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1000+ Urinary Calculus Disease MCQ for GMAT [Solved]

Thursday 9th of March 2023

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1. What parameter impairs the kidney stone-free rate, after ESWL?
A. short skin-to-stone distance (SSD)
B. end-stage renal failure
C. a stone in the upper calyx
D. the presence of a 30 cm, 4.7 Fr ureteral stent in situ
Answer : B
2. 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
3. What is the composition of brushite stones?
A. calcium phosphate
B. calcium oxalate monohydrate
C. sodium urate
D. 2,8 dihydroxyadenine
Answer : A
4. 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
5. Which event is unlikely to occur after placing a DJ ureteral stent?
A. can be forgotten in place
B. vesico-renal reflux
C. calyceal perforation
D. detrusor irritability and/or hematuria
Answer : C
6. What is the treatment of choice for a 15 mm stone in the lower calyx with a narrow infundibulum?
A. ESWL
B. PCNL
C. radial nephrolithotomy
D. pyelolithotomy with ureteral stenting
Answer : B
7. 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
8. What is the least serious complications of PCNL?
A. uncontrollable bleeding
B. incomplete removal of stones
C. pneumothorax
D. colonic perforation
Answer : B
9. 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
10. What is the preferred irrigation fluid during PCNL?
A. physiological saline 0.9%
B. glycine 1.5%
C. balanced salt solution
D. distilled water
Answer : A
11. 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
12. 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
13. What could the discomfort experienced during ESWL session be related to?
A. the energy density of the shock waves as they pass through the skin
B. the size of the focal point
C. a & b
D. none of the above
Answer : C
14. What could high dietary protein result in?
A. increase urinary calcium, oxalate, and uric acid excretion
B. decrease urinary calcium; but increase oxalate, and uric acid excretion
C. increased urinary calcium and uric acid; but decrease oxalate excretion
D. decreased urinary calcium, oxalate, and uric acid excretion
Answer : A
15. Invasive intervention in stone patients is NOT indicated in the following condition:
A. stone size
B. unrelieved obstruction
C. infection and septicemia
D. recurrent stone formation
Answer : D
16. 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
17. What is true concerning the use of intravenous fluids in renal colic cases?
A. patients should be given large amounts of fluids to hasten stones passage
B. fluids are given to keep the patient well hydrated
C. the recommended regimen is 2 L of ringer lactate over 2 hours
D. fluids are contraindicated if desmopressin (DDAVP) was given
Answer : B
18. What type of urinary diversion carries the highest risk of stone formation?
A. Kock pouch
B. Neobladder-to-urethra diversion
C. Florida pouch
D. Indiana pouch
Answer : A
19. For how long a completely obstructed ureter could be respited with no expected permanent damage to renal functions?
A. 2 days
B. 2 weeks
C. 2 months
D. 4 6 hrs.
Answer : B
20. 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
21. What are the expected findings on urinalysis in patients with acute renal colic?
A. blood cells more than pus cells
B. pus cells if infection was superadded
C. crystals might appear
D. all of the above
Answer : A
22. 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
23. What is the sure diagnostic finding of Ca.oxalate stones?
A. chemical analysis of a recovered stone
B. hypercalcemia
C. CT finding
D. high breakability on ESWL
Answer : A
24. 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
25. What is the most common organism that might complicate PCNL?
A. Proteus mirabilis
B. E. coli
C. Pseudomonas aeruginosa
D. Staphylococcus epidermidis
Answer : D
26. What medication could help in managing carbonate apatite stones?
A. ?-Mercaptopropionylglycine
B. acetohydroxamic acid
C. carbonic anhydrase inhibitors
D. xanthine oxidase inhibitors
Answer : B
27. 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
Answer : C
28. What does the treatment of hyperuricemia with urate stones include?
A. oral potassium sodium hydrogen citrate granules
B. increase hydration
C. allopurinol
D. all of the above
Answer : D
29. What is the preferred drug for medical expulsive therapy for lower ureteral stones?
A. furosemide
B. tamsulosin
C. nifedipine
D. diclofenac
Answer : B
30. 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
31. What is false regarding hypomagnesuric calcium nephrolithiasis?
A. it is characterized by low urinary magnesium and citrate
B. magnesium increases renal tubular citrate resorption
C. diarrheal is a remarkable side effect of magnesium therapy
D. potassium-magnesium preparations might restore urinary magnesium and citrate levels
Answer : B
32. 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
33. What type of shockwaves is generated by spark-gap technology?
A. piezoelectric
B. electrohydraulic
C. electromagnetic
D. microexplosive
Answer : B
34. What type of stones is soft, resilient, composed of mucoproteins of urine and serum?
A. matrix
B. indinavir
C. brushite
D. 2,8 dihydroxyadenine
Answer : A
35. What could carry the least risk of colon injury during PCNL?
A. subcostal puncture performed during full expiration
B. previous open nephrolithotomy
C. access lateral to the posterior axillary line
D. horseshoe kidney
Answer : B
36. 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
37. Patients having what kind of stones should refrain from eating purines?
A. cysteine
B. urate
C. calcium
D. none of the above
Answer : D
38. What is false concerning neonatal nephrolithiasis?
A. frequently caused by loop diuretics
B. stones are often radiolucent
C. may be reversed by the use of thiazides
D. low calcium-to-creatinine ratio predicts stones resolution
Answer : B
39. What is false concerning primary bladder stones?
A. commoner in females than in males
B. in pediatrics, are of calcium oxalate and/or ammonium urate composition
C. caused by bladder outlet obstruction
D. might result in bladder cancer
Answer : A
40.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
41. 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
42. Which method of the following stone analysis techniques is based on the interaction of polarized light with the stone crystals?
A. wet chemical analysis
B. thermogravimetry
C. scanning electron microscopy
D. none of the above
Answer : D
43. What stone is inherited as an autosomal recessive trait?
A. xanthine
B. ammonium urate
C. cystine
D. calcium oxalate dihydrate
Answer : C
44. 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
45. What is the Hounsfield density range of uric acid stones?
A. 400 600 HU
B. 600 800 HU
C. 800 1000 HU
D. 1000 1200 HU
Answer : A
46. 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
47. What is (are) the indication(s) of hospitalization of ureteral stone patients?
A. steinstrasse
B. a stone in ureterocele
C. fever, leucocytosis, pain
D. brushite stones
Answer : C
48. 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
49. What kind of stones is most amenable to ESWL?
A. cystine
B. brushite
C. Ca.oxalate monohydrate
D. Ca.oxalate dihydrate
Answer : D
50. 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

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