Gupta Bro

1
APPLIED ANATOMY
1.1 The ureteric bud originates from which aspect of the mesonephric duct :
(a) Anteromedial
(b) Posteromedial
(c) Anterorateral
(d) Posterorateral
1.2 A typical collecting duct drains about how many nephrons :
(a) 5-7
(b) 7-9
(c) 9-11
(d) 11-13
1.3 During embryogenesis by which stage the kidney reach the normal adult position :
(a) 10-14 mm stage

(b) 14-20 mm stage
(c) 20-25 mm stage
(d) 25-30 mm stage
1.4 By which week of gestation, the kidney reaches its, adult location :
(a) 8 weeks
(b) 10 weeks
(c) 12 weeks
(d) 14 weeks
1.5 Which is the level of origin of the renal blastema:
(a) Lower sacral segmen

(b) Upper sacral segmen
(c) Lower lumbar segment
(d) Upper lumbar segment
1.6 Approximately what is the ratio of polar kidney to fatal crow it rump length :
(a) 0,63
(b) 0,68
(c) 0,73
(d) 0,78
1.7 In which week of gestation the medulla of the kidney is evident by ultrasound examination :
(a) 23 rd
(b) 27 th
(c) 31 st
(d) 35 th
1.8 By which week of gestation, trantitional epithelium is present in the ureter :
(a) 14
(b) 16
(c) 18
(d) 20
1.9 Until about how many weeks of gestation, the external genetalia are sexually indifferent :
(a) 8
(b) 10
(c) 12
(d) 14
1.10 In which week of gestation, the glanural uretra appears :
(a) 12
(b) 14
(c) 16
(d) 18
1.11 By which week of gestation cowper glands are present :
(a) 10
(b) 12
(c) 14
(d) 16
1.12 After how many week of gestation, the testis descends from the external ring to the scrotum :
(a) 20-22 weeks

(b) 22-24 weeks
(c) 24-26 weeks
(d) after 26 weeks
1.13 Which cells produce mullerian inhibiting substance (MIS) ?
(a) Leydig cell

(b) Sertoli cells
(c) Interstitial cells
(d) All of the above
1.14 After of the weeks of development, mullerian inhibiding substates (MIS) ?
(a) 6
(b) 8
(c) 10
(d) 12
1.15 Which of the following statement is false regarding mullerian duct?
(a) The mullerian duets degenerates when exposed to mullerian inhiding substance (MIS)
(b) The degeneration occurs mostly in a cranio caudal direction
(c) The erantal portion of the duct is more sensitive to the effect of MIS than the caudal portion
of the duct
(d) The caudal end of the degenerating mullerian duct may persist as appendix of the testis
1.16 Which is the deepest layer in the anterolateral abdominal wall ?
(a) Latissimus dorsi

(b) External oblique
(c) Internal oblique
(d) Tranversus abdominis
1.17 Which of the following is the first muscle one encounters in the subcostal approach to the
kidney ?
(a) Serratus posterior inferior

(b) Lattisimus dorsi
(c) External oblique
(d) Internal oblique
1.18 The kidney a are :
(a) Intraperitoneal
(b) Retroperitoneal
(c) Insuaperitoral
(d) None of the above
1.28 Which of the following statement FALSE regarding kidneys ?
(a) The are paired, reddish brown, solid organs

(b) The size is relativly larger in female
(c) The dimensions are related to the over all body size
(d) The kidneys vary somewhat from right to left with the right kidney tredding to be shorter in
vertikal dimensions
1.29 What is the usual length of the adult kidney ?
(a) 8-10 cms

(b) 10-12 cms
(c) 12-14 cms
(d) 14-16 cms
1.30 What is the usual width of the adult kidney ?
(a) 3-5 cms

(b) 4-6 cms
(c) 5-7 cms
(d) 7-9 cms
1.31 What is the average thickness of the adult kidney ?
(a) 1 cms
(b) 2 cms
(c) 3 cms
(d) 4 cms
1.32 What is the usuall weight of the kidney normal adult male ?
(a) 140 gms

(b) 150 gms
(c) 160 gms
(d) 170 gms
1.33 The weight of the kidney constitutes approximately how many percent of the body weight of
the adult :
(a) 0.1
(b) 0.4
(c) 0.6
(d) 1.0
1.34 The weight of the kidney constitutes approximately how many percent of body weight of the
new born :
(a) 0.1
(b) 0.4
(c) 0.6
(d) 1.0
1.35 In case of congenital absennce of kidney. Gerota’s fascia is :
(a) Present
(b) Absence
1.36 The gerota’s fascia is not fused on which side of the kidney :
(a) Medially
(b) Superioly
(c) Inferiorly
(d) Laterally
1.37 Which of the following statement regarding gerota’s fascia is incorrect :
(a) There is a separate compartment between renal and adrenal gland

(b) It is fused in inferiorly
(c) oit is adherent to vertebral bodies
(d) It consists of an anterior (toldt) and a posterior (zukerkandl) layer
1.38 Which of the following statement is WRONG about perirenal or perinephric fat ?
(a) This is lemon yellow in colour

(b) It surrounds the renal capsule
(c) Remains outside the gerota’s fascia
(d) It is traversed by line but relatively firm fibres
1.39 The dromedari hump usually present in which part of the kidney :
(a) Midlateral countour

(b) Anterior surface
(c) Posterior surface
(d) Superomedial surface
1.40 Usually at which level renal arteries originate from the aorta :
(a) 1st lumbar vertebral body

(b) 2nd lumbar vertebral body
(c) 3rd lumbar vertebral body
(d) 4th lumbar vertebral body
1.41 Which is the first segment branch of the renal artery ?
(a) Posterior
(b) Apical
(c) Middle
(d) Lower
1.42 The anterior divisions renal artery supplies the following segments of the kidney except :
(a) Anterior
(b) Lower
(c) Posterior
(d) Anterior
1.43 The right renal artery passes posterior to the right renal vein, head of pancreas and second part
of duodenum. Apart from these, it also passes behind the :
(a) Left renal vein

(b) Inferior vena cava
(c) Body of the pancreas
(d) Aorta
1.44 The kidney is divisible in to how many segment on the basis of arterial distribution :
(a) 2 segments
(b) 3 segments
(c) 4 segments
(d) 5 segments
1.45 Which of the following segment of the kidney maybe supplied by branched from either the
anterior division or the posterior division of the renal artery ?
(a) Lower
(b) Apical
(c) Posterior
(d) Middle
1.46 The posterior segment renal artery reaches the posterior surface of the pelvis by coursing
which border of the pelvis :
(a) Superior border

(b) Inferior border
(c) No constant relationship
(d) Goes posteriorly directly from aorta
1.47 Which segmental arteri has the most variable origin ?
(a) Upper
(b) Middle
(c) Apical
(d) Lower
(e) Posterior
1.48 The afferent arteriosles to the glomeruli are the branches of :
(a) Lobar arteries

(b) Arcuate arteries
(c) Interlobular arteries
(d) Interlobar arteries
1.49 At the level of which vessel the renal parenchymal vein anatomosis freely :
(a) Arcuate
(b) Interlobar
(c) Lobar
(d) Interlobular
1.50 The vasa recta are derived from :
(a) Afferent arteriole

(b) Efferent arteriole
(c) Interlobular arteries
(d) Interlobular veins
1.51 The right renal artery has following differences from left renal artery except :
(a) It leave aorta at slightly lower level-

(b) It has a downward slope
(c) It passes behind the inferior vena cava
(d) It is longer
1.52 Which of the following statement is wrong regarding supernumerary renal arteries ?
(a) They ussually arise from aorta

(b) They ussualy more common on the right side
(c) They usually enter renal hilum or to renal parenchyma
(d) More common in ectopic kidney
1.53 As per scale. 1 F (freach) is equal to :
(a) 1/3 mm
(b) 1mm
(c) 2 mm
(d) 3 mm
1.54 While planning incision on the renal cortex for partial nephrectomy, the involved area of the
kidney does not become blue on compressing the segmental manually. All of the following can
be the reason, except ?
(a) The segmental artery was anatomosis with another artery

(b) The vessel was incompletely compressed
(c) The vessel was not compressed long enough
(d) High oxygen content of the venous blood in that area
1.55 The left renal vein has following differentces from right renal vein, except :
(a) It is longer
(b) It has tributaries
(c) In enters inferior vena cava at slightly higher level
(d) It enter inferior vena cava more posterolateraly
1.56 On which side, the lumbar vein joins left renal vein :
(a) Superiolly
(b) Inferiorly
(c) Anteriorly
(d) Posteriorly
1.57 Approximately how many glomeruli are usually present within :
(a) 0,5 – 1 million

(b) 1 – 2 million
(c) 2 - 3 million
(d) 3 - 4 million
1.58 Microscopically, renal collecting system has its origin in the renal :
(a) Cortex
(b) Medulla
(c) Corticomedullary junction
(d) Any of the a bove
1.59 How many renal papillae are usually present in a kidney ?
(a) 5-7
(b) 7-9-
(c) 9-11
(d) 11-13
1.60 Which of the following statement is FALSE ?
(a) The musculature of the upper urinary tract comprises only typical smooth muscle and
atypical smooth muscle cells
(b) There is localised thickening of muscles in the pelviureteric region and pelviureteric
sphincter can be localised on microscopy
(c) Autonomic nerve fibres occur in the muscle coat of the calyces,pelvis and ureter
(d) The ureter comprises of mucosa, muscle coat and adventitia from inside outwards
1.61 Which of the following statement is FALSE regarding the peristatic activity of the upper urinary
tract?
(a) Peristaltic waves are initiated by the pacemakers present in each minor calyx
(b) Not all peristaltic waves in the renal pelvis are propogated down the ureter
(c) The ureteral peristalsis depends on the myogenic contractile property of the smooth muscle
cells
(d) The autonomic nerve supply of the ureter is essential in achiving peristalsis
1.62 On an average, how many minor calyces are present :
(a) 4
(b) 6
(c) 8
(d) 10
1.63 In adults, the lenght of the ureter varies between :
(a) 10-24 cms

(b) 24-30 cms
(c) 30-36 cms
(d) 36-42 cms
1.64 The lenght of left ureter and right ureter is :
(a) Same
(b) Left 1 cm longer
(c) Right ureter is 1 cm longer
(d) Left ureter is 2 cms longer
1.65 At which level do both the ureters lie closest to each other :
(a) L2
(b) L3
(c) Just above sarcoiliac
(c) Ischial spine
1.66 At which level both the ureters are most widely separate each other :
(a) L2
(b) L3
(c) Just above sacroilliac joint
(d) Ischial spine
1.67 Which is the narrows part the ureter ?
(a) Uretero pelvic junction

(b) At the crossing of the iliac artery
(c) Uretero vesicle junction
(d) Lumbar
1.68 Approximately, what is the normal diameter of the perviuretereric junction ?
(a) 4F
(b) 6F
(c) 8F
(d) 10 F
1.69 Which is the intermost layer of muscle in the ureters ?
(a) Circular
(b) Oblique
(c) Longitudinal
(d) Any of the above
1.70 The blood supply of the ureters comes from :
(a) Renal artery

(b) Aorta
(c) Iliac spermatic arteris
(d) Vesical artery
(e) All of the a bove
1.71 From which direction the arterial branches within the pelvis approach the ureter :
(a) Medial
(b) Lateral
(c) Superior
(d) Inferior
1.72 The lymphatics of the ureter drain in to :
(a) Hypogastric lymhinodes

(b) Illiac
(c) Lumbar
(d) Preartic
(e) All of the above
1.73 The innervation of the ureter is autonomic with ganglionic cells limited to the :
(a) Adventitia
(b) Muscle
(c) Submocosa
(d) Mucosa
1.74 The reffered pain to ureteric colic is occasioned by the :
(a) lliotypogastric nerve (L1 or T12 and L1)

(b) llionginal nerve (T12 and L1)
(c) Enternal sprematic brarich of genitoforamoral nerve (L1 and L)
(d) All oh the above
1.75 Which is the largest autonomic nervous plexuse in the abdoment ?
(a) Celiac
(b) Renal
(c) Superior hypogastric
(d) Inferior hypogastric
1.76 From which spinal segment the kidney receives preganglionic sympatic input :
(a) T4-T9
(b) T6-T10
(c) T8-L1
(d)T10-L3
1.77 From which spinal segment, the ureter receives preganilonic sympatic input :
(a) T5-L1
(b) T10 - L2
(c) T12-L3
(d) L1-L4
1.78 From which lumbar spinal nerve, the obturator nerve originates :
(a) 1st and 2nd

(b) 2nd and 3rd
(c) 3rd and 4th
(d) 4th and 5th
1.79 From normal ureteral peristalsis, the intristic smooth muscle pacemaker sites are located in the:
(a) Collecting tubules

(b) Minor calycs
(c) Mayor calycs
(d) Renal pelvis
1.80 The ureters receives parasimpathetic input from which spinal segment :
(a) L5- s1
(b) S1-S3
(c) S2-S4
(d) S3-S5
1.81 The central point of perineum is formed by the fusion :
(a) Superficial tranversus perinei

(b) Bulbous Cavenosous
(c) Retrouretrhalis
(d) Sphincter Ani Externus
1.82 The deep perineal pouch contains following, except :
(a) Urethral Sphintcer

(b) Bulbourethral gland of cowper
(c) Pundendal nerve and vessel
(d) Gland of littre
1.83 Which of the following is false regarding puboprostatic ligament :
(a) it is a condensation of endopevic fascia

(b) it acts as an anchorage point for the prostat anteriorly
(c) it is highly vascular
(d) it may contain view muscle fibers
1.84 The following structures tranversing ischiorectal fossa, except
(a) Superior rectal arteries and nerves-

(b) Inferior rectal and nerves
(c) Pundendal nerves
(d) Internal pudendal nerves
1.85 Which is the main vessel for blood supply to the perineum :
(a) Obturator Artery

(b) Internal pudendal artery
(c) Superior gluteal artery
(d) Inferior gluteal artery
1.86 The following are present between the two layers of broad ligament, except :
(a) Coopers ligament

(b) Round ligament
(c) Ovarian ligament
(d) Uterine and ovarian vessel
1.87 In which week of embrio, the layers charateristic of the adult urethra and bladder can be
recognized :
(a) 8 weeks
(b) 10 weeks
(c) 12 weeks
(d) 14 weeks
1.88 Which surface the bladder mostly covered by the peritoneum ?
(a) Superior
(b) Infra lateral (anterolateral)
(c) Posterior
(d) Neck
1.89 Is which part of the bladder 3 muscle layer can be seperatly indentified :
(a) Superior
(b) Infralateral
(c) Posterior
(d) Neck
1.90 Radiographically in a lateral exposure, ureterovesical segment usually lies :
(a) Opposite upper 1/3 of the pubic bone

(b) Opposite midle 1/3 of the pubic bone
(c) Opposite lower 1/3 of the pubic bone
(d) Below the pubic bone
MATCH THE FOLLOWING
1.91 Rounded elevation of vesical neck (a) Bell’s Muscle
1.92 Interureteric bar (b) Mercier’s bar
1.93 Lateral margins of trigone (c) Lieutaud’s uvula
1.94 Normally, what is the angle of the uretero-vesical insertion :
(a) 300-500
(b) 500-700
(c) 700-900
(d) 900-1350
1.95 From which spinal segment, sympatetic nerve supply to bladder originates :
(a) T19-L1
(b) T11- L2
(c) T12-L3
(d) L1-L4
1.96 From which spinal segment, parasympatetic nerve supply to bladder original :
(a) L5-S1
(b) S1-S7
(c) S2-S4
(d) S3-S7
1.97 In which part of the bladder, sympatetic nerve are richly distributed :
(a) Blandder dome

(b) Right lateral wall
(c) Left lateral wall
(d) Bladder base and proximal
1.98 How many cell layers are present in the transitional epithelium lining the bladder mocusa ?
(a) One
(b) Two
(c) Three
(d) Four
(e) Five
1.99 In which of the following transition epithelium present :
(a) Urinarry bladder

(b) Ureter
(c) Renal pelvis
(d) Uretra
(e) All of above
1.100 There no reflux of urine from the bladder to the ureter during ?
(a) Empty blandder

