SSC JE - Urinary Calculus Disease 1000+ MCQ [Solved] PDF Download

1. 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

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

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

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

5. 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

6. 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

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

8. What condition might NOT cause uric acid stones?
A. Tumor lysis syndrome
B. hypoparathyroidism
C. myeloproliferative disorder
D. Lesch-Nyhan syndrome
Answer : B

9. 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

10. 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

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

12. 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

13. 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

14. 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

15. 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

16. What does nephrocalcin do?
A. dissolves cystine stones
B. enhances nephrocalcinosis process over old scared areas
C. inhibits Ca.oxalate aggregation and crystallization
D. plays a secondary role in metastatic calcification process
Answer : C

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

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

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

20. On treating uric acid stones, excessive alkalinization with potassium citrate could result in all of the following, EXCEPT:
A. formation of triple-phosphate stones
B. infection with Proteus species
C. increase production of endogenous uric acid
D. increase level of uric acid in THE blood
Answer : C

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

23. 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

24. 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

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

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

27. What is the preferred irrigation fluid during PCNL?
A. physiological saline 0.9%
B. glycine 1.5%
C. balanced salt solution
D. distilled water
Answer : A

28. 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

29. 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

30. 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

31. 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

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

33. What parameter impairs the kidney stone-free rate, after ESWL?
A. short skin-to-stone distance (SSD)
B. end-stage renal failure
C. a stone in the upper calyx
D. the presence of a 30 cm, 4.7 Fr ureteral stent in situ
Answer : B

34. 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

35. 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

36. 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

37. 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

38. 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

39. 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

40. What statement is false concerning the use of desmopressin (DDAVP) in renal colic patients?
A. it causes reduction in the mean intra-ureteral pressure
B. it reduces the pain of acute renal colic
C. it has a direct relaxing effect on the renal pelvis and ureteral musculature
D. it is indicated when stones are ? 4 mm in diameter
Answer : D

41. 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

42. 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

43. 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

44. 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

45. 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

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

47. 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

48. What congenital anomaly is unlikely to result in stone formation?
A. left ureterocele
B. bifid right renal pelvis
C. neurogenic bladder
D. bilateral UPJ stenosis
Answer : B

49. 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

50. 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