1000+ Urinary Calculus Disease MCQ for CAT [Solved]

1. What medications do NOT cause renal stones?
A. ciprofloxacin
B. indinavir
C. thiazides
D. triamterene
Answer : C

2. What is the preferred entry point into the collecting system for PCNL for a 2.4 cm renal pelvis stone?
A. anterior lower pole calyx
B. posterior lower pole calyx
C. anterior upper pole calyx
D. posterior upper pole calyx
Answer : B

3. During pyelolithotomy for removing a staghorn urate stone; how to ensure a complete removal of calyceal branches?
A. by performing intra-operative ultrasonography
B. by performing radial nephrotomies
C. by performing adjunct PCLN
D. by taking a scout KUB film
Answer : A

4. What is the principal defect in renal hypercalciuria?
A. impaired renal tubular calcium reabsorption
B. excessive glomerular leak of calcium
C. deficiency of the enzyme xanthine oxidase
D. hypercalcemia
Answer : A

5. What is false concerning recurrent stone formation?
A. best treated by total parathyroidectomy
B. first-time stone formers are at a 50% risk for recurrence
C. males have higher recurrence rate than females
D. stone formers produce stones of the same type every time
Answer : A

6. How is primary oxaluria treated?
A. terminal ilium resection
B. liver transplantation
C. kidney transplantation
D. regular hemodialysis
Answer : B

7. What kind of stones is most amenable to ESWL?
A. cystine
B. brushite
C. Ca.oxalate monohydrate
D. Ca.oxalate dihydrate
Answer : D

8. On treating uric acid stones, excessive alkalinization with potassium citrate could result in all of the following, EXCEPT:
A. formation of triple-phosphate stones
B. infection with Proteus species
C. increase production of endogenous uric acid
D. increase level of uric acid in THE blood
Answer : C

9. A 24-hr urine collection of a recurrent Ca. oxalate stone former patient having Crohn`s disease might reveal:
A. high citrate, high oxalate
B. low citrate, low oxalate
C. high citrate, low oxalate
D. low citrate, high oxalate
Answer : D

10. What is the favorable stone characteristic for ESWL treatment?
A. 1000 - 1300 HU density
B. 5 - 10 mm diameter
C. lower calyx location
D. mid ureteral location
Answer : B

11. What parameter is NOT considered in the stone burden concept?
A. the surface area of the stones
B. the volume of the stones
C. the density of the stones
D. the number of the stones
Answer : C

12. What is true regarding a stone in a urethral diverticulum?
A. is symptomless
B. should undergo a trial of milking out
C. diverticulectomy and stone extraction is the treatment of choice
D. ESWL is the preferred treatment option
Answer : C

13. What is false concerning cystine stones?
A. have diagnostic hexagonal crystals
B. dont respond to ESWL therapy
C. are highly soluble in water
D. inherited in an autosomal recessive fashion
Answer : C

14. Patients having what kind of stones should refrain from eating purines?
A. cysteine
B. urate
C. calcium
D. none of the above
Answer : D

15. What is false concerning patient`s preparation for PCNL?
A. active UTI is an absolute contraindication
B. fluoroquinolone is the first choice for antimicrobial prophylaxis
C. withholding aspirin for only 10 days is enough
D. despite sterile urine, stone fragmentation might release hidden bacterial endotoxins and viable bacteria
Answer : B

16. Which of the following dietary advice is recommended for Ca.oxalate stone formers?
A. limit beef, chicken, pork, eggs, fish, shellfish, and other animal proteins
B. limit beans, nuts, chocolate, coffee, dark green vegetables, and soda
C. limit canned, packaged, and fast foods
D. limit milk, cheese, and other dairy products
Answer : B

17. What type of shockwaves is generated by spark-gap technology?
A. piezoelectric
B. electrohydraulic
C. electromagnetic
D. microexplosive
Answer : B