(b) Full distande blandder
(c) During art of folding
1.101 With bladder distantion urine output drop and the glomerular filtration rate decreses due
to ?
(a) Incrase in resistance at the ureterovesical junction

(b) Neurally mediated vesicurenal response
(c) Humoral factor
1.102 What is the approximate length of the adult male urethra :
(a) 20 cms
(b) 23 cms
(c) 27 cms
(d) 30 cms
1.103 Which is the narrowest part of male urethra :
(a) MUE
(b) Penile
(c) Bulbous
(d) Membranous
(e) Prostatic
1.104 In which part of the male urethra the gland of littre are present :
(a) Fossa navicularis

(b) Pendoulous Bulbous
(c) Membranolis
(d) Prostatic
1.105 In which part of the urethra the ducts of cowper gland open :

(b) Pendulous
(c) Bulbous
(d) Membranous
(e) Prostatic
1.106 Which is the most fixed part of the urethra ?
(a) Pendulous
(b) Bulbous
(c) Membranous
(d) Prostatic
1.107 Approximately, what is the lenght of the prostatic urethra in adults :
(a) 3.5 cms

(b) 5.5 cms
(c) 7.5 cms
(d) 9.5 cms
1.108 Prostatic urethra is lined by which type of epithelium :
(a) Squamous epithelium

(b) Stratified pseudo columnar epithelium
(c) Transitional cell epithelium
(d) Columnar epithelium
1.109 Bulbar and pendoulus urethra are lined by which type of epithelium :
(a) Stratified squamous epithelium

(b) Stratified pseudo columnar epithelium
(c) Transitional cell epithelium
1.110 Fossa naviculari is lined by :
(a) Stratified squamous epithelium

(b) Stratified pseudo – columnar epithelium
(c) Transtional cell epithelium
1.111 What is the relationship of cavernous nerves to the prostate :
(a) Anterolateral
(b) Posterolateral
(c) Anteromedial
(d) Posteromedial
1.112 What is the relationship of cavernous nerve to the membranous ?
(a) Anterior
(b) Posterior
(c) Lateral
(d) Medial
1.113 What is the length of adult female urethra ?
(a) 2 cms
(b) 3 cms
(c) 4 cms
(d) 5 cms
1.114 In which part of the female urethra spincteric mechanism is present :
(a) Proximal urethral segment

(b) Mid urethral segment
(c) Distal urethral segment
(d) Entire lenght
1.115 Which is the mean caliber in girls aged from 5-9 ?
(a) 15 F
(b) 18 F
(c) 21 F
(d) 24 F
1.116 The dartos consists of :
(a) Elastic fibres

(b) Connevtive tissue
(c) Smooth muscle fibres
1.117 There are no connection between the lymphatic of scrotum and testis this statement is :
(a) True
(b) False
1.139 What is the length of normal seminal vesicle ?
(a) 3-4 cms

(b) 4-5 cms
(c) 5-6 cms
(d) 6-7 cms
1.140 What is the width of the normal seminal vesicle ?
(a) 5 mm
(b) 10 mm
(c) 15 mm
(d) 20 mm
1.141 The venous drainage of the semina vesicle terminate in tothe :
(a) Internal iliac vein

(b) External iliac vein
(c) Vesicoprotatic venous plexus
(d) Dorsal vein of the penis
1.142 The arterial blood supply of the seminal vesicle is derived from :
(a) Artery of the

(b) Internal artery
(c) Middle artery
(d) Inferior vesicle artery
1.143 Which is the main artery supplying blood to the seminal vesicle :
(a) Artery of the ductus deferens

(b) Internal iliac artery
(c) Middle recial artery
(d) Inferior vesicle
1.144 As completed to the diameter of the testis and epididymis, the diameter of the gubernacullum
is :
(a) One-fourth
(b) Half
(c) Same
(d) Double
1.145 Cremastic vein draine into:
(a) Internal spermatic vein

(b) Inferior epigastric vein
(c) Internal iliac vein
(d) External iliac vein
1.146 What is the normal diameter of prostatic urethra at the velmontanum ?
(a) 20 Fr
(b) 25 Fr
(c) 30 Fr
(d) 35 Fr
MATCH THE FOLLOWING
1.147 buck’s fascia (a) superficial fascia of the lower abdomen

1.148 dartos fascia (b) deep fascia of the lower abdomen
1.149 scarpa’s fascia (c) superficial fascia of the penis
1.150 gamper’s fascia (d) deep fascia of the penis
2
APPLIED PHYSIOLOGY
2.1 After how many weeks of development, the tubules of the human fetus start functioning :
(a) 7
(b) 9-
(c) 11
(d) 13
2.2 By which week of gestation, the loop of henle is functinal :
(a) 14
(b) 16
(c) 18
(d) 20
2.3 Which of the following is responsible low glomerular filtration rate (GFR) during fetal life :
(a) Smaller percent of cardiac output

(b) High renal vascular resistance
(c) Low filtration fraction
2.4 Around which week of gestation urine production in human kidney is known to begin :
(a) 8-10 weeks

(b) 10-12 weeks-
(c) 12-14 weeks
(d) 14-16 weeks
2.5 The daily lymph volume produced by the normal human kidneys in comparision to the daily
urine output is :
(a) 1/5 th
(b) half
(c) equal
(d) double
2.6 During fetal life, how many percent of the cardiac output is recieved by the kidney in utero :
(a) 1
(b) 2
(c) 3
(d) 4
2.7 How many percent of cardiac output is recieved by the kidney in newborns ?
(a) 13
(b) 15
(c) 17
(d) 19
2.8 The kidneys recieves how many percent of cardiac output in adult :
(a) 10
(b) 20
(c) 30
(d) 40
2.9 What percentage of body’s oxygen kidneys consume ?
(a) 2-4%
(b) 4-6%
(c) 6-8%
(d) 8-19%
2.10 How many ml of oxygen from 100ml of arterial blood do the kidney extract ?
(a) 0.5 ml
(b) 1.0 ml
(c) 1.5 ml
(d) 2.0 ml
2.11 What percentage of the renal blood flow does the renal cortex :
(a) 60%
(b) 70%
(c) 80%
(d) 90%
2.12 The elevation of blood pressure along with hydronephrosis maybe :
(a) Coincidental
(b) From uremia
(c) From retained sodium and water
(d) All of the a bove
2.13 How many tubules are present in the pronephros :
(a) 3
(b) 5
(c) 7
(d) 9
2.14 At about which week of fetal development, the mesonephros develops :
(a) 2
(b) 4
(c) 6
(d) 8
2.15 At which week of fetal life, the metanephros originates :
(a) 2
(b) 4
(c) 6
(d) 8
2.16 As early as in which week of fetal life, the nephrone in the metanephros appear to function :
(a) 8-9 th
(b) 9-10 th
(c) 10-11 th
(d) 11-12 th-
2.17 The loop of henle is present in the :
(a) Cortex
(b) Medulla
(c) Both
2.18 The brush border mucose is present in the :
(a) Proximal convulated tubules

(b) Loop of henic
(c) Distal convoluted tubule
(d) Collecting ducts
2.19 The glomerular capillaries allow filtration of molecule of which diameter :
(a) 5.0 nm
(b) 6.0 nm
(c) 7.0 nm
(d) 8.0 nm
2.20 Which of the following determine the degree of glomerular filtration of a molecule ?
(a) Size
(b) Shape
(c) Charge
2.21 The following are the principal determinants of extracellular fluid osmolality except :
(a) Sodium
(b) Chloride
(c) Potasium
(d) Bicarbonate
2.22 Filtration through the glomerulus is governed by :
(a) Hydrostatic pressure in bowman’s capsule

(b) The diference between the intracapillary pressure and the peritubular oncotic pressure
(c) Constriction of dilatation of afferent and efferent arterioles
2.23 How much glomerular filtrate is formed each minute in normal adult men ?
(a) 100-120 ml
(b) 120-140 ml
(c) 140-160 ml
(d) 160-180 ml
2.24 Approximately, how much glomerular filtrate is formed in 24 hours in normal adult men :
(a) 120 liters

(b) 140 liters
(c) 160 liters
(d) 180 liters
2.25 Approximately, how much glomerular filtrate is reabsorbed in the proximal convulted tubules :
(a) 50%
(b) 60%
(c) 70%
(d) 80%
2.26 In comparison to bowman’s capsule, the filtrate reaching the loop of henle is :
(a) Hypertonic
(b) Isotonic
(c) Hypotonic
2.27 In comparision to bowman’s capsule, the filtrate reaching the distal tubule is :
(a) Hypertonic
(b) Isotonic
(c) Hypotonic
2.28 Which of the following subtance is niether reabsorbed nor secreted into the renal tubule
(a) Saline
(b) Inulin
(c) Glucose
(d) Para amino hippurate (PAH)
2.29 The clearence of creatinine, in comparision to the rate of glomerular filtration is :
(a) More
(b) Same
(c) Less
2.30 What is the normal glomerular filtration rate (GFR) in adults?
(a) 80 ml/mnt
(b) 100 ml/mnt
(c) 120 ml/mnt
(d) 140 ml/mnt
2.31 The following subtance are passivley reabsorbed from the reneal tubules EXCEPT:
(a) Water
(b) Sodium
(c) Urea
(d) Calcium
2.32 The following subtance are secreted by renal tubules EXCEPT :
(a) Penicillins
(b) Salicylates
(c) Inulin
(d) Radiopaque constrat media
2.33 Potassium clearance can exceed inulin clearance because :
(a) More potassium is flitered through the glomerulus

(b) Less potassium is reabsorbed
(c) More inulin is reabsorbed
(d) Potassium is resecreted in the distal tubule
2.34 With the hight rate of sodium excretion that follows high instage of sodium, the potassium
excretion will be :
(a) Low
(b) High
(c) Same
2.35 Aldosterone, which incereases reabsorption of sodium and increases potassium excretion,
mainly acts on the :
(a) Proximal convoluted tubule

(b) Distal convoluted tubule
(c) Loop of henle
2.36 When the hydrogen ion content of the tubular cell is high, as in acidosis, potassium secretion in
to the tubular fluid, will be?
(a) Same
(b) High
(c) Low
2.37 In acid-base regulation, the hydrogen sodium exchange plays a large role in the reabsoption of :
(a) Chloride
(b) Bicarbonate
(c) Potassium
(d) Calcium
2.38 Hydrogen ion secreted into the proximal tubular lumen combines with the bicarbonate ion in
the filtrate to form :
(a) Citric acid

(b) Hydrochloric acid
(c) Carbonic acid
2.39 Ammonia is generated in the cells of the renal tubules by the demination of :
(a) Glutamine
(b) Glycine
(c) Alanine
2.40 What is the PH of the plasma :
(a) 5.4
(b) 6.4
(c) 7.4
(d) 8.4
2.41 What is the minimum PH of the urine ?
(a) 3.4
(b) 4.4
(c) 5.4
(d) 6.4
2.42 Antidiuretic hormone (ADH) is produced in the :
(a) Thalamus
(b) Hypothalamus
(c) Pituitary
(d) Kidney
2.43 The antidiuretic hormone (ADH) acts on :

(b) Loop of henele
(c) Distal convulated tubule and collecting ducts
2.44 How many percent of weight loss occurs to the kidneys between 4th and 8th decade of life ?
(a) 5
(b) 10
(c) 15
(d) Over 20
2.45 By which age, GFR reach adult level :
(a) 6 months
(b) 12 months
(c) 18 months
(d) 24 months
2.46 What is the value of the fractional excretion of sodium FENA% in acute renal failure of a
prerenal etiology ?
(a) Less than 1 percent

(b) 2 percent
(c) 3 percent
(d) 4 percent
2.47 Which segment of nephron is impermeable to water ?

(b) Descending limb of loop henle
(c) Ascending limb of loop of henle
(d) Distal convoluted tubule
2.48 Approximately, what is the normal filtered load of HCO3 in meg/day :
(a) 3500
(b) 4000
(c) 4500
(d) 5000
2.49 How many percent of filtered HCO, appear in the final urine ?
(a) Less than 0,1 percent

(b) 0,5 percent
(c) 0,8 percent
(d) 1,0 percent
2.50 Approximately how many percent of filtered HCO3, is reabsorped by the proximal tubule :
(a) 75
(b) 80
(c) 85
(d) 90
2.51 In which part of the nephron, most of the NET acid excretion occurs :

(b) Loop of henle
2.52 How many percent of plasma potassium undergo glomerular filtration ?
(a) 75
(b) 80
(c) 85
(d) More than 90
2.53 Ultrafiltrate calcium represents how many percent of total calcium :
(a) 50
(b) 60-
(c) 70
(d) 80
2.54 How many percent of filtered calcium is subsequently reabsorbped by tubules ?
(a) 92-94
(b) 94-96
(c) 96-98
(d) 98-100
2.55 Calcium absorption is stimulated by PTH in the following parts of the nephron EXCEPT :

(b) Loop of henle
2.56 In which part of the nephron frusemide inhibits calcium reabsoption :

(b) Loop of henle
(d) Colleting ducts
2.57 In which part of the nephron, chorthiazide stimulates calcium reabsoption :

(b) Loop of henle
2.58 The following factors stimulates calcium reabsorption between the late proximal tubule and
early distal convoluted tubules EXCEPTS :
(a) Hypocalcemia
(b) Metabolic alkalosis
(c) Vitamin d
(d) Phosphate loading
(e) Hypermagnesemia
2.59 How many percent of filtered phosphate is reabsoped ?
(a) 50-67
(b) 60-77
(c) 70-87
(d) 80-97-
2.60 With low purine diet, approximately what is the daily uric acid production from the endogenous
source ?
(a) 400 mgs

(b) 500 mgs
(c) 600 mgs
(d) 700 mgs
2.61 What percent of the filtered citrate load is excreated in men ?
(a) 10-35-
(b) 20-45
(c) 30-55
(d) 40-65
2.62 The following decreases citrate excretion EXCEPT :
(a) Metabolic alkalosis

(b) Metabolic acidosis
(c) Distal renal tubular acidosis
(d) Administration of acetazolamide
2.63 Which of the following hormone is not with cell membrane receptor ?
(a) Catecholamines
(b) Aldosterone
(c) Antidiuretic
(d) Parathyroid
2.64 Which of the following statement is WRONG about Prostaglandins ?
(a) It is a lipid which arises from the renal medulla

(b) It causes peripheral vasodilatation
(c) It decreases sodium excretion
(d) It plays a role in both regulation of blood pressure and sodium excretion
2.65 Frusemide acts directly on the :

(b) Ascending limb of the loop of henle
(c) Descending limb of the loop of henle
2.66 Which is the source of erythropoietin production in the body ?
(a) Kidney
(b) Ulterine myomas
(c) Cerebellar hemangioblastomas
2.67 Kidney is the site of synthesis of the following hormones EXCEPT :
(a) Erythropoietin
(b) 1.25 dihydroxyvitamin D
(c) Renin
(d) Insulin
2.68 During fetal life, which is the site of production of erythropoietin :
(a) Kidney
(b) Liver
(c) Spleen
(d) Lungs
2.69 Which is the primary mechanism of anaemia in patients with chronic renal disease ?
(a) Erythropoietin deficiency

(b) Bone marrow depression
(c) Chronic blood loss
(d) Lungs
2.70 When should erythropoietin be given to patient on dialysis and treatment with
erythropoientin?
(a) One day before dialysis

(b) Immediately before dialysis
(c) During the dialysis
(d) At the end of dialysis
2.71 Which is the major adverse event in patients with chronic renal failure recieving recombinant
human erythropoietin ?
(a) Allergic reactions

(b) Changes in WBC or platelet count
(c) Elevated blood pressure
(d) Electrocardiographic abnormalities
2.72 In which of the following ,increases renal production of erythropoietin can occour :
(a) Renal artery stenosis

(b) Hydronephrosis
(c) Renal cysts
2.73 Which of the following factors influence the biosynthesis and secretion of renin from kidney ?
(a) Renal perfusion pressure (intrarenal beroreceptor)

