Urinary Calculus Disease 1000+ MCQ with answer for IBPS Clerk

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

2. 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

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

4. 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

5. 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

6. 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

7. 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

8. 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

9. 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

10. 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

11. 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

12. 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

13. Which event is unlikely to occur after placing a DJ ureteral stent?
A. can be forgotten in place
B. vesico-renal reflux
C. calyceal perforation
D. detrusor irritability and/or hematuria
Answer : C

14. 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

15. 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

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

18. 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

19. 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

20. 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 bove
Answer : C

21. 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

22. What is the most appropriate antibiotic class for prophylaxis before urologic surgery?
A. aminoglycosides
B. macrolides
C. cephalosporins
D. fluoroquinolones
Answer : C

23. 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

24. 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

25. 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

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

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

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

29. 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

30. What is the proper sequence of the following stones when ordered from most radiopaque to most radiolucent as they appear on plain Xray film?
A. Ca.oxalate, Ca.phosphate, Na.urate, cystine
B. Ca.phosphate, Ca.oxalate, cystine, Na.urate
C. Ca.oxalate, Ca.phosphate, cystine, Na.urate
D. Ca.phosphate, Ca.oxalate, Na.urate, cystine
Answer : B

31. 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

32. 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

33. 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

34. 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

35. 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

36. 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

37. 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

38. What is false concerning struvite stones?
A. the commonest to form staghorn giant calculi
B. formed by urease producing bacteria
C. antibiotics have a role in the treatment
D. form at the two extremes of urinary pH range
Answer : D

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

41. 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

42. 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

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

44. 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

45. 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

46. 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

47. 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

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 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

50. 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