1000+ Urinary Calculus Disease MCQ for RRB JE [Solved]
Thursday 9th of March 2023
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1. 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
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
2. 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
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
3. 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 should cover Escherichia coli and Staphylococcus, Enterobacter, Proteus, and Klebsiella species
D. All of the above
Answer : D
A. they are mandatory when urine shows ? 10 WBCs/hpf in symptomatic patients
B. they aim at treating pyonephrosis and urosepsis
C. they should cover Escherichia coli and Staphylococcus, Enterobacter, Proteus, and Klebsiella species
D. All of the above
Answer : D
4. 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
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
5. 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
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
6. 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
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
7. 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
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
8. 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
A. Kock pouch
B. Neobladder-to-urethra diversion
C. Florida pouch
D. Indiana pouch
Answer : A
9. 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
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
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
A. oral potassium sodium hydrogen citrate granules
B. increase hydration
C. allopurinol
D. all of the above
Answer : D
11. 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
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
12. What is the most common organism that might complicate PCNL?
A. Proteus mirabilis
B. E. coli
C. Pseudomonas aeruginosa
D. Staphylococcus epidermidis
Answer : D
A. Proteus mirabilis
B. E. coli
C. Pseudomonas aeruginosa
D. Staphylococcus epidermidis
Answer : D
13. What is the least serious complications of PCNL?
A. uncontrollable bleeding
B. incomplete removal of stones
C. pneumothorax
D. colonic perforation
Answer : B
A. uncontrollable bleeding
B. incomplete removal of stones
C. pneumothorax
D. colonic perforation
Answer : B
14. 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
A. right hemicolectomy
B. small bowel resection
C. Roux-en-Y gastric bypass
D. b & c
Answer : D
15. 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
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
16. 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
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
17. 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
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
18. What risk factor(s) promote(s) stone formation?
A. dehydration
B. metabolic disorders
C. congenital anomalies
D. all of the above
Answer : A
A. dehydration
B. metabolic disorders
C. congenital anomalies
D. all of the above
Answer : A
19. What kind of stones is more likely to recur with infections if not removed completely?
A. urate
B. triple phosphate
C. oxalate monohydrate
D. matrix
Answer : B
A. urate
B. triple phosphate
C. oxalate monohydrate
D. matrix
Answer : B
20. 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
A. ? 2 cm diameter
B. upper calyx location
C. Na.urate composition
D. 600 - 800 HU density
Answer : A
21. 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
A. stone size
B. unrelieved obstruction
C. infection and septicemia
D. recurrent stone formation
Answer : D
22. 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
A. anterior lower pole calyx
B. posterior lower pole calyx
C. anterior upper pole calyx
D. posterior upper pole calyx
Answer : B
23. 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
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
24. Worldwide, the commonest type of urinary stones is:
A. calcium monohydrate
B. calcium oxalate
C. ammonium urate
D. none of the above
Answer : B
A. calcium monohydrate
B. calcium oxalate
C. ammonium urate
D. none of the above
Answer : B
25. What is false concerning PCNL in horseshoe kidneys?
A. the preferred access into the collecting system is through a posterior calyx
B. the posterior calyceal group is typically more medial than in the normal kidney
C. in most cases the lower pole calyces are posterior
D. it is desirable to make an upper pole collecting system puncture
Answer : C
A. the preferred access into the collecting system is through a posterior calyx
B. the posterior calyceal group is typically more medial than in the normal kidney
C. in most cases the lower pole calyces are posterior
D. it is desirable to make an upper pole collecting system puncture
Answer : C
26. What condition might NOT cause uric acid stones?
A. Tumor lysis syndrome
B. hypoparathyroidism
C. myeloproliferative disorder
D. Lesch-Nyhan syndrome
Answer : B
A. Tumor lysis syndrome
B. hypoparathyroidism
C. myeloproliferative disorder
D. Lesch-Nyhan syndrome
Answer : B
27. Which of the following bacteria split urea?
A. Klebsiella pneumonia