(b) Adrenergic nervous system
(c) Delivery of sodium to the macula densa (distal tubule)
(d) Atrial natriuretic factor
2.74 How many percent of renal kallikrein is found in the contex ?
(a) 60
(b) 70
(c) 80
(d) More than 90
2.75 The renal kalikrein kinin system can stimulate which of the following :
(a) Renal anglotensin sytem

(b) Prostaglandin system
(c) Both of them
(d) None of them
2.76 Approximately, what is the resting or baseline ureteral pressure:
(a) 0-5 cm H2 O
(b) 5-10 cm H2 O
(c) 10-15 cm H2 O
(d) 15-20 cm H2 O
2.77 Megaureter can be produced by :
(a) Normal ureteral pressure

(b) Sudden elevation of ureteral pressure
(c) Sustained elevation of ureteral pressure
(d) Sustained low ureteral pressure
2.78 Which of the following drugs have no effect on ureteral pressure complexes ?
(a) Epinephrine. Ephedrine

(b) Atropine
(c) Neostigmine
(d) Urecholine
2.79 Which of the following can cause impediment of efficient bolus transfer across the UVJ into the
bladder ?
(a) When there is an obstruction at the UVJ

(b) When intravesical pressure is excessive
(c) When flow rates are so high to exceed the transport capacity of the normal UVJ
2.80 On which of the following, effect of obstruction on the ureteral function is dependent
(a) Degree and duration of obstruction

(b) On the rate of urine flow
(c) On the presence or absence of infection
2.81 What are the factors which have been implicated in the development of vesicoureteral reflux?
(a) Anatomic and functional abnormalities at the UVJ

(b) Inordinately high intravesical pressures
(c) Impaired ureteral function
2.82 At what time first pathologic change are noted in the glomerulus after complete ureteral
obstruction :
(a) 7 days
(b) 14 days
(c) 21 days
(d) 28 days
2.83 At what time proliferation of the medullary interstitial cells is noted after complete ureteral
obstruction :
(a) 5 th day
(b) 7 th day
(c) 9 th day
(d) 11 th day
2.84 By which route, most of the fluid exits from the renal pelvis in hydronephrosis with low
pressure :
(a) Extravasation in to the perirenal space

(b) Pyelovenous backflow
(c) Pyelolymphatic backflow
(d) Pyelotubular backflow
2.85 Which of the following changes occur by the continous high protein intake ?
(a) Nephron hyperperfusion

(b) Hyperfiltration
(c) Both of them
(d) None of them
2.86 Which is the most accurate method of predicting the recovery potential of a hydronephrotic
kidney ?
(a) Intravenous urogram

(b) 99 Tc-DMSA scan
(c) 99 Tc DPTA scan
(d) Temporary relief of the obstruction by nephrostomy followed by test measuring renal
finction
2.87 Which of the following is not affected in the obstructed kidney ?
(a) Glomerular filtration

(b) Renal blood flow
(c) Hydrogen ion clearance
(d) Urinary dilution
2.88 Following are the changes in the obstructed kidney EXCEPT :
(a) Reduction in glomerular filtration

(b) Reduction in renal blood flow
(c) Impairement of acidification
(d) Reduction in urinary dilution
2.89 Which of the following is damaged last in a completely obstructed kidney ?
(a) Distal convoluted tubule

(b) Loop of henle
(c) Proximal convoluted tubule
(d) Glomerulus
2.90 Which of the following has slightly higher pressure ?
(a) Renal pelvis

(b) Intraperitoneal
(c) Bladder
(d) Extraperitoneal
2.91 What is the renal pressure measured with percutaneous puncture in a normal antidiuretic
patient ?
(a) 5.5 mm Hg
(b) 6.5 mm Hg
(c) 7.5 mm Hg
(d) 8.5 mm Hg
2.92 Which of the following determine effects of ureteral obstruction on renal function ?
(a) Severity
(b) Duration
(c) Totality
(d) Infection
2.93 The post obstructive diuresis is due to :
(a) Impaired sodium reabsorption

(b) Impaired urine concentrating ability
(c) Solute diuresis due to retained urea or administered glucose
2.94 How many percent of the output should be replaced in post obstrctive diuresis ?
(a) 50-60 percent

(b) 60-70 percent
(c) 70-80 percent
(d) 80-90 percent
2.95 Which fluid is preferred for replacement in post obstructive diuresis ?
(a) 5% dextropse
(b) 0.5% normal saline
(c) Ringer’s Lactate
(d) B&C
2.96 Which is the site of leakage in spontaneus extravasation following ureteral obstruction ?
(a) Ureter
(b) Pelvis
(c) Calyx
(d) Fernix
2.97 The osmolality of the stored urine remains :
(a) Same
(b) Low
(c) High
2.98 Which of the following stimulates renal growh ?
(a) Partial nephrectomy

(b) Protein ingestion. High sodium intake or low potassium
(c) Ingestion of folic acid. Thyroxin testosterone growth hormone. Corticoids.
2.99 With the loss of renal tissue. The compensating growth of the remaining tissue is mostly by ?
(a) Hypertrophy
(b) Hyperplasia
(c) None of the above
(d) Both of the above
2.100 The following occur in compensatory renal growth by hypertrophy EXCEPT :
(a) Cytoplasmic enlargement

(b) Increase in the ratio of RNA and protein to DNA
(c) Glomeruli increase in number
(d) Glomeruli increase insize
(e) Blood vessels increase in calibre
2.101 In which of the following a greater degree of hydronephrotic parenchymal atrophy will occur :
(a) If renal blood flow is decreased

(b) If renal venous outflow is restricted
(c) If posteropr branch of the renal artery is ligated
2.102 In a patient with one normal functioning hypertrophied kidney and other obstructed poorly
functioning kidney, after realease of obstruction. Funtion in the obstructed kidney will be :
(a) Increased
(b) Decreased
(c) Unchanged
3
URORADIOLOGY
3.1 What frequency of the sound is referred as ultrasound ?
(a) Less than 5 kHz

(b) 5-10 kHz
(c) 10-15 kHz
(d) More than 20 kHz
3.2 What is the average speed of sound when it passes through tissues ?
(a) 1540 meters/seconds

(b) 1640 meters/seconds
(c) 1740 meters/seconds
(d) 1840 meters/seconds
3.3 After 20 weeks of gestation, in how many percent of cases, ultrasound examination is accurate in
determining the gender of the fetus :
(a) 60 percent
(b) 70 percent
(c) 80 percent
(d) 90 percent
3.4 At 15 week of gestation, in how many percent of cases. Ultrasound examination is accurate in
determining the gender of the fetus :
(a) 60 percent
(b) 70 percent
(c) 80 percent
(d) 90 percent
3.5 Which zone of the prostate is less distinct sonographically ?
(a) Transitione zone

(b) Central zone
(c) Peripheral zone
(d) Anterior fibromuscular stroma
3.6 In which zone of the prostate, sonographically “beak sign” is present :
(a) Transition zone

(b) Central zone
(c) Peripheral zone
(d) Anterior fibromuscular stroma
3.7 A hypoechoic lesion of which size is less likely to be prostatic cancer :
(a) Smaller than 4-5 mm

(b) 5-10 mm
(c) 10-15 mm
(d) 15-20 mm
3.8 On which of the following, the positive predictive value (PPV) for cancer of a hypoechoic lesion in
the peripheral zone depends upon :
(a) Size of the lesion on ultrasound

(b) Result of digital rectal examnation
(c) Serum levels of PSA
3.9 Which transabdominal probe can produce acceptable sonogram of the kidney ?
(a) 3.5 Mhz

(b) 5.0 Mhz
(c) 7.0 Mhz
(d) A and B
3.10 Which transrectal probe is recomended for sonography of the prostate ?
(a) 3.5 Mhz

(b) 5.0 Mhz
(c) 7.5 Mhz
Match echogenic pattern of the kidney
3.11 Outer cortex (a) Hyperechoic

3.12 Renal pyramid (b) Homogenous
3.13 Pelvicalyceal sinus fat (c) Hypoechoic
3.14 Which is the most frequently encountered artifact simulating carcinoma prostate on transrectal
ultrasound ?
(a) Hematoma
(b) Abscess
(c) Granulomas
(d) Calculus
3.15 Which probe can be used for ultrasound of the scrotum ?
(a) 5 Mhz
(b) 7.5 Mhz
(c) 10 Mhz
3.16 What is the echogenic pattern in majority of the testicular tumours ?
(a) Isoechoic
(b) Hypoechoic
(c) Hyperechoic
(d) A and C
3.17 Which approach can image the bladder by ultrasonography ?
(a) Suprapubic
(b) Transurethral
(c) Transrectal
(d) A and B
3.18 For evaluation of stricuture urethra, ultasonography has following advantages over radiography
EXCEPT :
(a) Indentify lumen of the urethra and stricture

(b) Provide three dimentional imaging
(c) Measure the rigid fibrotic periurethral scar
(d) No irradiation to testicles
3.19 What is the average adult dose of iodine per pound body weight for excretary urography :
(a) 150 mgs

(b) 200 mgs
(c) 250 mgs
(d) 300 mgs
3.20 Following are haemodynamic changes following contrast injection EXCEPT :
(a) Trasnlent hypotension

(b) Peripheral vasodilation
(c) Increased pulmonary artery pressure
(d) Bradycardia
3.21 Approximately, what is the plasma half life of contrast agents, following bolus injection :
(a) 10 mnts
(b) 20 mnts
(c) 30 mnts
(d) 40 mnts
3.22 During intravenous urography, renal tomography significantly increased the recognition of the
following EXCEPT :
(a) Renal masses

(b) Fine renal clacifications
(c) Pelvicalyceal system
(d) Paranephric structures
3.23 During intravenous urography, erect film provide optimal view for the demonstration of the
following EXCEPT :
(a) Renal ptosis

(b) Bladder tumours
(c) Bladder hernias
(d) Cystocele
3.24 Which is the most accurate method for bladder volume measurement ?
(a) Clinical assesment by palpation and percussion

(b) Urethral catheterization
(c) Post void film of excretary urography
(d) Bladder ultrasonography
3.25 Nephrogram is the uroradiographic image of :
(a) Renal capsule

(b) Renal parenchyma
(c) Minor calyces
(d) Major calyces and pelvis
3.26 Which is the basic mechanism to produce a nephrogram ?
(a) Appearance of constrast in the renal vessels and glomeruli

(b) Filtration at the glomeruli
(c) Concentration in the proximal convoluted tubule due to tubular absorption of water
(d) Concentration in the collecting ducts
3.27 Which of the following statement about nephrogram is FALSE ?
(a) Absolute density of nephprogram corelates well with the clinical measure of renal function
(b) Intensity of nephrogram is propotional to the adminitered dose of contrast
(c) Intensity of nephrogram is unaffected by the state of hydration of the patient
(d) Density of nephrogram is due the contrast in intratubular space
3.28 How much time is required for a normal cortical nephrogram to appear after bolus injection of
contrast agent ?
(a) Within 20 seconds

(b) 20-30 seconds
(c) 30-40 seconds
(d) 40-50 seconds
3.29 Which of the following is diagnostic of “Rim sign” in a nephrogram ?
(a) Pyelonephritis
(b) Severe hydronephrosis
(c) Hypernephroma
(d) Polycystic kidney
3.30 A dense persistent nephrogram may be seen in all of the following EXCEPT :
(a) Acute ureteral obstrution

(b) Severe hydronephrosis
(c) Systemic hypertension
(d) Renal vein thrombosis
3.31 How much time is recquired for the constrast material to visible in the calyces after injection ?
(a) 2 mnts
(b) 3 mnts
(c) 4 mnts
(d) 5 mnts
3.32 How many times the contrast material is concentrated during its transit from the nephron to
produce a relatively dense pylogram ?
(a) 20 times
(b) 30 times
(c) 40 times
(d) 50 times
3.33 Which term is appropriete for a kidney that fails to excrete radiographically detectable amounts
of contrast agent in to its collecting system ?
(a) Nonvisualizing
(b) Nonfuntioning
(c) Nonexcreting
(d) Nonexcisting
3.34 “Goblet sign” is diagnostic of :
(a) Unc acid stone

(b) Trasitional cell tumour on a stalk
(c) Fungal ball
(d) Blood clot
3.35 The following patients are prone to intratubular block and renal shutdown when dehydrated
during urography EXCEPT :
(a) Multiple myeloma

(b) Hyperuricemia
(c) Patients recieving poorly soluble sulfa drugs
(d) Patients having single kidney
3.36 Which is the main indication of voiding cystourethrogram in children ?
(a) Pain on micturition

(b) Thin stream
(c) Dribbling
(d) Urinary tract infection
3.37 Which is the most common type of seminal vesicle invasion ?
(a) Extension along with the ejaculatory ducts

(b) Penetration through the capsul
(c) Micrometastasis without direct connection
(d) Lymphatic invasion
3.38 What are the indications of seminal vesiculography ?
(a) Male infertility

(b) Suspicion of a congenital anomaly
(c) Constat genital infection
(d) Palpaple abnormality of seminal vesicles
3.39 Which is the investigation of choice for the estimation of seminal vesicle volume ?
(a) Seminal vesiculography

(b) Transrectal ultrasonography
(c) Intravenous urography
(d) Micturating cystourethrography
3.40 What is the echogenicity of the kidney in comparision to the liver after neonatal period?
(a) Same
(b) More
(c) Less
3.41 The following are the sonographic criteria for a simple renal cyst EXCEPT :
(a) Absence of internal echoes

(b) Smooth and well defined walls
(c) Poor sound transmission
(d) Round or oval shape
(e) Acoustic shadow arising from the edges of the cyst
3.42 Bilateral increase in the echodensity of the cortex with preservation of corticomedullary
definition occurs in the following conditions EXCEPT :
(a) Medical renal disease

(b) Autosomal recessive (Infantile) polycystic kidney disease
(c) Infiltrative disease-Amyloaidosis and leukemia
(d) Disease cause cortical nephrocalcinosis
3.43 Which of the following condition ultimately lead to increased echos in both cortex and medulla
?
(a) Chornic Glomerulonephritis
(b) Alport’s disease
(c) Renal corical necrosis
(d) Oxalosis
3.44 Unilateral global increase in cortical echogenicity with loss of corticomedulary definition in a
patient with acute symptoms leads to the differential diagnosis of the following EXCEPT :
(a) Acute renal vein thrombosis

(b) Acute pyelonephritis
(c) Acute glomerulonephritis
(d) Renal infraction
3.45 Unilateral global increase in cortical echogenicity with loss of corticomedulary definition in a
patient without acute symptoms leads to a differential diagnosis of the following EXCEPT :
(a) Infiltrative tumours

(b) Xanthogranulomatous pyelonephritis
(c) Malacoplakia
(d) Chronic glomerulonephritis
3.46 Which is the route of excretion of modern contrast agent like diatrozoate ?
(a) Glomerular filtration

(b) Tubular secretion
(c) Both of them
(d) None of them
3.47 Which is the most important nucleus in MRI ?
(a) Phosphorus
(b) Hydrogen
(c) Sodium
(d) Calcium
3.48 Which solid organ in the abdomen has the highest signal density ?
(a) Liver
(b) Spicen
(c) Pancreas
(d) Kidney
3.49 CT scan is useful in the diagnosis of the following EXCEPT :
(a) Acute focal bacterial nephritis

(b) Pyonephrosis USG
(c) Renal abscesses
(d) Perirenal abscesses
3.50 The following are the CT criteria for a simple renal cyst EXCEPT :
(a) Sharp, thin, distinct, smooth walls and margins

(b) Spherical or ovoid shape
(c) Hornogenous content
(d) The density range from 30-40 Hounsfield
(e) No enhancement after the intravenous injection of contrast medium
3.51 Which of the following on CT or Ultrasound suspects the diagnonsis complicated renal cyst?
(a) Thick wall

(b) Calcification
(c) Septation
(d) Non homogenous or hyperdense fluid or fluid with internal echoes
3.52 What is the average radiodensity of TCC of upper urinary tracts on CT scan ?
(a) 36 Hounsfield units

(b) 41 Hounsfield units
(c) 46 Hounsfield units
(d) 51 Hounsfield units
In relation to the differential diagnosis of radiolucent filling defect in the renal pelvis,
Match the Following
Lesion Density on CT scan

