1000+ Urinary Calculus Disease MCQ for GRE [Solved]

1. 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

2. What stones are radiopaque on plain X-ray film?
A. 2,8 dihydroxyadenine stones
B. sulfa medications-induced stones
C. calcium oxalate stones
D. matrix stones
Answer : C

3. What is true concerning uric acid stones?
A. they are metabolic stones that form at high urinary pH
B. they score 800 1000 HU on CT
C. only 25% of affected patients have Gout disease
D. affected patients must stop eating animal protein
Answer : C

4. The process where nucleation and further precipitations occur by different components to form urinary stones, is called:
A. classical nucleation theory
B. heterogeneous nucleation
C. suspension solution
D. concentric lamination
Answer : B

5. 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

6. 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

7. 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

8. How does oral Mg.citrate inhibit Ca.oxalate stone formation?
A. by lowering urinary saturation of Ca.oxalate
B. by preventing heterogeneous nucleation of Ca.oxalate
C. by inhibiting spontaneous precipitation and agglomeration of Ca.oxalate
D. by all of the above
Answer : D

9. Why do patients with cystic fibrosis form stones?
A. because urine and body secretions are highly concentrated
B. due to renal leak hypercalciuria
C. as a result of distal renal tubular acidosis type I
D. because of reduced or absent of oxalobacter formigenes colonization
Answer : D

10. What is the first-line treatment of kidney stones of a burden greater than 2 cm?
A. ESWL
B. URS
C. PCNL
D. none of the above
Answer : C

11. 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

12. 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

13. 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

14. What is the incidence risk of ureteral strictures following ureteroscopy?
A. 3 6 %
B. 12 15 %
C. 0.4 0.8 %
D. 0.09 0.14 %
Answer : A

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

16. What is the most common composition of ureteral stones?
A. Ca.phosphate
B. Ca.oxalate
C. Na.urate
D. struvite
Answer : B

17. 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

18. 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

19. Worldwide, the commonest type of urinary stones is:
A. calcium monohydrate
B. calcium oxalate
C. ammonium urate
D. none of the above
Answer : B

20. Which of the following factors, positively, affect lower calyceal stone clearance after ESWL?
A. short and wide infundibulum
B. large lower-pole infundibulo-pelvic angle
C. the adjunct usage of PCNL
D. all of the above
Answer : D

22. What is the least likely condition to form bladder stones?
A. spinal cord injury
B. senile enlargement of prostate
C. augmented bladder
D. neurogenic hyper-reflexive bladder
Answer : D

23. What stone is inherited as an autosomal recessive trait?
A. xanthine
B. ammonium urate
C. cystine
D. calcium oxalate dihydrate
Answer : C

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

25. 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

26. Where do Randall plaques originate from?
A. transitional epithelium lining minor calyces
B. transitional epithelium lining major calyces
C. basement membrane of the loops of Henle
D. papillary tips of polar pyramids
Answer : C

27. What is the most common organism that might complicate PCNL?
A. Proteus mirabilis
B. E. coli
C. Pseudomonas aeruginosa
D. Staphylococcus epidermidis
Answer : D

28. 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

29. 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

30. 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

31. 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

32. What is false concerning preputial stones?
A. form due to inspissated smegma
B. form due to stasis of urinary salts
C. cause inguinal lymphadenopathy
D. often associated with phimosis in uncircumcised males
Answer : C

33. 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

34. 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

35. 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

36. 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

37. Ureteral stones of ? 7 mm:
A. should be treated with more analgesics
B. must undergo metabolic worked out
C. are unlikely to pass out spontaneously
D. chemolysis should be tried first
Answer : C

38. What is the fatality risk if a triple-phosphate staghorn stone left untreated?
A. 0 10%
B. 10 20%
C. 20 30%
D. 30 40%
Answer : C

39. 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

40. 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

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

42. What is (are) the indication(s) of ureteral stenting before ESWL?
A. stones in a solitary kidney
B. ureteral stones causing bilateral obstructions
C. a kidney stone of ? 2.5 cm in size
D. all of the above
Answer : D

43. 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

44. Two weeks of prolonged wound drainage after a non-stented Anderson-Hynes pyeloplasty. What would be next step in the management?
A. watchful waiting
B. open surgical correction
C. IVU with possible endoscopic ureteral stenting
D. perc. nephrostomy tube insertion
Answer : C

45. Which of the following bacteria split urea?
A. Klebsiella pneumonia
B. Morganella morganii
C. Proteus mirabilis
D. all of the above
Answer : D

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

47. When urine reaches a high tendency to form stones, the situation is called:
A. lithogenic anion to cation ratio
B. Randall cut off
C. saturation index
D. solubility product
Answer : C

48. 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

49. 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

50. 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