1000+ Urinary Calculus Disease MCQ for IBPS RRB [Solved]

1. 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

2. What statement is false concerning the use of desmopressin (DDAVP) in renal colic patients?
A. it causes reduction in the mean intra-ureteral pressure
B. it reduces the pain of acute renal colic
C. it has a direct relaxing effect on the renal pelvis and ureteral musculature
D. it is indicated when stones are ? 4 mm in diameter
Answer : D

3. 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

4. What is false concerning urethral stones?
A. stones at posterior urethra could be pushed back to the bladder
B. stones at anterior urethra have to undergo a trial of milking out, using copious intra-urethral xylocaine gel
C. often respond to a two-week course of tamsulosin
D. respond to Holmium laser treatment
Answer : C

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

6. 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

7. 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

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

9. 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

10. 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

11. 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

12. 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

13. 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

14. 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

15. 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

16. 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

17. 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

18. 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

19. What istrue 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

20. What is false concerning obesity and urinary stone formation?
A. obese patients have a higher tendency for uric acid stone formation
B. high-protein, low-carbohydrate diet might increase the risk of stone formation and bone loss
C. metabolic syndrome is associated with high urinary pH
D. Roux-en-Y-gastric bypass surgery may increase the risk for stone formation
Answer : C

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

22. 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

23. 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

24. 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

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 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

27. 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

28. 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

29. 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

30. 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

31. 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

32. 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

33. 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

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

35. 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

36. 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

37. 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

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

40. 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

41. Which statement is false concerning renal stones related to hyperparathyroidism (HPT)?
A. renal stones are found in 20% of patients with primary HPT
B. acidic arrest promotes crystallisation of calcium phosphate stones related to HPT
C. HPT, vitamin D excess, and malignancy could lead to hypercalcemia and hypercalciuria
D. only surgery can cure primary HPT
Answer : B

42. What is the most important parameter that determines the treatment modality of a kidney stone?
A. stone chemical composition
B. stone burden
C. first stone vs. recurrent
D. stone density
Answer : B

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

44. 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

45. When should renal stone patients be evaluated for metabolic diseases?
A. when stones are multiple and/or recurrent
B. when stones form in childhood
C. in cases where nephrocalcinosis and urolithiasis are present
D. all of the above
Answer : D

46. What is a remarkable disadvantage of ultrasonic imaging for ESWL?
A. localization of stones in the ureter is difficult or impossible
B. inability to visualize stones breaking down in real time
C. c. patient`s position on ESWL table is uncomfortable
D. d. inability to visualize radiolucent stones
Answer : A

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

48. 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

49. What type of stones is most effectively treated with PCNL?
A. Ca.oxalate monohydrate
B. cystine
C. matrix
D. Ca.oxalate dihydrate
Answer : C

50. 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