(Hounsfield (HU) (Units)
3.53 Uric acid stone (a) 30-55

3.54 Calcium uralate stone (b) 20-40
3.55 Transitional cell tumours (c) More than 500
3.56 Blood clot (d) 30-40
3.57 Papilla or fungal ball (e) More than 300
4
CLINICAL UROLOGY
4.1 Low power microscopic urine analysis is specifically diagnostic of the following EXCEPT :
(a) Bacteria
(b) Red blood cell casts
(c) Trichomonods
(d) Cystine crystals
4.2 In high power microscopic urine analysis, each bacterium seen per hpf signifies a bacterial count
of:
(a) Less than 5.000/ml

(b) Between 5.000-10.000/ml
(c) Between 10.000-20.000/ml
(d) More than 20.000/ml
4.3 Which of the following cast on urine analysis do not have pathologic significance ?
(a) Hyaline cast

(b) Granular cast
(c) Red cell cast
(d) Waxy cast
4.4 Which of the following is more reactive to dipstick reagents ?
(a) Albumin
(b) Globulin
(c) Bence-Jones proiens
(d) Mucoprotiens
4.5 The urinary dipstick for blood measures the following EXCEPT :
(a) Intact erythrocytes

(b) Free hemoglobin from lysed erythrocytes
(c) Myoglobin
(d) Leucocytes
4.6 In which part of the coverslip, in low power microsopic urine analysis, cast and other elements
tend to concentrate:
(a) Centre
(b) Between the edge and centre
(c) Edge
(d) Any part
4.7 Dipstick urine alaysis by oxidase peroxidase reaction is specific for :
(a) Fructose
(b) Glucose
(c) Lactose
(d) Galactose
4.8 Which of the following is identified by detection of nitrit in urine(Griess test) ?
(a) Ketones
(b) Bilirubin
(c) Bacteria
(d) Prodens
4.9 How many leucocytes per hpf accepted as the cut of level for significant piuria?
(a) One
(b) Two
(c) Three
(d) Four
(e) Five
4.10 Pseudohematuria can occur due to the following EXCEPT :
(a) Pyridium
(b) Beets. Vegetable dyes
(c) R.B.C.
(d) Porphyria
4.11 What is often accepted as the upper limit of normal for 24 hours urinary protein excretion in
healthy adults ?
(a) 50 mgs
(b) 150 mgs
(c) 200 mgs
(d) 250 mgs
4.12 Which of the following statement is WRONG regarding 3 percent sulfosalicylic acid test for
detection of urinary protiens?
(a) Accuracy and sensitivity is greater than the dipstick method

(b) It cannot detect bence jones proteins
(c) It can detect albumin
(d) It can determine the presence or absence of significant protelnuria
4.13 Which is the microscopic appearance of ureteral epithelial cell under high power field?
(a) ‘Diamond’ shaped

(b) ‘Envelop’ shaped
(c) ‘Star like’ appearance
(d) ‘Kite like’ appearance
4.14 How many percent of newborn void during the first day of life ?
(a) 70 percent
(b) 80 percent
(c) 90 percent
(d) 100 percent
4.15 Which is the commonest cause of neonatal ascities ?
(a) Congenital megacystis

(b) Bladder trauma
(c) Posterior urethral valves
(d) Pulsion diverticula of the bladder
4.16 The following conditions are associated with oligohidramnion EXCEPT:
(a) Severe obstructive uropathy

(b) Prune-Belly syndrome
(c) Neonatal ovarian cyst
(d) Renal agenesis
4.17 Which symptom leading to urologic surgery neonates in recquire immediate evaluation ?
(a) Abdominal mass

(b) Haematuria
(c) Hypertension
(d) Abnormal micturition
4.18 Which is the most common cause of neonatal abdominal mass ?
(a) Hydronephrosis
(b) Renal tumour
(c) Neuroblastoma
(d) Hydromentrocolpos
4.19 What is the means sistolic blood pressure at birth ?
(a) 76 ± 10 mm Hg
(b) 86 ± 10 mm Hg
(c) 96 ± 10 mm Hg
(d) 106 ± 10 mm Hg
4.20 Which is the most common cause of firm enlargement of the testis in neonates ?
(a) Torsion of the spermatic cord

(b) Epididymitis
(c) Orchitis
(d) Testicular tumour
4.21 Which is the most commonly found fluid in neonatal ascites ?
(a) Blood
(b) Urine
(c) Chyle
(d) Bile
4.22 Which is the most likely diagnosis in a child with ambiguous genitalia who have no gonads and
46 XX karyotype ?
(a) Female pseudohermaphroditism

(b) True hermaphroditism
(c) Male pseudohermaproditism
(d) Mixed gonadal dysgenesis
4.23 Which is the most likely diagnosis in a child with ambiguous genitalia who have 2
palpable gonads and 46 XY karotype ?
(a) Female pseudohermaphroditism

(b) Male pseudohermaphroditism
(c) True hermaphroditism
(d) Mixed gonadal dysgenesis
4.24 Which is the most likely diagnosis in child with ambigious genitalia who have one
palpable gonad and 46 xx karyotype ?
(a) female pseudohermaphroditism

(b) male pseudohermaphroditism
(c) true hermaphroditism
(d) mixed gonadal dysgenesis
4.25 Which is the most likely diagnosis in a child with ambiguous genitalia who have one palpable
gonad and 45 X / 46 XY or 46 XY karyotype ?
(a) female pseudohermaphroditism

(b) male pseudohermaphroditism
(c) true hermaphroditism
(d) mixed gonadal dysgenesis
4.26 What are the symptoms of abnormally located ectopic ureter orifice within bladder ?
(a) Incontinence of urine

(b) Recurrent UTI
(c) Dysuria
(d) No symptom
4.27 Which is the common cause of hematospermia ?
(a) Non spesific inflamation of prostat or seminal vesicle

(b) Tubercolosis of the prostate
(c) Adenocarcinoma of the prostate
(d) Transition cell carcinoma of the prostate
4.28 Which of the following is a rare cause of the pneumaturia:
(a) Diverticulitis
(b) Carcinoma of the sigmoid colon
(c) Regional enteritis
(d) Diabetes mellitus with gas forming infections
4.29 Which is the common cause of thick profused and yellow to gray purulent urethral
discharge ?
(a) Nonspecific urethritis

(b) Gonococcal urethritis
(c) Carcinoma urethra
(d) Nongonococcal urethritis
4.30 In which of the following, the normal size left kidney is paplable :
(a) Chidren
(b) Thin women
(c) Men
4.31 Which is the most common cause of priapism ?
(a) Sickle cell disease

(b) Advanced malignancy
(c) Coagulation disorders
(d) Pulmonary disease
4.32 In which age group, torsion of the testis usually occurs :
(a) Around puberty

(b) 20-25 years
(c) 25-30 years
(d) 30-35 years
4.33 In which of the following retroperitoneal tumor can be cause for varicocel :
(a) A sudden onset of a varicocele

(b) Right sided varicocele
(c) A varicocele which does not reduce in size in supine position
4.34 Which of the following not advice in the treatment of acute prostatitis ?
(a) Antibiotics
(b) Anti inflammatory drugs
(c) Sitz bath
(d) Rectal massage of the prostate
4.35 A cystic swelling along the posterior surface of the bladder can be :
(a) Wolffian duct remnants

(b) Mullerian duct remnants
(c) Prostatic cysts
4.36 Calcification of the vas is a pathognomonic sign of :
(a) Old age

(b) DM
(c) Hypercalciuria
(d) Hypertension
4.37 Which of the following are characteristic of the nephrotic syndrome ?
(a) Increased permeability of the glomerular basement membrane to albumin an IgG

(b) Increased serum concentration of 2 globulin
(c) Marked reduction sodium excretion in the urine
4.38 Which statement concerning acute renal failure is NOT true ?
(a) Diagnosis is based simply on presence of anuria or oligouria (urine volume 1800
cc/m2/24hrs)
(b) If patient is well hydrated, use of diuretic such as frusemide may be indicated
(c) Endogenous catabolism may be minimised by provision of at lest 30 calories/m2/day
(d) Intravenous fluids should include glucose, sodium and vitamins
(e) Inability to correct acidosisi or hyperkalemia by other methods are indications for dialysis
4.39 Which is the most impartant primary tubulus interstitial disease cause acute renal failure?
(a) A cute interstitial nephritis

(b) Acute tubular necrosis
(c) Pyelonephritis
(d) Nephrolithiasis
(e) Radiation nephritis
4.40 Which drug is most commonly associated with acute interstitial nephritis ?
(a) Penicillins
(b) Cephalosporines
(c) Trimethoprim
(d) Rifampicin
4.41 Which is the most common and most dangerous electrolyte abnormality seen with acute renal
failure ?
(a) Hyperkalemia
(b) Hypermagnesemia
(c) Hyperphosphaternia
(d) Hypercalcemia
4.42 Generally, proteinuria exceeding how many gm/day (normalized per 1.73 m2 body surface
area) suggest glomerular cause of chronic renal failure:
(a) 1.5 gm/day

(b) 2.5 gm/day
(c) 3.5 gm/day
(d) 4.5 gm/day
4.43 Which is the most common cause of acquired arteriovenous fistula ?
(a) Percutaneus needle biopsy

(b) Perietrating or blunt abdominai trauma
(c) Partial nephrectomy
(d) Nephrolithotomy
(e) Tumour
4.44 Which is the definitive diagnose study for arteriovenous fistula ?
(a) Intravenous urography

(b) Radionuclide angiography
(c) Doppler ultrasound
(d) Contrast angiography
4.45 What is the maximum level of protiens in mg/m2 of body surface area per day in normal urine in
small chlidren ?
(a) 80
(b) 100
(c) 120
(d) 140
4.46 Following are the common glomerular disease cause chronic renal failure EXCEPT :
(a) Minimal changed disease

(b) Focal segmental glomerulasclerosis
(c) Rapidly progressive glomerulonephritis
(d) Chronic glomerulonephritis
4.47 Anuria refers to the excretion of how many ml of urine in 24 hours :
(a) Less than 100 ml

(b) 100-200 ml
(c) 200-300 ml
(d) 300-400 ml
4.48 What should be the daily urine output cases of chronic renal failure :
(a) 1000-1500 ml/day

(b) 1500-2000 ml/day
(c) 2500-3000 ml/day
(d) 3500-4200 ml/day
4.49 Which is the investigation of choice for assesing the iron stone of patients with chronic renal
failure ?
(a) Measurement of serum iron

(b) Measurement of iron binding capacity of plasma
(c) Estimation of bone marrow for stainable iron
(d) Examination of peripheral blood smear
4.50 What is the treatment of choice for the management of anaemia of chronic renal failure ?
(a) Oral iron therapy

(b) Transfusion of packed fresh washed red cells
(c) Androgen therapy
(d) Intrasuscular iron
4.51 In which of the following group of patients, renal osteodistrophy will occur in chronic renal
failure :
(a) Treated with conservative therapy

(b) Treated with periotoneal dialysis
(c) Treated with haemodilysis
4.52 Which is major contribution cause of renal osteodystrophy ?
(a) Diminurion in 1.25DHCC

(b) Increae in serum phosphate
(c) Decrease in serum calcium
(d) Increase in serum potassium
4.53 The following decline with aging EXCEPT :
(a) Ladder capacity

(b) Bladder contractility
(c) Ability to postpone voiding
(d) Urine flow rate
4.54 Which is the leading cause of incontinence in older individuals?
(a) Detrusor overactivity

(b) Detrusor underactivity
(c) Outlet incompetence
(d) Outlet obstruction
4.55 Which is the leading cause of incontinence in middle age women ?
(a) Detrusor overactivity

(b) Detrusor underactivity
(c) Outlet incompetence
(d) Outlet obstruction
4.56 A patient with a history of cardiovascular and cerebrovascular disease developed prolonged
erection following intracavernous injection therapy. He came back for treatment within 6
hours. Which is the safest mode of therapy for him :
(a) Aspiration of corpora cavernosum

(b) Intra cavernous injection of alpha adrenergic agent
(c) Aspirin + intracavernous injection of alpha adrenergic agent
(d) Sub cutaneous injection of alpha adrenergic agents
4.57 A 25 years man developed erection during scrub prepration under spinal anaesthesia. Which is
the most effective treatment :
(a) Induction of general anaesthesia

(b) Use of heta blockers
(c) Use of ketamine
(d) Intravenus injection of dilution alpha adrenergic agent
4.58 Which of the following are NOT found on glans penis ?
(a) Acquired inclusion cyst

(b) Retention cyst
(c) Sebaceous gland
(d) Angiomas
5
CONGENITAL ANOMALIES AND PAEDIATRIC UROLOGY
5.1 Which is the most important facial feature in “potter’s syndrome “ ?
(a) Blunted nose

(b) Prominent fold of skin over each eye
(c) Low set ears
(d) Depression between lower lip and chin
5.2 Potter’s syndrome comprises of the following EXCEPT :
(a) Characteristic potter’s facies

(b) Pulmonary hypoplasia
(c) Adenoma sebaceum
(d) Amnion nodosum
(e) Renal anomalies
5.3 Following investigations help in the diagnosis of bilateral renal agenesis EXCEPT :
(a) Excretary urography

(b) Ultrasonography
(c) Renal scan
(d) Umblical artery catheterization and aortogram
(e) Retrograde pyelography
5.4 In which system the most commonly associated anomalies accur in unilateral renal agenesis :
(a) Genital
(b) CVS
(c) Musculoskeletal
(d) Respiratory
5.5 The following syndromes are associated with unilateral agenesisi EXCEPT :
(a) Tuener’s syndrome

(b) Polland’s syndrome
(c) VATER syndrome
(d) Potter’s syndrome
5.6 All of the following are true about supernumerary kidney EXCEPT :
(a) Its true accessory organ

(b) It has a separate blood supply
(c) It has a separate collecting system
(d) It is surrounded by the same capsule along with the normal kidney
(e) It is quite often hydronephrotc
5.7 The following are features of cephalad renal ectopia EXCEPT :
(a) Associated un cases with omphalad renal ectopia

(b) They are present above the diaphragm
(c) They are present at the level of 10 th thoracic vertebra
(d) The origin of the renal aftery is mor ecephalad than normal
5.8 Which is the most common site of a thoracic kidney ?
(a) Posterior mediastinum

(b) Middle mediastinum mediastinum
(c) Anterior mediastinum
(d) Superior mediastinum
5.9 The vascular pedicle and ureter of the intrathoracic kidney enters the thorax through :
(a) Foreman of Morgagni

(b) Oesophageal hiatus
(c) Foramen of Bochdalek
(d) Aorta hiatus
(e) Hiatus for the venacava
5.10 The following facts points to an ectopic kidney EXCEPT :
(a) Short ureter

(b) Level of the kidney below L2-L3
(c) Ectopic renal arteries
(d) Malrotation tends to point to a ptotic kidney rather than ectopic kidney
5.11 Which is the most clearly seen part in a pelvic kidney on IVP ?
(a) Ureter
(b) Pelvis
(c) Calyces
(d) Nephrogram
5.12 How many percent of the crossed ectopic kidneys are fused to their ipsilateral mate ?
(a) 60 percent
(b) 70 percent
(c) 80 percent
(d) 90 percent
5.13 The following facts about crossed renal ectopia are true EXCEPT :
(a) 90% of crossed ectopic kidneys are fused to the ipsilateral kidney of that side
(b) Unilaterally fused kidney with inferior ectopic is the least common
(c) Male : female : 2:1
(d) Left to right ectopia is 3 times more common than right to left
5.14 Which is the most common crossed renal ectopia ?
(a) Sigmoid kidney

(b) Crossed renal ectopia with superior fusion
(c) Crossed renal ectopia with inferior fusion
(d) Dishaped kidney
(e) Crossed ectopia without fusion
5.15 Which is the rarest from of crossed ectopic kidneys ?
(a) Crossed renal ectopia with fusion

