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

A. calcium monohydrate

B. calcium oxalate

C. ammonium urate

D. none of the above

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

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

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

A. watchful waiting

B. open surgical correction

C. IVU with possible endoscopic ureteral stenting

D. perc. nephrostomy tube insertion

A. physiological saline 0.9%

B. glycine 1.5%

C. balanced salt solution

D. distilled water

A. ≥ 2 cm diameter

B. upper calyx location

C. Na.urate composition

D. 600 - 800 HU density

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

A. uncontrollable bleeding

B. incomplete removal of stones

C. pneumothorax

D. colonic perforation

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

A. by performing intra-operative ultrasonography

B. by performing radial nephrotomies

C. by performing adjunct PCLN

D. by taking a scout KUB film

A. can be introduced from the bladder or kidney or any part of the ureter`s course

B. the standard adult size is 32 cm long, 4 mm calibre

C. might result in encrustations and ureteral obstruction

D. might result in ureteral dilation

A. stone chemical composition

B. stone burden

C. first stone vs. recurrent

D. stone density

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

A. 400 600 HU

B. 600 800 HU

C. 800 1000 HU

D. 1000 1200 HU

A. impaired renal tubular calcium reabsorption

B. excessive glomerular leak of calcium

C. deficiency of the enzyme xanthine oxidase

D. hypercalcemia

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

A. dissolving homogenous nucleation

B. high tendency to form cystine sulfate stones

C. indicates the amount of dietary protein

D. post ESWL therapy

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

A. furosemide

B. tamsulosin

C. nifedipine

D. diclofenac

A. terminal ilium resection

B. liver transplantation

C. kidney transplantation

D. regular hemodialysis

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

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

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

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

A. 3 6 %

B. 12 15 %

C. 0.4 0.8 %

D. 0.09 0.14 %

A. commonly unilateral

B. commonly due to repeated infections

C. urate stones are the second most common cause of staghorn calculi

D. ESWL monotherapy with ureteral stenting is the ideal treatment

A. Ca.oxalate monohydrate

B. cystine

C. matrix

D. Ca.oxalate dihydrate

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

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