18. What is false concerning struvite stones?
A. the commonest to form staghorn giant calculi
B. formed by urease producing bacteria
C. antibiotics have a role in the treatment
D. form at the two extremes of urinary pH range
Answer : D

19. Expectant therapy for ureteral stones is indicated when:
A. stone size of ? 4 mm
B. stone burden of ? 22 mm
C. there is a distal partial obstruction
D. the patient has end-stage renal failure
Answer : A

20. What could high level of sulfate in 24-hr. urine collection mean?
A. dissolving homogenous nucleation
B. high tendency to form cystine sulfate stones
C. indicates the amount of dietary protein
D. post ESWL therapy
nswer : C

21. What is true regarding prostatic stones?
A. they are multiple and small in size
B. usually, they are voided spontaneously
C. they, rarely, form large stones within the peripheral zone
D. contrast CT is the conventional method for diagnosis
Answer : A

22. ESWL in pediatric patients is characterized by all of the following, EXCEPT:
A. often need sedation or anesthesia
B. vesico-ureteral reflux must be excluded
C. pediatrics have a higher clearance rate of stones when compared to adults
D. safety measures must be taken to avoid lung contusions
Answer : B

23. What is the most favorable stone characteristic for PCNL treatment?
A. ? 2 cm diameter
B. upper calyx location
C. Na.urate composition
D. 600 - 800 HU density
Answer : A

24. What is false concerning cystine stones?
A. result from an inherited defect of renal tubular reabsorption of cysteine
B. characteristically, urate and cysteine stone are radiolucent
C. cysteine is a dibasic amino acid
D. on plain X-ray, cysteine stones exhibit ground-glass appearance
Answer : B

25. What is true concerning primary hyperparathyroidism and stone formation?
A. orthophosphates may have a role in the treatment
B. hyperparathyroidectomy and levothyroxine replacement is the optimum treatment
C. management includes Calcium chelating agent and repeat 24hr urine collection in 3 months
D. surgical excision of the adenoma(s) is the treatment of choice
Answer : D

26. What does nephrocalcin do?
A. dissolves cystine stones
B. enhances nephrocalcinosis process over old scared areas
C. inhibits Ca.oxalate aggregation and crystallization
D. plays a secondary role in metastatic calcification process
Answer : C

27. What is false concerning prostatic stones?
A. composed of calcium phosphate and calcium carbonate
B. the vast majority are asymptomatic
C. most of the calculi are found in the transitional zone
D. they dont affect PSA levels
Answer : C

28. What congenital anomaly is unlikely to result in stone formation?
A. left ureterocele
B. bifid right renal pelvis
C. neurogenic bladder
D. bilateral UPJ stenosis
Answer : B

29. In what kind of renal stones do antibiotics help most?
A. indinavir
B. magnesium ammonium phosphate
C. xanthine
D. matrix
Answer : B

30. How can the effectiveness of ESWL treatment session be enhanced?
A. by ensuring optimal coupling of the patient to the lithotripter
B. by running the treatment at a slower rate (60 shocks/min)
C. by running the treatment with general anesthesia
D. by all of the above
Answer : D

31. Which of the following is a relative contra-indication to ESWL?
A. renal insufficiency
B. active urinary tract infection
C. uncorrected bleeding disorder
D. third trimester pregnancy
Answer : A

32. What bowel surgery could result in enteric hyperoxaluria?
A. right hemicolectomy
B. small bowel resection
C. Roux-en-Y gastric bypass
D. b & c
Answer : D

33. Which patient is at lowest risk for the development of perinephric hematoma after ESWL?
A. hypertensive patient
B. patient on aspirin withheld 5 days prior to ESWL
C. a stone in a scared poorly functioning kidney
D. ESWL every other day
Answer : C

34. What does NOT appear as a filling defect in the renal pelvis on IVU?
A. fungal ball
B. radiolucent stone
C. urothelial growth
D. upper end of DJ ureteral stent
Answer : D

35. What type of stones do laxative abusers might develop?
A. ammonium urate
B. sodium urate
C. calcium oxalate
D. calcium phosphate
Answer : A

