Multiple Choice Questions (MCQ)

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Category: Urology--->Urolithiasis
Page: 2

Question 6#Print Question

Which of the following is true regarding extracorporeal shockwave lithotripsy?

a. ESWL is more effective than ureteroscopy for an 8-mm distal ureteric stone
b. Anticoagulation with warfarin is not an absolute contraindication
c. Hounsfield Units (HU) of the stone is of limited use in predicting success
d. Fragmentation is more successful at a shock rate of 1 Hz compared to 2 Hz
e. Shockwaves converge on focal point F1 where stone fragmentation occurs

Question 7#Print Question

The following are true of stones in horseshoe kidneys except:

a. PUJ obstruction and abnormal drainage of horseshoe kidneys predisposes to urinary stasis and stone formation in approximately 20%
b. Horseshoe kidneys are malrotated such that their calyces are situated in a medial position
c. The blood supply is quite variable and may predispose to increased bleeding risk with PCNL
d. Extracorporeal shockwave lithotripsy is contraindicated
e. The use of flexible nephroscopes and flexible ureteroscopes may reduce the need for multiple punctures where PCNL is used to treat stones in horseshoe kidneys

Question 8#Print Question

The following are true of cystinuria, except:

a. Cystinuria is inherited as an autosomal dominant condition with an incidence of 1 in 20,000
b. The pKa of cystine is 8.3 and the cyanide nitroprusside test is used to test for cystinuria
c. Treatment with effervescent ascorbic acid (vitamin C) may increase the solubility of cystine
d. Homozygous cystinurics typically pass more than 600-mg cystine in their urine per day
e. Cystine stones are usually visible on plain abdominal radiograph due to the presence of disulphide bonds

Question 9#Print Question

The following are true of bladder calculi, except:

a. In the Western world bladder calculi are most commonly composed of uric acid
b. Malnutrition and low phosphate diets predispose to endemic bladder stones in the developing world
c. More than 90% of men with bladder calculi require surgery for bladder outflow obstruction
d. Cystolitholopaxy should be undertaken before bladder outflow surgery where the procedures are combined
e. The holmium laser may be used to treat large bladder calculi as an alternative to open stone removal

Question 10#Print Question

The following are true regarding analgesia in patients presenting with acute ureteric colic, except:

a. Non-steroidal anti-inflammatory drugs (NSAIDs) are associated with less vomiting than opioids
b. NSAIDs have been shown to reduce glomerular filtration rate and intrarenal pressure through their action on prostaglandin synthesis
c. Less ‘rescue’ medication is required with NSAIDs compared to opioids
d. Analgesia should not be given until a firm diagnosis of ureteric colic has been made to prevent diagnostic confusion
e. Rectal administration of NSAIDs should be considered, especially in patients who present with vomiting

Category: Urology--->Urolithiasis
Page: 2 of 4