(b) Crossed renal ectopia without fusion
(c) Bilateral crossed renal ectopia
(d) Solitary crossed renal ectopia
5.16 In the embryo, before renal ascent , the renal pelvis faces :
(a) Posteriorly
(b) Medially
(c) Laterally
(d) Anteriorly
5.17 The following facts are true about horse shoe kidney EXCEPT :
(a) In 60% patient the kidneys join at the lower pole

(b) The kineys tend to be lower than normal
(c) The pelves and ureters are anteriorly placed
(d) The ureter has a high pelvic insertion
(e) Abnormally accurs after 4-6 weeks of gestation prior to ratation
5.18 Which is the most frequently affected calyx in calyceal diverticulum ?
(a) Upper
(b) Middle
(c) Lower
(d) Equal in all sites
5.19 The following facts about calyceal diverticulum are true EXCEPT :
(a) Lined by transsitional epithelium

(b) Connected to a major calyx by a narrow channel
(c) Can be congenical or acquired
(d) Cystic cavity lying in renal substance
5.20 A cystic dilation of a mojor calyx lined by transtional epithelium and connected to the renal
pelvis is called :
(a) Calyceal cyst

(b) Calyceal diverticulum
(c) Hydrocalycosis
(d) Megacalycosis
(e) Infundibulopelvic dysgenesis
5.21 A non obstruction enlargement of the calyces due to a malformation of the renal papillac with a
nondilated renal pelvis and normal pelvi ureteric junction is called :
(a) Calyceal cyst

(c) Hydrocalicosis
(d) Megacalicosis
(e) Infundibulopelvic dysgenesis
5.22 Which of the following statement is FALSE regarding simple renal cyst ?
(a) The frequency increases with age

(b) They may present at any time soon from birth to old age
(c) They are usually solitary but can be multiple or bilateral
(d) They are lined by single layer of transitional epithelium
5.23 Which of the following is an indication for renal cyst ispiration ?
(a) Suspected infection

(b) Presence of low level echoes on sonography
(c) Borderline lesion in a poor surgical candidate
5.24 Which of the following statement is FALSE regarding acquired renal cystic disease (ARCD) ?
(a) It is confined to the patient recieving haemodialysis

(b) Higher incidence in male patients
(c) Incidence increase with the durtion of renal failure
(d) Higher incident of benign and malignant renal amours
5.25 Which of the following factors help in differentiating acquired renal cystic disease (ARCD) from
autocomal dominent (adult) polycystic kidney disease (APCD) ?
(a) Size of the cyst

(b) Size of the kidneys
(c) Present of infected cyst
(d) Present of tumour
5.26 Acquired renal cyst can arise from any part of the nemron but they have a predilection for :
(a) Glomerulus
(b) Proximal convoluted tubules
(c) Distal convulated tubules
(d) Loop of Henle and collecting tubules
5.27 Renal sinus cyst can arise from the following EXCEPT :
(a) Arteries
(b) Lymphatics
(c) Renal parenchyma
(d) Fat
5.28 Which of the following is FALSE regarding renal sinus cyst ?
(a) Predominantly derives from the lymphatics

(b) Usually single cyst
(c) Usually bilateral
(d) Majority appear after the 5th decade
5.29 Uremic medullary cystic disease complex includes all of the following EXCEPT :
(a) Familial nephronpthisis

(b) Medullary cystic disease
(c) Medullary sponge kidney
(d) Renal-retinal dysplasia
5.30 The following are false about infantile polycystic kidney disease EXCEPT :
(a) Autosomal recessive

(b) Not associated with intrahepatic biliary alterations
(c) Homogenous
(d) Older children with IPCD have more severe renal involvement
5.31 Infantile polycystic disease is characterised by the following EXCEPT :
(a) The histologic apearance in the members of one family is remakably consistent
(b) Characteristic lesion is medullary ductal ectasia
(c) Kidneys are mostly not enlarged
(d) Cortico-medullary relation is preserved
5.32 The effects of APCD on renal function can be varying and is characterised by the following
EXCEPT :
(a) Reduced renal plasma flow

(b) Reduced GFR
(c) Normal concentration ability
(d) Defective acidification
5.33 Older children, presenting after first year of life with infantile polycystic kidney disease usually
are characterised by the following EXCEPT :
(a) Milder from of renal impairement

(b) Coexistence of portal hypertension and systemic hypertension
(c) Not associated with congenital hepatic fibrosis
(d) Kidney are usually palpable
5.34 Which is the most common cause of bilateral renal enlargement in new borns ?
(a) Multicystic dysplasia

(b) Infantile polycystic disease of infancy
(c) Meckel’s syndrome
(d) Bilateral hydronephrosis due to lower tract obstruction
5.35 Amongst the following grave complications of infantile polycystic kidney disease the LEAST
common is :
(a) Bleeding oesophageal varices

(b) Rupture of berry aneurysm
(c) Systemic hypertension
(d) Renal failure
(e) Pulmonary hypoplasia
5.36 Which of the following statement is FALSE for autosomal dominant (Adult) polycystic kidney
disease ?
(a) It account for 9-10 percent of cases recieving chronic haemodialysis

(b) The gene has been localized to the short arm of chromosome 16
(c) This condition is never recogized in newborns
(d) The renal failure is seldom seen before the age of 40 years
5.37 The following hypothesis have been put forward for adult polycystic kidney disease EXCEPT :
(a) Obstruction of tubules by casts

(b) Backpressure due to lower tract obstruction
(c) Altered growth of the tubular wall due to exposure to diphenylamine
(d) Altered compliance of tubular wall
5.38 Which of the following is TRUE about adult polycystic kidney disease ?
(a) Autosomal recessive

(b) It is related to infantile polycystic kidney disease
(c) The cystic nephron is APCD is capable of functioning and often communicates with the
urinary system
(d) APCD can not be a cause for death
5.39 The progressive renal failure in APCD is mainly because of :
(a) Compression of renal parenchyma by enlarging cysts and hypertension

(b) Diminished concentrating ability
(c) Diminished GFR
(d) Prerenal hypovolaemia
5.40 Which is the most likely complication that can occur in a patient of APCD who dies suddenly ?
(a) Rupture berry aneurysm

(b) Gram negative sepsis
(c) Gross haematuria
(d) Anuria
5.41 Which of the following statement is FALSE regarding autosomal dominent (Adult) polycystic
kidney disease ?
(a) Approximately 10 to 40 percent of patients have berry’s aneurysm

(b) Approximately 9 percent of patients with berry aneurysm die because of subarachnoid
haemorrhage
(c) All intracranial haemorrhages in patients with APCD are subarachnoid bleeding secondary to
berry’s aneurysm
(d) Earlier detection and treatment of the hypertension can epect fewer death from intracranial
haemorrhages
5.42 What is the percentage of accompanying cerebral aneurysm in a patient of adult polycystic
kidney disease ?
(a) 10%
(b) 45%
(c) 60%
(d) 70%
5.43 Which of the following statements about APCD is TRUE ?
(a) Reptrograde ureteric studies should be done to percutaneous renal bipsy should be done for
tissue diagnosis
(b) Percutaneous renal biopsy should be done for tissue diagnosis
(c) APCD is always bilateral
(d) If untreated. Renal mortality is 25%
5.44 In what percentage of patients does hypertension occur in APCD :
(a) 10%
(b) 20-30%
(c) 50-70%
(d) 100%
5.45 What is the actiopathogenesis of hypertension in APCD ?
(a) Fluid overload

(b) Renin hypertension
(c) Essential hypertension
(d) Atherosclerosis
5.46 Which statement is FALSE concerning the prognosis in APCD ?
(a) Renal failure is relentless and mortality 100%

(b) Average age at death is 50 years
(c) Onset before 50 yrs is associated with poor survival
(d) Once uremia develops. The prognosis is poor
5.47 In atleast how many percent of cases of adult polycystic kidney disease, diagnosis can be made
by ultrasound examination before the age of 25 years :
(a) 65 percent
(b) 75 percent
(c) 85 percent
(d) 95 percent
5.48 In how many percent of cases of adult polycystic kidney disease, diagnostic accuracy can be
reached by combined genetic studies and ultrasound examination before the age of 25 years :
(a) 70 percent
(b) 80 percent
(c) 90 percent
(d) 100 percent
5.49 In which chromosome, abnormality is localized in antosomal dominant (adult) polycystic kidney
disease :
(a) 12
(b) 14
(c) 16
(d) 18
5.50 How many percent of the children of the adult polycystic kidney disease will be affected by the
same disease ?
(a) 2 percent
(b) 5 percent
(c) 7 percent
(d) 12 percent
5.51 The following are indication of surgery in adult polycystic kidney disease EXCEPT :
(a) Hypertension
(b) Intactable pain
(c) Intactable infection
(d) Acute renal failure
5.52 Medulary sponge kidney is a congenital malformation of :
(a) Renal cortex

(b) Renal medulla
(c) Collecting system
5.53 The case in medullary sponge kidney represents dilater :
(a) Gameruli
(b) Poximal convoluted tubules
(c) Distal convoluted tubules
(d) Collecting tubules-
5.54 The radiographic diagnosis cf MSK can be based on the folowing criteria EXCEPT :
(a) Usually in the pelvis

(b) Cystic tubules at apices of the pyramids have contrast medium
(c) Leiocalcyceal Filling occurs
(d) Contrast Medium persists in pyramidal tubules calyes have emptied
5.55 Which is the commonest complication arising in medullary sponge kidney ?
(a) Infection
(b) Nephrolithiasis
(c) Haematuria
(d) Hypertension
5.56 What is the meaning of renal dysplasia ?
(a) Reduction in renal mass

(b) Failure of renal mass to develop
(c) Arrest of development with failure of cytidufferenciation
(d) Retention of fetal renal structures
5.57 Segmental renal dysplasia usually involving the upper pole is frequently found in association
with :
(a) Ipsilateral ureteric obstruction

(b) Ectopic ureterocele
(c) Vesial outlet obstruction
(d) Urethral obstruction
(e) None of the above
5.58 ‘Mechkel;s syndrome’ consists of the following EXCEPT :
(a) Congenital heart disease

(b) Renal cystic dysplasia
(c) Posterior encephalocele
(d) Polydactyly
(e) Microcephaly
5.59 Which is the most common cystic disease in childhood ?
(a) Infantile polycystic kidney disease of infancy

(b) Infantile polycystic kindney disease of childhod
(c) Medullary sponge kidney
(d) Multicystic dysplastic kidney-
5.60 When a kidney has multicystic dysplasia, the acidence of abnormality in the contralateral kidney
is approximately ?
(a) 0%
(b) 5%
(c) 15%
(d) 30%-
5.61 The following ultrasound features are diagnostic of multicystic kidney EXCEPT :
(a) Visible interfaces between cysts

(b) Nonmedial location of large cysts
(c) Absence of identifiable renal sinus
(d) Conncection usually an be demostrated between the peripheral cyst and a central medial
cyst
5.62 What does it suggests if a patient suffering from a plastic dysplasia of kidney develops urinary
tract infection ?
(a) The ureter of the aplastic kidney has started refluxing

(b) The contralateral kidney has developed infection
(c) The aplastic kidney is having obstruction in its outflow tract
5.63 The “beckwith wiedeman syndrome” comprises all of the following EXCEPT :
(a) Congenital dislocation of hip

(b) Omphalocele
(c) Macroglossia
(d) Hypoplastic visceromegaly
(e) Endorine abnormalities
5.64 “Vin huppel-lindan disease” consists of all of the following EXCEPT :
(a) Renal cysts and adnenocarcinoma

(b) Cerebellar and retinal haemangioblastomas
(c) Not hereditary
(d) Pancreatic cysts
(e) Polycythemia
5.65 Which is the most common malformation seen in von hippel lindau disease ?
(a) Renal cyst

(b) Renal cell carinoma
(c) Pheochromocytoma
(d) Retinal ahgioma
5.66 In how many percent of cases renal cysts are seen in von-hippel lindau disease :
(a) 56 percent
(b) 66 percent
(c) 76 percent-
(d) 85 percent
5.67 Which is the most common type of renal cell carcinoma seen in von-hippel lindau disease ?
(a) Granular cell

(b) Clear cell
(c) Spindle cell
(d) Sarcomatous
5.68 Uremic medullary cystic disease complex includes the following EXCEPT :
(a) Familial juvenile nephronophthisis

(b) Tuberous sclerosis complex
(c) Medullary cystic disease
(d) Renal retinal dysplasia
5.69 Which of the following can demonstrate tubular blush in a medullary sponge kidney ?

(b) Retrograde pyelography
(c) Renal arteriography
5.70 Which is the most common type renal artery aneurysm ?
(a) Saccular
(b) Fusiform
(c) Dissecting
(d) Arteriovenous
5.71 Which is the more common site of arteriovenous malformation in the kidney ?
(a) Upper pole

(b) Midp portion
(c) Lower pole
5.72 Which of the following statement is WRONG about ask-up mark kidney ?
(a) Most patients are 10 years or older at diagnosis

(b) Severe hypetension is a porminent symptom
(c) These kidneys are normal is size
(d) In unilateral disease, partial or total nephrectomy may control hypertension
5.73 The following statemets about childhood type polycystic kidney disease are true EXCEPT :
(a) It is more likely to present in the adolescent as portal hypertension than a renal disease
(b) There is decrease function on intravenous urography
(c) The ureters, bladder and urethra have a characteristic pathologic appearance
(d) Potter’s facles may be present
(e) Gross or microscopic haematuria may be present
5.74 Which of the following are TRUE about extrophy of the bladder ?
(a) Inquinal and umblical hernias and rectal prolapse are frequently associated
(b) Upper tract infection with renal damage almost always occurs
(c) Late complication include malignancy of the bladder
(d) With vigorous multi-disciplinary surgical therapy salisfactory results can usually be obtained
5.75 A man of forty has polycystic kidneys, a blood pressure of 180/120, blood urea of 258 mgm%
and creatinine clearance of 5ml/minute. Which of the following is NOT true :
(a) He is more likely to suffer a subarachnoid haemorrhage than a patient with essential
hypertension of the same severity
(b) His sons may suffer from polycystic disease but his daughters will escape
(c) He should be given a low protien. High caloric low salt diet
(d) If he has osteoramalicia of the spine with hypocalcemia he should be treated with vitamin D
5.76 Approximately how many percent of normal renal pelvis are bifid :
(a) 5 percent
(b) 10 percent
(c) 15 percent
(d) 20 percent
5.77 Which is the mpst common cause of dilatation of the collecting system in the fetal kidney ?
(a) Multicystic dysplastic kidney

(b) Ureteropelvic junction obstruction
(c) Primary obstructive megaureter
(d) Posterior urethral valves
5.78 Ureteropelvic junction obstruction accounts for how many percent of cases of dilatations of the
collecting system in fetal kidney :
(a) 60%
(b) 70%
(c) 80%
(d) 90%
5.79 Which is the most common congenital anomaly in the contralateral kidney in a case of
ureteropelvic junction obstruction ?
(a) Ureteropelvic junction obstruction

(b) Renal dysplasia multicystic kidney disease
(c) Unilateral renal agenesis
5.80 Which is the ideal time to confirm the diagnosis of hydronephrosis suspected in prenatal
examination ?
(a) Immediately after birth

(b) Postnatal day 1-5
(c) After 1st wek of life
(d) Ater 1st month of life
5.81 Which is the best method of differentiating pelviureteric junction obstruction from dilated
nonobstructed pelvis ?
(a) Symptomatology
(b) Intravenous urogram
(c) Diuresis urogram
(d) Renogram
(e) Diuresis renogram
5.82 Diuresis renogram is used to access :
(a) Static renal imaging

(b) Renal function
(c) Renal pelvic urodynamics
(d) Renal function and urodynamics
5.83 Which of the following is essential for proper evaluation of PUJ obstruction by renogram ?
(a) Presence of both kidneys

(b) Presence of good renal function of that kidney
(c) Presence of non-dilated system
(d) Absence of urinary infection
5.84 Which is the best course of management for a patient complaining of loin pain and dilated non
obstructured renal pelvis ?
(a) Nothing has to be done

(b) Repeated follow up intravenous urogram
(c) Repeated diuresis renogram asses ment at regular intervals
(d) Pyeloplasty
5.85 The following statemets are true in whitaker test for pressure flow studies of the renal pelvis
and ureter EXCEPT :
(a) Vesion-ureteric reflux has to be ruled out before the procedure

