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

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

2. 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

3. What is true concerning primary hyperparathyroidism and stone formation?
A. orthophosphates may have a role in the treatment
B. hyperparathyroidectomy and levothyroxine replacement is the optimum treatment
C. management includes Calcium chelating agent and repeat 24hr urine collection in 3 months
D. surgical excision of the adenoma(s) is the treatment of choice
Answer : D

4. What is false concerning primary bladder stones?
A. commonly occur in patients with senile prostatic enlargement
B. common in children exposed to low-protein, low-phosphate diet
C. rarely recur after treatment
D. respond to ESWL
Answer : A

5. 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

6. 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

7. 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

8. 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

9. 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

10. 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

11. 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

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

13. What is the composition of brushite stones?
A. calcium phosphate
B. calcium oxalate monohydrate
C. sodium urate
D. 2,8 dihydroxyadenine
Answer : A

14. 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

15. 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

16. 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

17. 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

18. 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

19. 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 effec of magnesium therapy
D. potassium-magnesium preparations might restore urinary magnesium and citrate levels
Answer : B

20. 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

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 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

23. 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

24. 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

25. 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

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

27. 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

28. 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

29. 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

30. 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

31. 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

32. 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

33. 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

34. 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

35. 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

36. 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

37. 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

38. 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

39. 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

40. What parameter is NOT considered in the stone burden concept?
A. the surface area of the sones
B. the volume of the stones
C. the density of the stones
D. the number of the stones
Answer : C

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

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

43. 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

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

45. 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

46. 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

47. 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

48. 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

49. 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

50. 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