1000+ Urinary Calculus Disease MCQ for SSC MTS [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 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

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

4. What type of stones do laxative abusers might develop?
A. ammonium urate
B. sodium urate
C. calcium oxalate
D. calcium phosphate
Answer : A

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 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

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

8. 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

9. 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

10. 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

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

12. 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

13. 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

14. 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

15. 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

16. 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

17. 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

18. 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

19. 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

20. 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

21. 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

22. 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

23. 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

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

25. 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

26. 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

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

28. 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

29. 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

30. 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

31. 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

32. 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

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

34. 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

35. 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

36. 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

37. 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

38. 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

39. 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

40. 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

41. What is the treatment of choice for a 15 mm stone in the lower calyx with a narrow infundibulum?
strong>A. ESWL
B. PCNL
C. radial nephrolithotomy
D. pyelolithotomy with ureteral stenting
Answer : B

42. 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

43. 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

44. 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

45. What risk factor(s) promote(s) stone formation?
A. dehydration
B. metabolic disorders
C. congenital anomalies
D. all of the above
Answer : A

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

47. 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

48. 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

49. 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

50. 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