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GENITO URINARY SURGERY​


GENITO URINARY SURGERY MCQs

1:-The mean age of a child with vaginal rhabdomyosarcoma is
 A:-younger than 2 years
 B:-2-4 years
 C:-4-8 years
 D:-8-12 years
Ans: A

2:-Hydrocele formation after varicocele ligation is least likely after
 A:-retroperitoneal ligation
 B:-subinguinal ligation
 C:-microscopic inguinal ligation
 D:-transvenous embolisation
Ans: D

3:-All of the following are true regarding Pollakiuria EXCEPT
 A:-it may be associated with a history of recent death or life threatening event in the family
 B:-it is always associated with urinary tract infection or polyuria
 C:-affected child may have very high day time frequency, even as high as 50 times per day
 D:-Absence of nocturnal frequency differentiates it from Overactive Bladder (OAB)
Ans: B

4:-Which of the following disease has the highest chance of developing Renal Cell Carcinoma (RCC) ?
 A:-Von Hippel-Lindau desease
 B:-Acquired renal cystic desease
 C:-Tuferous sclerosis
 D:-ADPKD
Ans: A

5:-The test with highest sensitivity to detect Urinary Tract Infection (UTI) is
 A:-Leukocyte esterase
 B:-Urinary nitrite
 C:-Urinary nitrate
 D:-Serum procalcitonin
Ans: A

6:-Antibiotic prophylaxis for a major operation is best
 A:-Administered 1 hr. before surgery incision
 B:-Administered the night before surgery
 C:-Administered following incision
 D:-Administered immediately ofter completing surgery
Ans: A

7:-Technetium 99 m (99m Te) Dimercapto Succinic Acid (DMSA) is taken up by which renal cell ` `
 A:-Glomerulus
 B:-Proximal tubule
 C:-Distal tubule
 D:-Collecting tubule
Ans: B

8:-The fetal kidney develops from
 A:-Paraxial mesoderm
 B:-Intermediate mesoderm
 C:-Lateral mesoderm
 D:-Neural tube
Ans: B

9:-Regarding sipuleucel T vaccine, all the following are true, EXCEPT
 A:-It is a treatment option for patients with minimally or asymptomatic prostate cancer
 B:-Sipuleucel-T causes marked symptomatic relief in patients with bone pains
 C:-The drug was approved based onthe survival benefit compared to place bo
 D:-Sipuleucel-T will not cause any meaningful PSA decline
Ans: B

10:-The non steroidal antiandrogen associated with interstitial pneumonetis and delayed adaption to darkness after exposure to bright illumination
 A:-Bicalutamide
 B:-Nilutamide
 C:-Flutamide
 D:-Cyproterone acetate
Ans: B

11:-The most common malignant tumor associated with bladder diverticula is
 A:-Urothelial carcinoma
 B:-Adeno carcinoma
 C:-Squamous cell carcinoma
 D:-Sarcoma
Ans: A

12:-Which of the biomarkers has the greatest specificity for the presence of prostate cancer in patients with elivated PSA ?
 A:-PCA 3
 B:-TMPRSS 2 : ERG
 C:-F-PSA
 D:-4 Kscore
Ans: B

13:-A fourtyeight years old women who had abdominal hysterotomy 2 months back presents for evaluation of clear vaginal discharge since surgery. Following oval intake of pyridium, her pads continue to have clear watery discharge. The most likely diagnosis is
 A:-Vesico vaginal fistula
 B:-Uretero vaginal fistula
 C:-Peritoneo vaginal fistula
 D:-Vesico uterine fistula
Ans: C

14:-The key elements of abdominal sacrocolpopexy do NOT include
 A:-use of permanent monofilamentmesh
 B:-Secure fixation to the sacral promontory
 C:-Secure fixation to the vaginal cuff
 D:-Use of a biologic graft
Ans: D

15:-The consistent advantage of laperoscopic/robotic prostatectomy over open prostatectomy is
 A:-Less bleeding
 B:-Less urinary incontinence
 C:-Preservation of erectle function
 D:-Less post operative pain
Ans: A

16:-The test with highest positive predictive value in prostate cancer is
 A:-Digital Rectal Examination (DRE)
 B:-PSA
 C:-Transrectal Ultrasonography (TRUS)
 D:-Human Glandular Kallikrein (hKz)
Ans: B