(b) Both renal and urinary bladder pressures are monitored
(c) Infusant fluid is diluted contrast
(d) Diuretic stress is achieved by inj. Lasix during the procedure
5.86 The following are contraindications for whitaker test EXCEPT :
(a) Ptotic kidney

(b) Bleeding diathesis
(c) Acute urianary infection
(d) High grade or complete obstruction
(e) VUR wihout ipsilateral trapping
5.87 Intra-rensi reflux is produced when the pelvic pressure exceed :
(a) 5 cm H2 O
(b) 10 cm H2 O
(c) 20 cm H2 O
(d) 35 cm H2 O
5.88 Following are the critaria for operative correction of hydronephrosis EXCEPT :
(a) Savere degree of pyelocaliectasis in IVP

(b) Increase of 22% in size of pelvis on planimetry in diuresis urogram
(c) Pelvic pressure 10-12 cm H2 O on whitaker test
(d) Obstructive pattern on renogram after I/V lastix
5.89 In which of the following pathological change is last to undergo following complete ureteral
obstruction :
(a) Proximal convoluted tubules

(b) Glomeruli
(c) Distal convoluted tubules
5.90 Which is the commonest safety valve mechanism in complete ureteral obstruction ?
(a) Pyelosinus backflow

(b) Pyelotubular backflow
(c) Pyelolymphatic backflow
(d) Pyelovenouse backflow
5.91 Which of the following mechanism is not physiologic ?
(a) Pyelotubular backflow

(b) Pyelocanalicular backflow
(c) Pyelosinus backflow
(d) Pyelovenous backflow
(e) Pyelolymphatic backflow
5. 92 Which is the commonest site where ectopic ureter opens in males ?
(a) Prosatic urethra

(b) Seminal vesicle
(c) Vasa
(d) Ejaculatory duct
5.93 The ectopic ureter in males is commonly associated with renal disgenesis when it opens in to
the following structures EXCEPT :
(a) Prostatuc urethra

(b) Seminal vesicles
(c) Vasa
(d) Ejaculatory duet
5.94 Which of the following is FALSE about double ureter ?
(a) The lower pole ureter has the ectopic ureteral opening
(b) The lower pole ureter more commonly refluxing the upper
(c) The lower pole ureter opens higher and lateral to the upper
(d) Parenchymal thining of lower pole segment is more consistent with hypoplasia than with
scarring
(e) One third of renal parenchyma is drained by upper collecting system
5.95 Weigeri Meyer is associated with :
(a) Ectopic ureter

(c) Complete ureteral duplication
(d) Dysplastic ureter
5.96 The following fact about ectopic ureters are true EXCEPT :
(a) In the males the ectopic ureter drains into mesonephric duet derived structures
(b) In the female the ectopic ureter draines into paramesonephric duet derived structures
(c) The males are incontinent
(d) The females are incontinent
5.97 In partial duplication of ureter, the following are true EXCEPT :
(a) Ureteric yo-yo can occur

(b) Vesico-ureteric reflux never occurs
(c) Urinary stasis is more marked if the Y junction is more distal
(d) Retrograde waves of urine preferentially pass into the slightly dilated limbs rahter than
down the common stem
5.98 Following are the fact about vesicoureteral junction EXCEPT :
(a) Distal ureter is covered by the superficial and deep waldeyer’s periureteral shealth
(b) Waldeyer’s shealth is coritinous with deep trigone and ureter is continous with superficial
trigone
(c) The more medial the ureteric orifice, the more likely V-U reflux will occur
(d) Length of normal submucosal tunnul is 5 times diameter of ureteric orifice
5.99 Which is the most common manifestation of a congenital abnormalities of the uretero vesical
junction ?
(a) Obstruction
(b) Vesico ureteral reflux
(c) Ectopic opening
(d) Aperistaltic distal ureteral segemnt
9.100 Approximately, how many percent of siblings of children with known reflux are found to have
vesico-ureteric reflux :
(a) 10 percent
(b) 20 percent
(c) 30 percent
(d) 40 percent
5.101 According to lyon’s classification, which of the following will be associated with greater degree
of reflux :
(a) Volcano shaped orifice

(b) Stadium orifice
(c) Horse-shoe orifice
(d) Golf-hole orifice
5.102 Which of the following is most important in deciding whether reflux shall be cured by
operative or conservative management ?
(a) Lyon’s classification of ureteric openings

(b) Degree of hydronephrosis on cystogram
(c) Estimated lenght of intravesical ureter
(d) Age of the patient
(e) Presence of other factors that may contribute to reflux
5.103 Following are the indications for early surgery in vesicoureteral reflux EXCEPT :
(a) Gold-hole/horse shoe orifice

(b) Pyelonephritic scarring
(c) Grade 2B or less reflux
(d) Recurrences of infection after chemotherapy
(e) Short (2-5 mm) intravesical ureter
5.104 The following are helpful in the diagnosis of vesico ureteric reflux EXCEPT :
(a) Retrograde pyelogram

(b) Micturating cystourethrogram
(c) Intravenous urogram
(d) Radionuclide cystogram
(e) Cystopanendoscopy
5.105 How many weeks of infection free interval is recommended before the cystogram to detect
vesico-ureteral reflux ?
(a) 1-2 weeks

(b) 2-4 weeks
(c) 4-6 weeks
(d) 6-8 weeks
5.106 Approximately. What is the length of sub mucosal course of ureter at birth :
(a) 5 mm
(b) 10 mm
(c) 13 mm
(d) 15 mm
5.107 Approximately, what is the length of sub mucosal course of the ureter by the age of 10 years :
(a) 5 mm
(b) 10 mm
(c) 13 mm
(d) 15 mm
5.108 Approximately, what is the length of sub mucosal course of ureter in adults :
(a) 5 mm
(b) 10 mm
(c) 13 mm
(d) 15 mm
5.109 Which of the following statements about the length of submucosal ureter is FALSE ?
(a) At birth 5 mm
(b) At 10 yrs. 10 mm
(c) At adulthood 13 mm
(d) At 50 yrs 17 mm
5.110 Approximately, in how many percent of cases, primary reflux will cause spontaneously, if the
submucosal tunnel is more than 5 mm at the time of diagnosis :
(a) 30-40 percent

(b) 40-50 percent
(c) 50-60 percent
(d) 60-70 percent
5.111 The following factors suggest that reflux shall cease with growth and will not impede renal
development or function EXCEPT :
(a) Relatively young child

(b) Golf hole ureter
(c) Intravesical length of ureter 5 cms
(d) Grade 2B reflux or less
5.112 On cystography if reflux is demonstrated which cause pelvocalyccal filling with mild calyccal
blunting then it is graded as :
(a) Grade 2 A
(b) Grade 2 B
(c) Grade 3
(d) Grade 4
5.113 Which of the following change occurs in the intravesical ureter when a blous of urine pass
down ureter ?
(a) Decrease in length of intramural segment

(b) Decrease in length of submucosal segment
(c) Decrease in total intravesical length of ureter
(d) Shortening and widening of the intravesical ureter
5.114 The follow up of a patient of V-U reflux who has been put on medical management, should
comprise of all of the following tests at regular intervals EXCEPT :
(a) Urine culture

(c) Cystogram
(d) Cystopanendoscopy
5.115 The following are the basic requirements of a seccessful ureteroneocystostomy EXCEPT :
(a) Thension free anastomosis between the ureter and bladder

(b) Submucosal tunnel length 5 times the diameter of the ureter
(c) Firm support of underlying bladder musculature to the ureter
(d) Implantation of the ureter in the floor of the bladder
5.116 The surgical procedurs of cross-trigonal reimplantation for correction of V-U reflux goes by the
name of :
(a) Cohen
(b) Glenn-anderson
(c) Lich
(d) Poltano –lead better
5.117 In case of unilateral V-U reflux if the contralateral nonrefluxing ureteric orifice is golf-hole and
has a short submucosal tunnel, prophylastic reimplantation of this is indicated when the
refluxing ureter is reimplanted. This statement is :
(a) True
(b) False
5.118 What is the incidence of promary congenital vesico-ureteral reflux in the asymptomatic
paediatric population ?
(a) 0.4-1.8 percent

(b) 1.8-3.2 percent
(c) 3.2-4.6 percent
(d) 4.6-5.8 percent
5.119 How many percent of kidneys with grade 1 vesico-ureteral reflux will have renal scarring ?
(a) 5-20 percent

(b) 20-35 percent
(c) 35-50 percent
(d) 50-65 percent
5.120 How many percent of kidneys with grade 5 vesico ureteral reflux will have renal scarring ?
(a) 20 percent
(b) 30 percent
(c) 40 percent
(d) 50 percent
5.121 The following are the advantages of radionuclide cystography in detection of vesico-ureteral
reflux EXCEPT :
(a) It allows continous monitoring of the patient with minimal radiation exposure
(b) Abnormalities of the urethra, bladder or reflux in to the distal ureter only can be appreciated
(c) Useful in follow up of patients after antireflux surgery
(d) It allows calculation of bladder volume at which reflux begins
5.122 In how many percent of cases of vesico-ureteral reflux in neonates and infants, intra renal
reflux can be observed :
(a) 5-15 percent

(b) 15-30 percent
(c) 30-45 percent
(d) 45-60 percent
5.123 The following statements are correct about primary obstructure megaureter EXCEPT :
(a) In obstructive aperistaltic segment there is deragement of the nervous plexuses on

histopatplogy
(b) Regarade ureteric catheterization is unhindered
(c) Usually the calyces are normally cupped
(d) Make females 4.1
5.124 Primary restructed megaureter can occur in the following conditions EXCEPT :
(a) Adynamic segment

(b) Ureteral stenosis
(c) Neurophatic bladder
(d) Intrasic obstruction
5.125 The non-obstructed nonrefluxing megaureter can be seen in the following conditions EXCEPT :
(a) Primary non-refluxing non-obstructed megaureter

(b) Polyuria
(c) Infection
(d) Neuropathic bladder
5.126 The following characterise the non-refluxing nonobstructed megaureter EXCEPT :
(a) Is a developmental variant

(b) Increased intraluminal pressures
(c) No muscular hypertrophy/hyperplasla
(d) Pyelocalyceal system normal
5.127 Which is the commonest site of congenital ureteral stenosis ?
(a) Ureteropelvic juntion

(b) Midureter at the peivic brim
(c) Ureter crossed by vas deferens
(d) Just above ureterovesical juntion
5.128 Which of the following statement is FALSE regarding ureteral valves ?
(a) They are uncommon cause of ureteral obstruction

(b) They consists of traseverse folds of redundant mucosa which containes smooth muscles
(c) The ureter is dilated below the ureteral valves
(d) They are distributed throughtout the length of the ureter
5.129 Which is the most common from of ureteral triplication ?
(a) Complete triplication

(b) Incomplete triplication
(c) Trifid ureter
(d) Two ureters from the kidney. One becoming an inverse Y bifurcation, resulting in three
draining orifices below
5.130 Chawalla’s membrane is characterised by all of the following EXCEPT :
(a) Two layered occluding membrane

(b) Normally present between ureter and urogenital sinus
(c) Present in the 15 mm, embryo
(d) Disappears by the 20 mm stage
(e) Persistence can be the cause of ureteral obstruction
5.131 Which of the following ureteroccle can usually be most ectopoic in position ?
(a) Stenotic ureterocele

(b) Sphinteric ureterocele
(c) Sphincterostenotic ureterocele
(d) Caecoureterocele
5.132 In which of the following ureterocele, can the ureteric orifice be normal or even larger in size :
(a) Stenotic
(b) Sphinteric
(c) Sphinterostenotic
(d) Simple
5.133 Which of the following statement about preureteral venacava is FALSE ?
(a) Almost invariably the right ureter is involved

(b) It is a congenital variation in ureteral develoment
(c) On RGP. It gives a fish-hook appearance
(d) Retrocaval ureteral segment lies at the level of L or L
5.134 All of the following can be used as investigation in the preoprative assessment of megaureter
EXCEPT :
(a) Pyeloureteral dynamics

(c) Voiding cystourehrogram
(d) Cystoscopy
(e) Non of the above
5.135 Which of the following statement is FALSE about double collecting system ?
(a) Upper pole ureter is more commonly associated with ureterocele

(b) Lower pole ureter is more commonly associated with V-U reflux
(c) Megaureter involves the upper pole ureter more often
(d) The lower pole ureteric orifice is ectopic
5.136 Which of the following fact about prune-Belly syndrome is FALSE ?
(a) It effects female children mostly

(b) Deficient lower abdominal musculature
(c) Cryptorchidism
(d) Congental talipes equinovarus
5.137 How many percent of ectopic ureters associated with a duplicated sytem ?
(a) 60 percent
(b) 70 percent
(c) 80 percent
(d) 90 percent
5.138 All of the following are true about ectopic ureter EXCEPT :
(a) Causes incontinence in girls with an otherwise normal voiding pattern

(b) Usually associated with a duplex system in which case the ureter to the lower pole is ectopic
(c) Commonly leads to hydronephrosis of concerned renal segment in males
(d) The boys are usually not incontinent
5.139 All of the following are urographic features of ectopic ureter EXCEPT :
(a) Dipoping flower appearence

(b) Distance of upper calyx from upper pole of the kidney is greater than the distance of lower
calyx from the lower pole
(c) Non-visualisation of the lower pole in a duplex system
(d) Non-visualisation of a diminutive dysplastic kidney in case of a single renal unit
5.140 The following are true about ectopic ureter EXCEPT :
(a) More common in boys

(b) In girls there is usually duplex system and in boys it is usually a single system
(c) It is more likely to be associated with a dysplastic kidney
(d) In boys usual treatment is nephrectomy or nephroureterectomy
5.141 Which of the following statement is false regarding ureterocele ?
(a) It is three to four times more common in girls

(b) It is more common on the right side
(c) Between 1- and 15 percent are bilateral
(d) Familial occurence is known
5.142 All of the following statements about ureterocele are true EXCEPT :
(a) Upper tract changes are more severe in ectopic ureterocele than in a simple ureterocele
(b) V-U reflux is more common in a simple ureterocele than in ectopic one
(c) IVP demonstrates the characteristic cobra head deformity
(d) Trans-urehral deroofing of ureterocele usually results in postoperative V-U reflux
5.143 All of the following are true in the differences between simple and ectopic ureterocele EXCEPT
:
(a) Ectopic ureteroceles are more common in girls

(b) The renal unit associated with and ectopic ureterocele is more commonly dysplastic
(c) On IVP, the filling defect in the bladder is central in ectopic ureteocele and peripheral in
simple ureterocele
(d) V-U reflux is commonest in caecoureterocele
5.144 At the end of which week of embryonic development is the cloaca by the urorectal septum in
to a dorsal anorectal canal and primitive urogenital sinus :
(a) 4th week

(b) 5th week
(c) 6th week
(d) 7th week
5.145 At what stage of embryonic development does the mesonephric duct, which empties first in to
the cloaca and subsenquently in to the envolving urogenital sinus, produce the ureteric bud :
(a) 4th week

(b) 5th week
(c) 6th week
(d) 7th week
5.146 The bladder is derived from the endoderm and the ureter and trigone are derived from :
(a) Endoderm
(b) Mesoderm
(c) Ectoderm
(d) Coelomic cavity
5.147 Double voiding is one of the conservative methods used in the management of :
(a) Hyperreflexic bladder

(b) Vesico-ureteric reflux
(c) Urethrotrigonal syndrome
(d) Stress incontinence
5.148 The cremaster muscle is derived from :
(a) External oblique muscle

(b) Internal oblique muscle
(c) Tranversalis
(d) Fascia transversalis
5.149 Until after which month of gestation, in the human embryo, the testis donot move from the
abdominal cavity through the inguinal canal and in the scrotum :
(a) 5th month

(b) 6th month
(c) 7th month
(d) 8th month
5.150 Testosterone is essential for the virilization of the following EXCEPT :
(a) Urogenital sinus

(b) Urogenital swellings
(c) Genital tubercle
(d) Wolffian duct
5.151 Testoterone is responsible for the virilization of which of the following :
(a) Wolffian duct

