1000+ Urinary Calculus Disease Multiple Choice Question Answer [Solved]

1. 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

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

3. 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

4. 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

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

6. 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

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

8. 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

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 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

11. 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

12. 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

13. 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

14. 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

15. 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

16. 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

17. 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

18. 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

19. 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

20. 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

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

22. 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

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

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

25. 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

26. 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

27. 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

28. 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

29. 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

30. 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

31. 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

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

33. 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

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

35. 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

36. 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

37. 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

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

39. 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

40. 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

41. 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