17:-Significant probability of disease recurrence and risk of secondary graft dysfunction can occur in all the  following EXCEPT
 A:-Chronic glomerulonephritis
 B:-Focal segmental glomerulosclerosis
 C:-Haemolytic uremic syndrome
 D:-Primary oxalosis
Ans: A

18:-Foley Y-V pyloplasty is useful in
 A:-anterior crossing vessel
 B:-high ureteral insertion
 C:-redundant renal pelvis
 D:-small intra renal pelvis
Ans: B

19:-A patient with serum creatinine 2.5 mg/dL requires renal angiography. The best way to protect renal function is
 A:-saline diuresis
 B:-pre-study mannitol
 C:-furosemide before study
 D:-dopamine throughout the study
Ans: A

20:-The most common bacteria causing xantho-granulomatous pylonephritis is
 A:-E. Coli
 B:-Proteus mirabilus
 C:-Pseudomonas
 D:-Klebsiella
Ans: B
​21:-Cause of congenital pelvi-urteric function obstruction include
 A:-Presence of an a peristalitic segment of ureter similar to that found in primary obstructive mega ureter
 B:-True ureteral stricture at PUJ, that is congenital
 C:-Kinks or valves produced by unfolding of ureteral mucosa and musculature
 D:-All of the above
Ans: D

22:-Which of the following is typically associated with organic E. D. in contrast with psychogenic E.D. ?
 A:-Sudden loss of erections
 B:-Gradual decline in erectile ability
 C:-Situational erectile difficulty
 D:-Erection responses on awakening
Ans: B

23:-The structure not located in retro peritoneum is
 A:-Asending color
 B:-Adrenal
 C:-Transverse color
 D:-Second part of duodenum
Ans: C

24:-All the following are true regarding Germ Cell Tumor (GCT) EXCEPT
 A:-It occures bilaterally approximately 15% of the time
 B:-Cryptorchidisism is associated with increased risk for GCT
 C:-Intratubular Germ Cell Neoplasia (ITGCN) is associated with high risk for GCT
 D:-GCT incidence may be high when there is a family history of Testicular cancer
Ans: A

25:-For minimising the gap between healthy urethral margins before anastamosis in pelvic fracture urethral injuries, all the following procedures are useful, EXCEPT
 A:-Excesion of Bucks Facia from corpus spongiosum
 B:-Mobilising the corpus spongiosum off the corpora cavernosa up to the corona of the glans
 C:-Dissection of intracrural space down to the pubis
 D:-Periosteal elevations infra pubectomy
Ans: B

26:-Regarding Bladder Pain Syndrome (BPS)/Interstitial Cystitis all the statements are true EXCEPT
 A:-A childhood presentation is extremely rare. The average age of onset is 40 years
 B:-Patients with BPS have a 10 fold higher incidence of childhood voiding problems than do patients without the syndrome
 C:-Bladder compliance in patients with interstitial cystitis is always abnormal
 D:-Urine Anti Proliferative Factor (APF) appears to have the highest sensitivity and specificity among the markers studied
Ans: C

27:-Cancer occuring in urinary intestinal diversion is most likely to occure in
 A:-Uretero sigmoidostomies
 B:-Ileal conduits
 C:-Colon conduits
 D:-Sigmoid conduits
Ans: A

28:-Which of the following is NOT a contra indication for Testosterone supplementation therapy ?
 A:-Cogestive heart failure
 B:-Polycythemia
 C:-Breast Cancer
 D:-Angina pectoris
Ans: D

29:-Health related quality of life is best assesed by
 A:-Patient themselves
 B:-Sponses or immediate family members
 C:-Specialist caring for the patient
 D:-Specially trained examiners
Ans: A

30:-Transuretero-ureterostomy is contraindicated in
 A:-Retroperitoneal fibrosis
 B:-Urothelial malignancy
 C:-Nephrolithiasis
 D:-All of the above
Ans: D

31:-Hyper calciuria in sarcoidosis is
 A:-Absorptive hypercalciuria
 B:-Renal hypercalciuria
 C:-Recorptive hypercalciuria
 D:-None of the above
Ans: A