B. Morganella morganii
C. Proteus mirabilis
D. all of the above
Answer : D
A. Klebsiella pneumonia
B. Morganella morganii
C. Proteus mirabilis
D. all of the above
Answer : D
28. 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
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
29. 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
A. impaired renal tubular calcium reabsorption
B. excessive glomerular leak of calcium
C. deficiency of the enzyme xanthine oxidase
D. hypercalcemia
Answer : A
30. What is the unfavorable stone characteristic for a rigid URS treatment?
A. size of 5 mm
B. location at the lower calyx
C. density of 400 HU
D. being recurrent
Answer : B
A. size of 5 mm
B. location at the lower calyx
C. density of 400 HU
D. being recurrent
Answer : B
31. What is the composition of brushite stones?
A. calcium phosphate
B. calcium oxalate monohydrate
C. sodium urate
D. 2,8 dihydroxyadenine
Answer : A
A. calcium phosphate
B. calcium oxalate monohydrate
C. sodium urate
D. 2,8 dihydroxyadenine
Answer : A
32. 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
A. hypercalciuria and hypocitraturia
B. hypercalciuria and hypercitraturia
C. hypocalciuria and hypocitraturia
D. hypocalciuria and hypercitraturia
Answer : A
33. What is the immediate management of ureteral avulsion on retrieving an upper ureteral stone by a basket?
A. placement of a percutaneous nephrostomy drain
B. surgical exploration and primary repair
C. conservative management
D. endoscopic retrograde ureteral stenting
Answer : A
A. placement of a percutaneous nephrostomy drain
B. surgical exploration and primary repair
C. conservative management
D. endoscopic retrograde ureteral stenting
Answer : A
34. 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
A. lithogenic anion to cation ratio
B. Randall cut off
C. saturation index
D. solubility product
Answer : C
35. What medication could help in managing carbonate apatite stones?
A. ?-Mercaptopropionylglycine
B. acetohydroxamic acid
C. carbonic anhydrase inhibitors
D. xanthine oxidase inhibitors
Answer : B
A. ?-Mercaptopropionylglycine
B. acetohydroxamic acid
C. carbonic anhydrase inhibitors
D. xanthine oxidase inhibitors
Answer : B
36. 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
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
37. What is the proper sequence of the following stones when ordered from most radiopaque to most radiolucent as they appear on plain Xray film?
A. Ca.oxalate, Ca.phosphate, Na.urate, cystine
B. Ca.phosphate, Ca.oxalate, cystine, Na.urate
C. Ca.oxalate, Ca.phosphate, cystine, Na.urate
D. Ca.phosphate, Ca.oxalate, Na.urate, cystine
Answer : B
A. Ca.oxalate, Ca.phosphate, Na.urate, cystine
B. Ca.phosphate, Ca.oxalate, cystine, Na.urate
C. Ca.oxalate, Ca.phosphate, cystine, Na.urate
D. Ca.phosphate, Ca.oxalate, Na.urate, cystine
Answer : B
38. 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
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
39. 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
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
40. 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
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
41. What is false regarding DJ ureteral stents?
A. can be introduced from the bladder or kidney or any part of the ureter`s course
B. the standard adult size is 32 cm long, 4 mm calibre
C. might result in encrustations and ureteral obstruction
D. might result in ureteral dilation
Answer : B
A. can be introduced from the bladder or kidney or any part of the ureter`s course
B. the standard adult size is 32 cm long, 4 mm calibre
C. might result in encrustations and ureteral obstruction
D. might result in ureteral dilation
Answer : B
42. 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
A. matrix
B. indinavir
C. brushite
D. 2,8 dihydroxyadenine
Answer : A
43. 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
A. 2 days
B. 2 weeks
C. 2 months
D. 4 6 hrs.
Answer : B
44. Patients having what kind of stones should refrain from eating purines?
A. cysteine
B. urate
C. calcium
D. none of the above
Answer : D
A. cysteine
B. urate
C. calcium
D. none of the above
Answer : D
45. 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
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
46. 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
A. 400 600 HU
B. 600 800 HU
C. 800 1000 HU
D. 1000 1200 HU
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
A. aminoglycosides
B. macrolides
C. cephalosporins
D. fluoroquinolones
Answer : C
48. In what kind of renal stones do antibiotics help most?
A. indinavir
B. magnesium ammonium phosphate
C. xanthine
D. matrix
Answer : B
A. indinavir
B. magnesium ammonium phosphate
C. xanthine
D. matrix
Answer : B
49. 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
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
50. What is the preferred drug for medical expulsive therapy for lower ureteral stones?
A. furosemide
B. tamsulosin
C. nifedipine
D. diclofenac
Answer : B
A. furosemide
B. tamsulosin
C. nifedipine
D. diclofenac
Answer : B
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