1000+ Urinary Calculus Disease MCQ for SBI PO [Solved]

1. What sequence of ureteral parts represents the most to least favorable stone response to ESWL treatment?
A. upper, lower, mid
B. lower, upper, mid
C. mid, upper, lower
D. mid, lower, upper
Answer : A

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

3. 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

4. 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

5. 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

6. 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

7. 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

8. 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

9. 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

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

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

12. 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

13. 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

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 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

16. 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

17. 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

18. 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

19. 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

20. What is false concerning neonatal nephrolithiasis?
A. frequently caused by loop diuretcs
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

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

22. 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

23. 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

24. 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

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 (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

27. 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

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

29. 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

30. 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

31. 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

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

33. What is the least serious complications of PCNL?
A. uncontrollable bleeding
B. incomplete removal of stones
C. pneumothorax
D. colonic perforation
Answer : B

34. 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

35. 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

36. 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

37. 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

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

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

40. 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

41. 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

43. 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

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

45. 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

46. 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

47. 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

48. 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

49. 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

50. 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