32:-Most sigfnificant complication of PCNL is
 A:-Incomplete stone removal
 B:-Extravesation of irrigation fluid
 C:-Urinary tract infection
 D:-Hemorrage
Ans: D

33:-A characteristic finding in angiomyolipoma is
 A:-Positive staining for vimentin
 B:-Unique cytokeratin expression pattern
 C:-Positive staining for Human Melanoma Black-45 (HMB-45)
 D:-Occasional aneuploidy
Ans: C

34:-Most common cancer after kidney transplantation
 A:-Skin
 B:-Cervix
 C:-Kaposi sarcoma
 D:-Thyroid
Ans: A

35:-The ideal site of meision in endo pyelotomy is
 A:-Anterior
 B:-Posterior
 C:-Medial
 D:-Lateral
Ans: D

36:-The nerve likely to be injured is Psoas hitch is
 A:-Obturator nerve
 B:-Ilio hypogastric nerve
 C:-Genitofemoral nerve
 D:-Lio inguinal nerve
Ans: C

37:-Indication for radiologic imaging in urologic trauma include all EXCEPT
 A:-All penetrating trauma
 B:-High impact rapid deceleration trauma
 C:-Adult patients with microscopic hematuria without shock
 D:-All pediatric patients with microscopic hematuria
Ans: C

38:-The stone most unlikely to be fragmented with ESWL
 A:-Calcium oxalate dehydrate
 B:-Calcium oxalate monohydrate
 C:-Struvite
 D:-Uric acid
Ans: B

39:-The most appropriate treatment for patients with renal tubular acidosis include
 A:-Thiazides
 B:-Sodium alkali
 C:-Potassium alkali
 D:-Aceto hydroxamic acid
Ans: C

40:-The preferred site of puncture in to the collecting system for PCNL is
 A:-Upper pole calyx
 B:-Posterior lower pole calyx
 C:-Anterior lower pole calyx
 D:-Upper pole infendibulum
Ans: B

41:-The siglemost important prognostic factor for RCC is
 A:-Tumor stage
 B:-Tumor grade
 C:-Tumor size
 D:-Histologic subtype
Ans: A

42:-Struvite stones (infection stones) can be produced by all the organisms EXCEPT
 A:-Proteus
 B:-Klebsiella
 C:-E-Coli
 D:-Staphylococcus
Ans: C

43:-Para neoplastia syndromes in RCC include all the following EXCEPT
 A:-Hypertension
 B:-Polycythemia
 C:-Hepatic dysfunction
 D:-Hypothyroidism
Ans: D

44:-Most accurate examination to document the presence of bladder stone is
 A:-Ultrasonography
 B:-Excretory urography
 C:-Computed tomography
 D:-Cystoscopy
Ans: D

45:-Which among the following has best prognosis among renal tumors ?
 A:-Sarcoma
 B:-Carcinoid
 C:-Small cell
 D:-Adult Wilms tomor
Ans: B

46:-The best treatment option for a 9 year old female with right 2 cm renal pelvicstone and cystinuria is
 A:-Extracorporeal Shock Wave Lithotripsy (ESWL)
 B:-Ureteroscopy with laser Lithotripsy and stone basketing
 C:-PCNL
 D:-Anatrophic nephrolithotomy
Ans: C

47:-Which of the following statements is true regarding children with non-neurogenic neurogenic bladder ?
 A:-Constriction of urinary sphincter occures during voiding in a voluntary form of detrusor sphincter dyssyenergia
 B:-Gradual bladder de-compensation and myogenic failure result from incomplete emptying
 C:-Gradual bladder de-commpensation and myogenic failure result from increasing amounts of residual urine
 D:-All of the above
Ans: D

48:-The estimated prevalence of vesico ureteric reflux in children with Urinary Tract Infection (UTI) is
 A:-3%
 B:-5%
 C:-10%
 D:-30%
Ans: D

49:-The most useful study for the detection of phychonephritis and cortical renal scarring is
 A:-DTPA scan
 B:-DMSA scan
 C:-MAG-3 scan
 D:-CT urogram
Ans: B

50:-Which of the following is NOT considered a urachal anomaly ?
 A:-Patent urachus
 B:-Urachal cyst
 C:-Urethral-urachus fistual
 D:-Umbulical urachal sinus
Ans: C

