Urinary Calculus Disease 1000+ MCQ with answer for RBI Assistant

1. 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

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

3. What is the sure diagnostic finding of Ca.oxalate stones?
A. chemical analysis of a recovered stone
B. hypercalcemia
C. CT finding
D. high breakability on ESWL
Answer : A

4. 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

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

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

7. 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

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

9. 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

10. 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

11. 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

12. 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

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

14. 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

15. 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

16. 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

17. 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

18. 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

19. 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

20. 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
strong>D. respond to ESWL
Answer : A

21. 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

22. 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

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. 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

25. 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

26. 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

27. 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

28. 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

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

30. 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

31. 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

32. 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

33. 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

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

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 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. 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

38. 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

39. 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