36. What is (are) true concerning ESWL?
A. a stone is fragmented when the force of the shockwaves overcomes the tensile strength of the stone
B. fragmentation occurs as a result of compressive and tensile forces, erosion, shearing, spalling, and cavitation
C. the generation of compressive and tensile forces and cavitation are thought to be the most important
D. all of the above
Answer : D

37. What medication could help in managing carbonate apatite stones?
A. ?-Mercaptopropionylglycine
B. acetohydroxamic acid
C. carbonic anhydrase inhibitors
D. xanthine oxidase inhibitors
Answer : B

38. What is the preferred drug for medical expulsive therapy for lower ureteral stones?
A. furosemide
B. tamsulosin
C. nifedipine
D. diclofenac
Answer : B

39. What metabolic disturbances could result from renal tubular acidosis type I?
A. hypercalciuria and hypocitraturia
B. hypercalciuria and hypercitraturia
C. hypocalciuria and hypocitraturia
D. hypocalciuria and hypercitraturia
Answer : A

40. What is false concerning the use of antibiotics in stone patients?
A. they are mandatory when urine shows ? 10 WBCs/hpf in symptomatic patients
B. they aim at treating pyonephrosis and urosepsis
C. they shold cover Escherichia coli and Staphylococcus, Enterobacter, Proteus, and Klebsiella species
D. All of the above
Answer : D

41. What is (are) the indication(s) of using DJ ureteral catheters?
A. to stent the ureter after ureteral surgery
B. to facilitate stone passage
C. after a tough ureteroscopy procedure
D. all of the above
Answer : D

42. What is the most favorable stone characteristics for laparoscopic and robotic approaches for the treatment of a kidney stone?
A. a stone in the lower calyx with a wide mouth of infundibulum and obtuse lower calyx to ureter angle
B. a stone in an anterior group calyceal diverticulum with thin overlying renal parenchyma
C. 5 mm calcium-containing stone in an intrarenal pelvis and wide UPJ
D. 6 years post anatrophic nephrolithotomy, recurrent mid calyceal stone
Answer : B

43. What is true regarding DJ ureteral stents?
A. can be placed through perc. nephrostomy
B. might slip out, especially in females
C. usually radiopaque
D. all of the above
Answer : D

44. What is the treatment of choice for a 15 mm stone in a mid calyceal diverticulum?
A. ESWL
B. PCNL with fulguration of the diverticulum
C. ureteroscopy with fulguration of the diverticulum
D. pyelolithotomy with diverticulectomy
Answer : B

45. What is the most appropriate antibiotic class for prophylaxis before urologic surgery?
A. aminoglycosides
B. macrolides
C. cephalosporins
D. fluoroquinolones
Answer : C

46. What medication(s) could be helpful in the management of cystinuria?
A. ?-Mercaptopropionylglycine
B. d-Penicillamine
C. a & b
D. none of the above
Answer : C

47. As per the fixed particle theory of stone formation:
A. the initial step is papillary plaque formation
B. crystals formation occurs inside the nephron
C. tubular precipitates form harmless crystalluria
D. the attraction of organic compounds and activation crystallization is regulated by osteopontin
Answer : A

48. What is false concerning primary bladder stones?
A. commonly occur in patients with senile prostatic enlargement
B. common in children exposed to low-protein, low-phosphate diet
C. rarely recur after treatment
D. respond to ESWL
Answer : A

49. What is false concerning staghorn calculus?
A. commonly unilateral
B. commonly due to repeated infections
C. urate stones are the second most common cause of staghorn calculi
D. ESWL monotherapy with ureteral stenting is the ideal treatment
Answer : D

50. What situation carries lower risk for lung injury during supracostal upper pole access for PCNL?
A. placing the patient in anti-Trendelenburg position
B. making the puncture under local anesthesia
C. injection Co2 gas to create a safety space under the diaphragm before puncturing
D. making the puncture during full expiration
Answer : D