasis
Answer: B
58. The radiographic study most useful to detect renal injury is
A. Intravenous Pyelogram (IUP)
B. Magnetic Resonance Imaging (MRI) of abdomen
C. Focused Assessment with Sonagraphy for trauma (FAST) ultrasound
D. Triphasic abdominal Computed Tomography (CT)
Answer: D
59. Adolescent urology is defined as the care of patients
A. From 10-19 years old
B. From puberty until death
C. From puberty to 25 years old
D. From 14-25 years old for males and from 12 to 21 years for female
Answer: B
60. Which of the following is true regarding Mullerian Inhibiting Substance (MIS) ?
A. it is secreted by the fetal leydig cells
B. it acts systemically to produce Mullerian regression
C. it functions normally in patients with hernia uteri inguinal
D. it is secreted at 7-8 weeks of gestation representing the initial endocrine function of the fetal testis
Answer: D
61. The mean age of a child with vaginal rhabdomyosarcoma is
A. younger than 2 years
B. 2-4 years
C. 4-8 years
D. 8-12 years
Answer: A
62. Hydrocele formation after varicocele ligation is least likely after
A. retroperitoneal ligation
B. subinguinal ligation
C. microscopic inguinal ligation
D. transvenous embolisation
Answer: D
63. All of the following are true regarding Pollakiuria EXCEPT
A. it may be associated with a history of recent death or life threatening event in the family
B. it is always associated with urinary tract infection or polyuria
C. affected child may have very high day time frequency, even as high as 50 times per day
D. Absence of nocturnal frequency differentiates it from Overactive Bladder (OAB)
Answer: B
64. Which of the following disease has the highest chance of developing Renal Cell Carcinoma (RCC) ?
A. Von Hippel-Lindau desease
B. Acquired renal cystic desease
C. Tuferous sclerosis
D. ADPKD
Answer: A
65. The test with highest sensitivity to detect Urinary Tract Infection (UTI) is
A. Leukocyte esterase
B. Urinary nitrite
C. Urinary nitrate
D. Serum procalcitonin
Answer: A
66. The test with highest positive predictive value in prostate cancer is
A. Digital Rectal Examination (DRE)
B. PSA
C. Transrectal Ultrasonography (TRUS)
D. Human Glandular Kallikrein (hKz)
Answer: B
67. Significant probability of disease recurrence and risk of secondary graft dysfunction can occure in all the following EXCEPT
A. Chronic glomerulonephritis
B. Focal segmental glomerulosclerosis
C. Haemolytic uremic syndrome
D. Primary oxalosis
Answer: A
68. Foley Y-V pyloplasty is useful in
A. anterior crossing vessel
B. high ureteral insertion
C. redundant renal pelvis
D. small intra renal pelvis
Answer: B
69. A patient with serum creatinine 2.5 mg/dL requires renal angiography. The best way to protect renal function is
A. saline diuresis
B. pre-study mannitol
C. furosemide before study
D. dopamine throughout the study
Answer: A
70. The most common bacteria causing xantho-granulomatous pylonephritis is
A. E. Coli
B. Proteus mirabilus
C. Pseudomonas
D. Klebsiella
Answer: B
71. Regarding pre-operative renal artery embolisation all are true EXCEPT
A. It can cause shrinkage of arterialised Vena-caval tumor thrombus enabling easy removal
B. It prevents micrometastasis during surgery
C. It facilitates dissetion due to development of tissue plane odema
D. It causes fever, flank pans and nausea us upto 75% of patients
Answer: B
72. The most consistent segmental branch which supplies nearly 25% of the renal unit is
A. Apical (Superior) segemental artery
B. Anterior superior segmental artery
C. Posterior segmental artery
D. Basilar segmental artery
Answer: C
73. Which of the following statement is true regarding Vitamin D metabolism ?
A. Vitamin D increases renal excretion of calcium
B. Dermally synthesised cholicalciferol must be hydroxylated by both liver and kidney for maximal potency
C. Vitamin D activity is mediated through membrane bound Vitamin D receptors
D. Dermally synthesised cholecalciferol is the most potent form of Vitamin D
Answer: B
74. Regarding major pelvic urologic surgery all are true EXCEPT
A. Warfarin may be stopped 5 days before the surgery
B. Aspirin and clopidogrel should be discontinued 7 days before surgery
C. Fresh Frozen plasma is not useful in immediate reversal of warfarin and replacement of specific clotting factors
D. Hypothermia results in increased blood loss and increased wound infection
Answer: C
75. Which of the following statement about cytokine therapy for metastatic Renal Cell Carcinoma (RCC) is true ?
A. Lymphokine-Activated Killer (LAK) cells augment the efficacy of both interferon α(IFNα) and IL-2
B. The complete response with interferon α monotherapy is 10%
C. The combination of IL-2 and interferone leads to higher overall response rates than either agent alone
D. All the above statement are true
Answer: C
76. The most common histology in penile carcinoma is
A. Squamous cell carcinoma
B. Melanoma
C. Verrucous carcinoma
D. Adeno carcinoma
Answer: A
77. Cause of enteric hyper oxaluria is
A. Excessive oxalate intake
B. Reduced excretion of oxalate
C. Fat malabsorption
D. Increased dietary fat
Answer: C
78. The only segment of urethra that does not have transitional epithelium is
A. Prostatic urethra
B. Fossa navicularis
C. Bulbar urethra
D. Membraneous urethra
Answer: B
79. An advantage of supine versus prone position for percutaneous renal surgery is
A. Improved pulmonary mechanics
B. Easier entry in to upper pole calyx
C. Easier entry in to posterior calyx
D. Reduced pressure in the collecting system
Answer: D
80. Transplant between two siblings who are Histocompatability Leukocyte Antigen (HLA) identical (perfect class I and II match) can be rejected this may be due to
A. Direct antigen presentation
B. Indirect antigen presentation
C. Difference is complement proteins
D. Differences in numbers of circulating platelets
Answer: B