(b) Urogenital sinus
(c) Urogenital swellings
(d) Genital tubercle
5.152 What is least distance between the pubic tubercle and the centre of the testis, in a 2500 gm
baby, in order for the testis to be termed fully descended :
(a) 1.0 cm
(b) 2.0 cm
(c) 3.0 cm
(d) 4.0 cm
5.153 All of the following statements about a high scrotal testis are true EXCEPT :
(a) It is the commonest site amongst the undescended testis

(b) It can not be drawn in to the lower part of hte scrotum
(c) It is usually well formed, mature testis
(d) It can retract in to the superficial inquinal pouch
5.154 How much is the temprature elevation in intraabdominal testis in comparision to scrotal
location ?
(a) 0.5-1.0oC
(b) 1.0-1.5oC
(c) 1.5-2.0oC
(d) 2.0-2.5oC
5.155 During testicular descent, the epididymis preceds the testis in its journey to the scrotum : this
statement is
(a) True
(b) False
5.156 What is the incidence of undescended testis in full gsm (birth weight greater than 2500 gms)
infants camined at birth ?
(a) 1.4 percent

(b) 2.4 percent
(c) 3.4 percent
(d) 4.4 percent
5.157 What is the incidence of bilateral cryptorchidism in infants weighing less than 900 gsm ?
(a) 70 percent
(b) 80 percent
(c) 90 percent
(d) 100 percent
5.158 Approximately, in how many percent of full term cystorchid testis, spontaneously descent will
occur by 1 year of age :
(a) 65 percent
(b) 75 percent
(c) 85 percent
(d) 95 percent
5.159 Approximately, in how many percent of premature crytochid testis, spontaneously descent
will occur by 1 year of age :
(a) 65 percent
(b) 75 percent
(c) 85 percent
(d) 95 percent
5.170 Which of the following are conflicting changes in the undescended testis ?
(a) Small seminiferous tubules

(b) Fewer spermatogonia
(c) More peritubular tissue
(d) Changes in the leydig cells
5.171 Which of the following are conflicting changes on electron microscopy in the undescended
testis ?
(a) Degeneration of mitochondria

(b) Increase in collagen fibres in the spermatogonia and sertoli cells
(c) Loss of ribosomes in both the cytoplasm and smooth endoplasmic reticulum
(d) Changes in the leydig cells
5.172 Approximately how many percent of testicular tumours rise from indescended testis :
(a) 6 percent
(b) 8 percent
(c) 10 percent
(d) 12 percent
5.173 What is the treatment of choice, if a testis is undescended but palpable in a patient who is old
than 32 years ?
(a) Observation
(b) Orchiopexy
(c) Orchidectomy
(d) Abdominal exploration
5.174 What are the chances of the other testis becoming malignant, if both the testes are
intraabdominal and one tesis become malignant ?
(a) 10 percent
(b) 20 percent
(c) 30 percent
(d) 40 percent
5.175 Tubular fertility index (TFI) signifies :
(a) Percentage of mature spermatogonia

(b) Percentage of tubules containing indentifiable spermatogonia
(c) Percentage of mobile sperms
(d) Percentage of tubules which contain glycogen and lipid
5.176 All of the following statements are true about undescended testis EXCEPT :
(a) undescended testis are 48 times more likely to undergo malignant changes than a fully
descended testis
(b) successful orchiopexy removes the risk of malignant transformation
(c) there is a primary cellular abnormality germinal and nutritive series
(d) hereditary cryptorchidism is transmitted by an autosomal dominent gene with ari
incomplete penetration
5.177 Torsion of the testis occurs inside the :
(a) tunica albuginea (Parietal layer)

(b) tunica vaginalis
(c) creamaster muscle and fascia
(d) scrotum
5.178 All of the following predispose to testicular torsion EXCEPT :
(a) capacious tunica vaginalis

(b) malrotated testis
(c) long and narrow mesentry of the testis
(d) increased fluid inside the tunica
5.179 The following statements about testicular torison are true EXCEPT :
(a) usually occurs when the testis becomes larger and heavier at puberty
(b) must be differentiated from epididymo-orohitis
(c) watchful waiting is the preferred treatment
(d) in the neonates, the clinical picture usually is of a hard, enlarged, apparently non-tender
mass
5.180 What is the incidence of phimosis by 17 years of age ?
(a) less than 1 percent

(b) 1-2 percent
(c) 2-3 percent
(d) 3-4 percent
5.181 In general, atleast what should be the length of penis of a fullterm newborn :
(a) 1.5 cm
(b) 2.5 cm
(c) 3.5 cm
(d) 4.5 cm
5.182 Following are the features in a case of penile agenesis EXCEPT :
(a) The karyotype 46 XY

(b) There is a well developed scrotum with descended testis
(c) There is absent penile shaft
(d) The anus is generally displace posteriorly
5.183 Which is the most common site of ectopic scrotum ?
(a) Supra inquinal

(b) Infra inquinal
(c) Perineum
5.184 Is the exstrophy complex congenital anomalies are less commonly found in :
(a) Kidneys
(b) Bladder
(c) Pubic bone
(d) Genitaha
5.185 All of the following congenital anomalies can be present in a of classic exstrophy
of the bladder EXCEPT :
(a) Epipadiac
(b) Bilateral ins ia
(c) Vesico-ure
(d) Widening pubis
(e) Deficlent minal wall with everted bladder
5.186 In extrophy in coming rotational and lateral deformities of a girdle can be present
EXCEPT :
(a) Outward of mnominate bones

(b) Outward of pubic bones
(c) Lateral in tion of innominate bones
(d) Fusion and of sacro llac joints
5.187 All of the following are associated with exatrophy of the bladder EXCEPT :
(a) Incontine
(b) Hydroneph
(c) Bladder ma
(d) Wadding
(e) Autosoma inheritence
5.188 In a patient presenting ith two hemibladders separated by an area of intestine, accompanied
variably by episadius, diphallus widening of symphysis pubis and a double inferior vena cava,
your first diagnosis would be :
(a) Classical extrophy

(b) Cloacal extrophy
(c) Pseudoxstrophy
(d) Duplicate extrophy
5.189 Which of the following clinical finding clinches the diagnosis of superior vesical fissure as
opposed to a patent urachus ?
(a) Musculo-skeletal defects

(b) Well formed upper urinary tracts
(c) Urinary continence
(d) Minimal bladder eventration present only below the umblicus
5.190 A patient presented with a characteristic widened symphysis pubis, a stubby upward pointing
penis, a patch of extrophic bladder mucosa lying immediately below the umblicus and normal
urinary bladder, trigone and urethra is most probaly a patient of :
(a) Exstrophy of the bladder

(b) Cloacal extrohpy
(c) Pseudoexstrophy
(d) Superior vesical fissure
(e) Duplicate exstrophy
5.191 Which is the rarest variety of epispadius ?
(a) Gladular
(b) Panile
(c) Penopubic
5.192 Incontinence is the characteristic feature of which type of epispadius :
(a) Glandular
(b) Periile
(c) Penopubic
5.193 All of the following surgical procedures are recquired during the repair of a penile epispadius
EXCEPT :
(a) Release of urehra from corpora cavernosa

(b) Penile lengthening
(c) Correction of incontinence
(d) Formation of peno-glandular
5.194 surgery to cure incontinence by incising the bladder neck and proximal urethra anteriorly,
excisting a wedge of tissue from each side to narrow the bladder outlet and suturing to convert
the originally funnelled bladder in to a tubular shape is called :
(a) Young-dess operation

(b) Tanagho-smith operation
(c) Leadbetter operation
(d) Marshall-marchetti-krantz operation
5.195 The achievement of continence following surgery for epispadiac incontinece may be
considerably delayed. All of the following theories have been proposed for this EXCEPT :
(a) Gradual development of vesico-urethral muscle

(b) Ijury to the nerves supplying the bladder neck at the time of surgery
(c) Social maturity at puberty
(d) Development of prostate at puberty
5.196 Which is the commonest in the spectrum of extrophic lesion ?
(a) Superior vesical fissure

(b) Cloacal extrophy
(c) Classical extrophy
5.197 The operation to cure incontinence by lengthening of the posterior urethra by a pedicled flap
of the anterior bladder wall which is formed in to a tubular neourethra and interpose between
the bladder and the natural urethra is named :
(a) Young-dees operation

(b) Tanagho-smith operation
(c) Leadbetter operation
(d) Marshall-marchetti-krantz operation
5.198 Before contemplating sugical closure, an extrophic bladder should have all of the following
characteristic EXCEPT :
(a) Functioning integrity

(b) Elaticity and pliability
(c) An estimated capacity of at least 50 ml at birth
(d) Healthy mucosal surface
5.199 Which is the optimum age for a child for surgical closure of the extrophy bladder ?
(a) Within 48 hours

(b) Within a month
(c) Before one year of age
(d) At he time of puberty
5.200 In approximately, how many percentage of patients having bilateral vesico ureteric reflux
following surgical closure of the exstrophic bladder :
(a) 25%
(b) 50%
(c) 75%
(d) 100%
5.201 Which is the most common type of malignancy occur in exstrophy bladder ?
(a) Adenocarcinoma
(b) Squamous cell carcinoma
(c) Rhabdomyosarcoma
(d) Transitional cell carcinoma
5.202 Which are the two most common cause megaureter ?
(a) Prune belly syndrome and neurogenic bladder

(b) Obstruction at the uretero-vesical junction and vesico ureteric reflux
(c) Diabetes insipidus and latrogenic cause
(d) Posteropr irethral valves and anomalies of urehra
5.203 Accentuation of which of the following normally existing structure is characteristic of
obstructive urethral valves :
(a) Verumontanum
(b) Crista urehralis
(c) Plicae colliculi
(d) External urehral sphineter
5.204 Which is the commonest type of posterior urethral valves according to young’s cassification ?
(a) Type I
(b) Type II
(c) Type III
(d) Type IV
5.205 Valves which consist of oblique posterior mucosal fold extending from the lower end of
verumontanum distally up to the urogenital diaphragm are classified as :
(a) Type I
(b) Type II
(c) Type III
(d) Type IV
5.206 To which segment of the circumference of the urethral wall are the young type I valves distally
attached :
(a) Posterior
(b) Anterior
(c) Lateral
(d) Anywhere
5.207 Which of the following theory has been suggested regarding the embryogenesis of the
posterior urehral valves ?
(a) Enlargement of normal urethral folds

(b) Persistence of urogenital membrane
(c) Urethral groove
5.208 Which is the investigation of choice in posterior urethral valves ?
(a) Micturating cystourethrogram

(b) Retrograde urethrogram
(c) Cystopanendoscopy
(d) Ultrasound scanning
5.209 Which is the following statement is INCORRECT regarding posterior urethral valves ?
(a) The older the patient worse is the prognosis

(b) Young type i valves are the commonest
(c) Cut vesicostomy is a better temporary diversion than suprapubic cystostomy
(d) Transurethral resection of valves should be done primarily in a patient of PUV with minimally
damaged upper tracts
5.210 Which of the following statement is FALSE regarding classical type 1 posterior urethral valves ?
(a) This is an obstructing membrance which radiates in a distal direction from the
verumontanum posteriorly towards the membranous urethra anteriorly
(b) Children with classic type 1 valve have plicae colliculli
(c) They make up more than 95 percent of all types of valves
(d) The clinical presentation is in a variety of ways depending primarily on the degree of
obstruction
5.211 What is the usual cause of death in neonates who die as a result of posterior urethral valves ?
(a) Respiratory failure

(b) Renal failure
(c) Infections
(d) Dehydration and electrolyte imbalance
5.212 Which is the single most significant abnormality that will determine ultimate renal function in
cases of posterior urethral valves ?
(a) Renal parenchymal dysplasia

(b) Hydronephrotic changes
(c) Infection
(d) Progresive glomerulosclerosis for hyperfiltration
5.213 Which anatomic condition in association with posterior urethral valves appears to be
associated with generally improved renal funtion ?
(a) Massive vesko ureteral reflux

(b) Large bladder diverticula
(c) Urinary ascites
5.214 Which of the following characteristic finding detected by ultrasound is FALSE in a fetus with
posterior valves ?
(a) Bilateral hydronephrosis

(b) Distended nonthickened bladder
(c) Dilated posterior urethra
(d) Varying degrees of amniotic fluid abnormality
5.215 Following fetal urinary estimation are good prognostic predictor for post natal renal funtion in
a fetus with posterior urethral valves EXCEPT :
(a) Sodium (mEg.L) > 100

(b) Chlorid (mEg/L) < 90
(c) Osmolarity (mOsm) < 210
(d) Urinary output (ml/Hour) > 2
5.216 Whic is the treatment of choice in a patient of PUV with moderate bilateral
hydroureteronephrosis, blood urea 80%, serum creatinine 2.8 mg% with sterile urine ?
(a) Transurethral resection of valves (TURV)

(b) TURV with close follow up to observe response of upper urinary tract which will decide
further management
(c) Bilateral nephrostomy followed by TURV three weeks later
(d) Bilateral pyelostomy followed by TURV one year later
5.217 Lyon’s ring is synonym for :
(a) Young type III valves

(b) Congenital urethral stricture
(c) Distal urethral stenosis
(d) Anterior urethral valves
5.218 The saccular anterior urethral diverticulum is most commonly located at :
(a) Distal bulbar urethra

(b) Peno-scrotal junction
(c) Penile urethra
(d) Navicular fossa
5.219 Which is the most common cause of congenital anterior urethral obstruction ?
(a) Anterior urethral valves

(b) Valvular obstruction of the fossa navicularis
(c) Cystic dilatation of the ducts of cowper’s glands
(d) Megalourethra
5.220 Which is the commonest type of hypospadius ?
(a) Glanular
(b) Subcoronal
(c) Anterior penile
(d) Midshaft
5.221 Approximately what is the estimated in cidence of hypospadius :
(a) 1 in 100
(b) 1 in 200
(c) 1 in 300
(d) 1 in 400
5.222 What is the incidence of hypospadius in fathers of hypospadiac children ?
(a) 2 percent
(b) 4 percent
(c) 6 percent
(d) 8 percent
5.223 What is the incidence of hypospadius in siblings ?
(a) 12 percent
(b) 14 percent
(c) 16 percent
(d) 18 percent
5.224 Which are the commonamolics associated with hypospadius ?
(a) Undescended testis

(b) Inquinal hernia
(c) Upper urinary tract anomalies
(d) Myeomeningocele
(e) Imperforate anus
5.225 Which is the technique of choice for repair of anterior hypospadius with glanular meatus with
good mobolity of the urethra and without chordee ?
(a) Meatal advancement and glanuloplasty (MAGPI)

(b) Para-meatal based flap (mathieu procedure)
(c) Onlay island flap urethral extension
(d) Mustarde procedure
5.226 Which is the technique of choice for repair of anterior hypospadius with sub-coronal meatus
without mobolity of the urethra and chordee ?

(b) Parameatal based flap (Mathleu procedure)
(d) Mustarde procedure
5.227 Which is the technique of choice for repair of antering hypospadius when the meatus us too
proximal, the ventral skin is too thin for a flap and there is no chordee ?

