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4

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

Correct Answer :

C. a stone in a scared poorly functioning kidney


a scared poorly functioning kidney is less viable and unlikely to bleed. Every other day ESWL encourages existing small hematomas to get bigger and to open into the perinephric space. Aspirin users have to stop the medication preferably 10 days before the procedure.

Related Questions

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4

What is the most common organism that might complicate PCNL?

A. Proteus mirabilis

B. E. coli

C. Pseudomonas aeruginosa

D. Staphylococcus epidermidis

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4

What type of stones do laxative abusers might develop?

A. ammonium urate

B. sodium urate

C. calcium oxalate

D. calcium phosphate

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4

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

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4

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

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4

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

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4

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

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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

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4

What type of stones is soft, resilient, composed of mucoproteins of urine and serum?

A. matrix

B. indinavir

C. brushite

D. 2,8 dihydroxyadenine

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4

What condition might NOT cause uric acid stones?

A. Tumor lysis syndrome

B. hypoparathyroidism

C. myeloproliferative disorder

D. Lesch-Nyhan syndrome

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4

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

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4

What medication could help in managing carbonate apatite stones?

A. α-Mercaptopropionylglycine

B. acetohydroxamic acid

C. carbonic anhydrase inhibitors

D. xanthine oxidase inhibitors

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4

What bowel surgery could result in enteric hyperoxaluria?

A. right hemicolectomy

B. small bowel resection

C. Roux-en-Y gastric bypass

D. b & c

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4

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

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4

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

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4

What kind of stones is most amenable to ESWL?

A. cystine

B. brushite

C. Ca.oxalate monohydrate

D. Ca.oxalate dihydrate

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4

What is the most appropriate antibiotic class for prophylaxis before urologic surgery?

A. aminoglycosides

B. macrolides

C. cephalosporins

D. fluoroquinolones

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4

What is false concerning primary bladder stones?

A. commoner in females than in males

B. in pediatrics, are of calcium oxalate and/or ammonium urate composition

C. caused by bladder outlet obstruction

D. might result in bladder cancer

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4

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

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4

Which of the following bacteria split urea?

A. Klebsiella pneumonia

B. Morganella morganii

C. Proteus mirabilis

D. all of the above

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4

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

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4

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

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4

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

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4

What is the composition of brushite stones?

A. calcium phosphate

B. calcium oxalate monohydrate

C. sodium urate

D. 2,8 dihydroxyadenine

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4

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

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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

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4

What type of shockwaves is generated by spark-gap technology?

A. piezoelectric

B. electrohydraulic

C. electromagnetic

D. microexplosive

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4

When urine reaches a high tendency to form stones, the situation is called:

A. lithogenic anion to cation ratio

B. Randall cut off

C. saturation index

D. solubility product

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4

What is the incidence risk of ureteral strictures following ureteroscopy?

A. 3 6 %

B. 12 15 %

C. 0.4 0.8 %

D. 0.09 0.14 %

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4

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

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4

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