51:-Most common intra abdominal injury associated with laperoscopic surgery is
 A:-Bowel injury
 B:-Liver injury
 C:-Vascular injury
 D:-Bladder injury
Ans: C

52:-Accessory pudental artery usually arise from
 A:-Obturator artery
 B:-External liac artery
 C:-Superior vesical artery
 D:-Femoral artery
Ans: A

53:-The mycobacteria which does not cause tuberculosis (TB)
 A:-Mycobacterium bovis
 B:-Mycobacterium microti
 C:-Mycobacterium africanum
 D:-Mucobacterium avium intracellulare
Ans: D

54:-The effect of testosteron includes all the following EXCEPT
 A:-enhances sexual interest
 B:-increase frequency of sexual act
 C:-increases frequency of noct.erections
 D:-enhances fantasy induced or visually stimulated erections
Ans: D

55:-The gold standard in measuring renal function in children with myelodisplasia is
 A:-Serum creationine
 B:-GFR as estimated by the Modification of Diet in Renal Risease (MDRD) equation
 C:-Serum cystatin
 D:-Nuclear renography
Ans: D

56:-Pre-ureteral venacava occurs due to the persistance of
 A:-subcardinal vein
 B:-supracardinal vein
 C:-posterior cardinal vein
 D:-inferior vitelline vein
Ans: A

57:-Regarding ask-upmark kidney, all are ture EXCEPT
 A:-it is always associated with renal artery intimal disease
 B:-hypertension and its sequelae like encephalopathy, retinopathy etc are commonest mainfestations
 C:-segmental vascular anomalies have been cited as the possible cause of hypertension
 D:-disease is primarily seen in young women and girls
Ans: A

58:-Hypercalcimia in Renal Cell Carcinoma(RCC) can be due to all the following EXCEPT
 A:-osteolytic metastalic involvement of the bone
 B:-production of parathyroid hormone like peptide by tumor
 C:-excessive tubular re-absorption of calcium
 D:-action of tumor derived 1,25-dihydroxyvitamine `D_(3)` and prostaglandins
Ans: C

59:-Drugs used for intravesical instillation in carcinoma urinary bladder include all the following EXcept
 A:-Bacille Clamette-Guerin (BCG)
 B:-Cisplatin
 C:-Mitomycin-C
 D:-Thiotepa
Ans: B

60:-Bacteriuria without pyuria is indicative of
 A:-Infection
 B:-Colonisation
 C:-Tuberculosis
 D:-Stones
Ans: B
61:-Blood volume in children is estimated as
 A:-55 ml/kg
 B:-25 to 50 ml/kg
 C:-70-80 ml/kg
 D:-65-70 ml/kg
Ans: C

62:-Which of the following groups of antibiotics include the best choice for treating an infected renal cyst in a patient with ADPKD ?
 A:-Trimethoprim-sulphamethoxazole, chloromphenicol, fluroquinolones
 B:-Cephalosporins, trimethoprim-sulpha methoxazole doxycycline
 C:-Gentamycin, cephalosporins, vancomycin
 D:-Doxycycline, amoxicillin, gentamicin
Ans: A

63:-Which of the following is confirmatory in the diagnosis of tuberous sclerosis ?
 A:-Renal angio myolipoma and multiple renal cysts
 B:-Hamartomatous rectal polyp and facial adenoma sebaceum
 C:-Renal angiomyolipoma and cardiac rhabdomyoma
 D:-Mitral valve prolapse, renal angiolipoma and gingival fibromas
Ans: C

64:-The most common type of retroperitoneal soft tissue sarcoma is
 A:-Liposarcoma
 B:-Leiomyosarcoma
 C:-Malignant fibrous histiocytoma
 D:-Adrenal myelolipoma
Ans: A

65:-A 24 Fresh (Fr) Foley balloon catheter
 A:-Measures 24 cm long
 B:-Measures 8 mm in outer diameter
 C:-Measures 8 mm in inner diameter
 D:-Can hold 24 ml of fluid in the balloon
Ans: B

66:-Regarding pre-operative renal artery embolisation all are true EXCEPT
 A:-It can cause shrinkage of arterialised Vena-caval tumor thrombus enabling easy removal
 B:-It prevents micrometastasis during surgery
 C:-It facilitates dissetion due to development of tissue plane odema
 D:-It causes fever, flank pans and nausea us upto 75% of patients
Ans: B

67:-The most consistent segmental branch which supplies nearly 25% of the renal unit is
 A:-Apical (Superior) segemental artery
 B:-Anterior superior segmental artery
 C:-Posterior segmental artery
 D:-Basilar segmental artery
Ans: C

68:-Which of the following statement is true regarding Vitamin D metabolism ?
 A:-Vitamin D increases renal excretion of calcium
 B:-Dermally synthesised cholicalciferol must be hydroxylated by both liver and kidney for maximal potency
 C:-Vitamin D activity is mediated through membrane bound Vitamin D receptors
 D:-Dermally synthesised cholecalciferol is the most potent form of Vitamin D
Ans: B

69:-Regarding major pelvic urologic surgery all are true EXCEPT
 A:-Warfarin may be stopped 5 days before the surgery
 B:-Aspirin and clopidogrel should be discontinued 7 days before surgery
 C:-Fresh Frozen plasma is not useful in immediate reversal of warfarin and replacement of specific clotting factors
 D:-Hypothermia results in increased blood loss and increased wound infection
Ans: C

70:-Which of the following statement about cytokine therapy for metastatic Renal Cell Carcinoma (RCC) is true ?
 A:-Lymphokine-Activated Killer (LAK) cells augment the efficacy of both interferon α(IFNα) and IL-2
 B:-The complete response with interferon α monotherapy is 10%
 C:-The combination of IL-2 and interferone leads to higher overall response rates than either agent alone
 D:-All the above statement are true
Ans: C

71:-The most common histology in penile carcinoma is
 A:-Squamous cell carcinoma
 B:-Melanoma
 C:-Verrucous carcinoma
 D:-Adeno carcinoma
Ans: A

72:-Cause of enteric hyper oxaluria is
 A:-Excessive oxalate intake
 B:-Reduced excretion of oxalate
 C:-Fat malabsorption
 D:-Increased dietary fat
Ans: C

73:-The only segment of urethra that does not have transitional epithelium is
 A:-Prostatic urethra
 B:-Fossa navicularis
 C:-Bulbar urethra
 D:-Membraneous urethra
Ans: B

74:-An advantage of supine versus prone position for percutaneous renal surgery is
 A:-Improved pulmonary mechanics
 B:-Easier entry in to upper pole calyx
 C:-Easier entry in to posterior calyx
 D:-Reduced pressure in the collecting system
Ans: D

75:-Transplant between two siblings who are Histocompatability Leukocyte Antigen (HLA) identical (perfect class I and II match) can be rejected this may be due to
 A:-Direct antigen presentation
 B:-Indirect antigen presentation
 C:-Difference is complement proteins
 D:-Differences in numbers of circulating platelets
Ans: B

76:-The normal baseline or resting ureteral pressure is
 A:-0-5 cm `H_(2)O`
 B:-5-10 cm `H_(2)O`
 C:-10-15 cm `H_(2)O`
 D:-15-20 cm `H_(2)O`
Ans: A

77:-The feature associated with worst survival in children with wilms tumor is
 A:-diffuse tumor spill
 B:-diffuse anaplasia
 C:-incomplete tumor resection
 D:-lung metastasis
Ans: B

78:-The radiographic study most useful to detect renal injury is
 A:-Intravenous Pyelogram (IUP)
 B:-Magnetic Resonance Imaging (MRI) of abdomen
 C:-Focused Assessment with Sonagraphy for trauma (FAST) ultrasound
 D:-Triphasic abdominal Computed Tomography (CT)
Ans: D

79:-Adolescent urology is defined as the care of patients
 A:-From 10-19 years old
 B:-From puberty until death
 C:-From puberty to 25 years old
 D:-From 14-25 years old for males and from 12 to 21 years for female
Ans: B

80:-Which of the following is true regarding Mullerian Inhibiting Substance (MIS) ?
 A:-it is secreted by the fetal leydig cells
 B:-it acts systemically to produce Mullerian regression
 C:-it functions normally in patients with hernia uteri inguinal
 D:-it is secreted at 7-8 weeks of gestation representing the initial endocrine function of the fetal testis
Ans: D
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