(b) Arameatal based flap (Mathleu procedure)
(d) Musterde procedure
5.228 Following are the feathures of Klinefelter syndrome EXCEPT :
(a) Small firm testis

(b) Azoospermia
(c) Gynaecomastia
(d) Low levels of urinary gonadotrophins
5.229 Which are the common karytotype pattern seen in Klinefelter syndrome ?
(a) 46 XY
(b) 47 XXY
(c) 46 XY/ 57 XXY
(d) 46 XXX
5.230 Which is the fundamental chromosomal defect in Klinefelter syndrome ?
(a) Absence of chromosome

(b) Presence of an extra X chromosome in males
(c) Presence of an extra X and Y chromosome in males
5.231 Which of the following is wrong about Klinefelter syndrome ?
(a) Raised FSH level

(b) Raised LH level
(c) Raised testosterone level
(d) Raised estradiol level
5.232 Following are the histological findings in the testis in a acse of Klinefelter syndrome EXCEPT :
(a) Hyalinization of the tubules
(b) Absence of spermatogenesis
(c) Increae in leying cells
(d) Increase in sertoli
5.233 What is the diagnosis in a acse in which bilateral streak gonads are associated with normal
46XX or 46 XY karyotype, normal stature and primary amenorrea ?
(a) Mixed gonadal dysgenesis

(b) Pure gonadal dyspgenesis
(d) Noonan syndrome
5.234 What is the diagnosis in a case in which there i a testis on one side and a streak gonad on the
other ?
(a) Mixed gonadal dysgenesis

(b) Pure gonadal dysgenesis
(d) Female pseudohernaphroditism
5.235 The following are eponysm for absent testis syndrome EXCEPT :
(a) Anorchia
(b) Gonadal agenesis
(c) Pure gonadal dysgenesis
(d) Testicular regression
(e) Agonadism
5.236 Which is the most common cause of congenital adrenal hyperplasia ?
(a) 21 hydroxylase deficiency

(b) 11 Betahydroxylase deficiency
(c) 17 alpha hydroxylase deficiency
(d) 20-22 desmolase deficiaency
5.237 Which of the following statement is FALSE regarding Rokitansky kester-hanser syndrome ?
(a) There is congenital absence of vagina

(b) Someform of abnormal or absent uterus
(c) The breasts, axillary and pubic hair habitus are famine in character
(d) Renal skeletal and other congenital anomalies are rare
5.238 The following hormonal deficiency can result in to congenital adrenal hyperplasia and male
pseudo-hermaphroditism EXCEPT :
(a) 20-22 desmolase

(b) 3 betahydroxysteroid dehydrogenase
(c) 17 alpha hydroxylase
(d) 17 beta hydroxysteroid
5.239 Which hormones deficiency can result in male pseudohermaphroditism only ?
(a) 17 betahydroxysteroid
(b) 17-20 desmolase
(c) 20-22 desmolase
(d) 3 beta hydroxysteroid
5.240 Which is the most common form of male pseudohemafroditism ?
(a) 5 alpha reductase deticiency

(b) Complete testicular feminization
(c) Reifenstein syndrome
(d) Infertile male sydrome
5.241 In how many percent of the nuclie of normal females, the barr body is found :

(b) 5-10 percent
(c) 10-15 percent
(d) 20 percent and above
5.242 In how many percent of the nuclie of normal males, the barr body is found ?

(b) 2-5 percent
(c) 5-10 percent
(d) 10-15 percent
6
INFECTION
6.1 In which of the following, urinary tract infection are more common :
(a) Men
(b) Women
(c) Boys
(d) Girls
6.2 In comparision to males, female prodonderance in UTI, is due to :
(a) Short urethra

(b) Deficient host defence
(c) Urinary obstruction
(d) Haematogenous infections
6.3 How many percent of new born boys have symptomatic UTI ?
(a) 1%
(b) 3%
(c) 5%
(d) 10%
6.4 What is the incidence of asymptomatic bacteriuria (ABU) in girls of preschool and school age ?
(a) 1%
(b) 3%
(c) 5%
(d) 10%
6.5 how many percent of newborn girl have symptomatic UTI ?
(a) 1%
(b) 3%
(c) 5%
(d) 10%
6.6 What is the frequency of obstruction in boys having UTI ?
(a) Less than 10%

(b) 10-25%
(c) 25-40%
(d) 40-60%
6.7 What is the frequency of obstruction in girls having UTI ?
(a) 1-2%
(b) 5-10%
(c) 10-15%
(d) 15-20%
6.8 How many percent of diabetic men can have urinary tract intections ?
(a) 1 percent
(b) 2 percent
(c) 3 percent
(d) 4 percent
6.9 How many percent of women older than 65 years have bacteriuria ?
(a) 10
(b) 20
(c) 30
(d) 40
6.10 How many percent of men older than 65 years have bacteriuria ?
(a) 5 percent
(b) 10 percent
(c) 15 percent
(d) 20 percent
6.11 Which of the following is the most likely route of urinary tract infection in males ?
(a) Haematogenous
(b) Ascending
(c) Descending
6.12 Which is the valid criteria of the present of the urinary tract infection in males ?
(a) Demonstarion A significant number of bacteria

(b) Demonstration of pus cells in urine
(c) Decreased concentration capacity
(d) Presence of elevated antibody titre
6.13 For significant bacteriuria, what should be the colony count per ml of urine, in speciment ?
(a) 102
(b) 103
(c) 104
(d) 105
6.14 The presence of how many bacteria will claim complete eradication of urinary tract infection :
(a) No bacteria
(b) 1-2 per hpf
(c) 2-3 per hpf
(d) 3-4 per hpf
6.15 Which is the most common cause of unresolved bacteriuria during treatment ?
(a) Development of resistance from initially susceptible bacteria

(b) Bacterial resistance to the drug selected for treatment
(c) Bacteriuria caused by two different bacterial species with mutualli exclusie susceptibilities
(d) Azotemia
6.16 Which is the commonest organism or the majority of urinary tract infection in patients without
a complicating disorder of the urinary system ?
(a) E-Coli
(b) proteus
(c) Staphylococcus
(d) Psudomonas
(e) Klebsiella
In segmented bacteriologic localisation cultures for localization of lower urinary tract infections in
male
Match the Following
6.17 VB1 (a) Mid stream culture

6.18 VB2 (b) Prostatic secretions
6.19 VB3 (c) First voided after prostatic massage
6.20 EPS (d) First voided 10 ml
6.21 For unilateral localisation of urinary tract infection which of the following is the best of choice :
(a) Frale’s bladder wasout test

(b) Thomas’s antibody coating technique
(c) Ureteral catheterization studies
6.22 Which of the following are the commonest urea-spilitting organism ?
(a) E. Coli
(b) Klebsiella
(c) Pseudomonas
(d) Proteus Mirabilis
6.23 Urea splitting organisms cause :
(a) Alkalinization of the urine

(b) Acidification of the urine
(c) Both of the above
6.24 Urea spitting organisms cause precipitation of which of the following salts :
(a) Calcium (Ca)

(b) Magnesium (Mg)
(c) Animonium (NH4)
6.25 Cure of urinary tract infection is depndent on the anti microbial levels achieved in the :
(a) Urine
(b) Serum
(c) Stool
(d) Seminal fluid
6.26 Which organisms have natural resistance to nitrofurantoin ?
(a) E. Coli
(b) Streptococcus faecalis
(c) Proteus species
(d) Klebsielia
6.27 Which organisms have natural resistance to cephalexin ?
(a) E. Coli
(b) Streptococcus faecalis
(c) Proteus species
(d) Klebsiella
6.28 Which of the following organism is not sensitive to trimethoprim ?
(a) Staphylococcus albus

(b) Lebsiella
(c) Proteus
(d) P. Aeruginosa
(e) E. Coli
6.29 The following sulfonamides dissociate as acids EXCEPT :
(a) Sulfisorazole
(b) Sulfamethiazole
(c) Sulfadimidine
(d) Sulfageranidine
6.30 To which antibiotic most species of proteus are resistant :
(a) Garamycin
(b) Ampicilin
(c) Cephalexin
(d) Polymixin
6.31 To which antibiotic all species of streptococcurs faecalis are resistant :
(a) Nalidixid acid

(b) Penicilins
(c) Cephexin
(d) Garamycin
6.32 What is the dosage of Nalidixic acid in mg per kg body weight in 24 hrs in a person with normal
renal function ?
(a) 20
(b) 40
(c) 60
(d) 80
6.33 What is the dosage of Nitrofurantoin in mg per kg body weight in 24 hrs in a person with
normal renal funtion ?
(a) 1
(b) 2
(c) 3
(d) 4
6.34 The following are the flouroquinolone derivatives EXCEPT :
(a) Norfloxacin
(b) Ciprofloxacin
(c) Ofloxacin
(d) Cephotaxime
6.35 In which of the following plasmid mediated factor (R factor) resistance is rare:
(a) Tetracyclines
(b) Sulfonamides
(c) Penicillins
(d) Nitrofurantoin
6.36 In which of the following R factor transfer never been demonstrated:
(a) Nitrofurantoin
(b) Quinolon
(c) Tetracyline
(d) Sulphonamides
6.37 Which of the following are at risk for increased morbidity from asymptomatic bacteriuria due to
protens species and need treatment?
(a) Severe diabetics

(b) Children under 4 years of age with reflux
(c) Pregnant women
6.38 Which of the following can be detected by hippuran 131 and technetium 99 glucoheptonate
scans in acute renal infections ?
(a) Focal parenchymal damage

(b) Renal function impairement
(c) Decreased renal perfusion
6.39 In human acute clinical pyelonephritis, which serum antibodies against the infecting bacteria
are elevated :
(a) igA
(b) igM
(c) igG
6.40 “A normal white cell count can exclude UTI”. This statement is :
(a) True
(b) False
6.41 The presence of white cell in the urine is a sign of :
(a) Inflammation
(b) Infection
(c) Both
6.42 In a case of UTI, presence of white cells casts suggest involvement of :
(a) Urethra
(b) Bladder
(c) Prostate
(d) Kidney
6.43 Which is a preferable method for collection of urine for culture in a child in the first year of life?
(a) Clean catch

(b) Plastic bag collection
(c) Bladder puncture
(d) Catherization
6.44 At what temperature bacterial count remain unchanged in urine for at least 48 hours :
(a) 0-4oC
(b) 4-8oC
(c) 8-12oC
(d) 12-16oC
6.45 Chronic pyelonephritis is a term used for describing:
(a) Certain characteristic histologic lesions of renal parenchyma

(b) Focal renal parenchymal defect visible on X-ray examination
(c) Clinical condition characterised by continous excretion of bacteria or by frequent recurrence
of infection
6.46 Which is the urographic hallmark of chronic pyelonpehritis :
(a) Coarse focal renal scar with clubbing underlying calyx

(b) Coarse focal renal scar with normal underlying calyx
(c) Normal renal outline with clubbed underlying calyx
(d) Small kidney with normal calyces
6.47 Segmental renal ischaemic and chronic pyelonephritis give to renal scarring on IVP. The finding
that goes in favour segmental renal ischemia is:
(a) Non – visualisation of renal outline

(b) Hyperdense nephrogram
(c) Underlying calyx normally copped
(d) Increase in renal size
6.48 Which is the best mean of detecting less prominent renal scarring bluting of calyces in chronic
pyelonephritis ?
(a) Measuring renal length

(b) Measuring renal bredth
(c) Measuring interpapillary line
(d) Measuring the axis of the two kidneys
6.49 What is the thickness of normal adult renal parenchym of measured from interpapillary line ?
(a) 1-2 cm
(b) 2-3.5 cm
(c) 3.5-4.5 cm
(d) 4.5-5.5 cm
6.50 The thickness of renal parenchyma in relationship to calyces is greatest at :
(a) Renal poles

(b) Upper lateral margins
(c) Middle lateral margins
(d) Inferior lateral margins
6.51 The following are urographic features of chronic pyelonephritis EXCEPT :
(a) Renal focal scaring

(b) Corresponding calyceal blunting
(c) Diffuse renal scarring contracted kidney
(d) Non obstructive hydronephrosis
(e) Necrosis of sloughly papillae
6.52 Which is the commonest route of infection in chronic pyelonephritis ?
(a) Haematogenous
(b) Ascending
(c) Lymphatic
(d) Contigous
6.53 The following are important factors in the pathogenesis of renal scarring in chronic
pyelonephritis EXCEPT :
(a) Intrarenal reflux

(b) Infection
(c) Ureteric yo yo
(d) Vesico uretric reflux
6.54 The renal scar in chronic pyelonephritis represent fibrosis of :
(a) Renal capsule

(b) Renal cortex
(c) Renal medulla
(d) Whole thickness of renal parehchyma
6.55 How many percent patients with symptomatic febril reaction will acquierd of renal scar:
(a) 5-10%
(b) 10-20%
(c) 20-30%
(d) 30-40%
6.56 Agglutinating and hemagglutinating antibodies to G. Antigen of the infecting E.coil can be
demonstrated in serum of patients having :
(a) Urethritis
(b) Cystitis
(c) Prostatitis
(d) Pyelonephritis
6.57 Which is the most common condition associated with papillary necrosis ?
(a) Analgesic abuse

(b) Pyelonephritis
(c) DM
(d) Sickle cell hemoglobinopathies
6.58 What is the hallmark of diagnosis of emphysematous Pyelonephritis :
(a) Presence of gas in the collecting system

(b) Appearence of intraparenchym gas
(c) Presence of gas in the perinephric region
(d) Presence of gas under the diaphragm
6.59 Which is the most useful investigation to diagnose pyonephritis ?
(a) Intravenosu urography

(c) Ultrasound
(d) CT scan
6.60 Which are the organisms in majority of cases of perinephric abscess?
(a) Staphylococci
(b) E. Coli
(c) Proteus
(d) B&C
6.61 What is the white blood cell count in most patients with perinephric abscess ?
(a) Less than 4.000

(b) 4.000 to 6.000
(c) 6.000 to 10.000
(d) More than 10.000
6.62 The following are commonly associates with Xanthogranulomatous pyonephritis EXCEPT :
(a) Nonfunctioning kidney

(b) Infection
(c) Stone
(d) Tumor
6.63 Which of the following statement in FALSE regarding xanthogranulomatous pyonephritis ?
(a) Can be confused with renal cell carcinoma

(b) 85% cases are associated with non functioning kidney
(c) Proteus mirabilis is the most common uropathogen
(d) Arteriography always differentiate it from renal cell carcinomas
6.64 Which operation is commonly performed in Xanthogranulomafous pyonephritis ?
(a) Percutaerious nephrostomy

(b) Stone removal
(d) Nephrectomy
6.65 Which is the most common organism involved with Xanthogranulomafous pyonephritis ?
(a) E. Coli
(b) Proteus
(c) Klebsiella
(d) Pseudomonas
6.66 Which is the typical finding of multifocal malacoplakia on intravenous urography ?
(a) Large non functioning kidney

(b) Enlarged kidney with multiple filling defects
(c) Pressence of stones with hydronephrosis
(d) Presece of renal calcification
6.67 Which of the following are characteristic histological faetures in Malacoplakia ?
(a) Von hanseman cells

(b) Michaelis-Gutmann bodies
(c) Xanthoma cells
(d) A&B
6.68 Pneumaturia could be due to :
(a) Infection with a gas forming bacteria

(b) Vescoenteric fistula
(c) None
(d) Both
6.69 Which is the most common organism causing gram negative bacteremia ?
(a) E. Coli
(b) Proteus
(c) Klebsiella
(d) Pseudomonas
6.70 The culture of which of the following is sufficient to determine urethral bacteriology :
(a) Labia major

(b) Labia minor
(c) Vaginal intraoitus
(d) Bladder
6.71 The following drugs are recommended in the prophylaxis of recurrent urinary tract infections
EXCEPT :
(a) Trimethoprisulfamethoxazole
(b) Amoxilcillin
(c) Nitrofurantoin
(d) Cephalexin
(e) Flouroquinolones
6.72 Which complication can happen after longterm treatment of Nitrofurantion ?
(a) Allergic pneumonitis

(b) Neuropathy
(c) Liver damage
(d) Pulmonary fibrosis
6.73 In which of the following Nitrofurantion should not be used :
(a) Prepubertal children

(b) Children with glucose 6 phosphate dehydrogenase deliciency
(c) Children with mild renal failure
(d) Children with vesico ureteral reflux
6.74 Which of the following drug is contraindicated during the first few months of life ?
(a) Nitrofurantoin
(b) Cephalaxin
(c) Trimethoprim sulfametoxazol
(d) Trimethoprim
6.75 How many percent of children have radiological scar after the second symptomatic urinary tract
infection ?
(a) 13 percent
(b) 15 percent
(c) 17 percent
(d) 19 percent
6.76 How many percent of chidren have radiological scars after symptoms of a first urinary tract
infection ?
(a) 1.5 percent

(b) 2.5 percent
(c) 3.5 percent
(d) 4.5 percent
6.77 During witch age, prepucial aerobic bacterial colonization is highest :
(a) During the first month after birth

(b) During 3-6 monts of age
(c) During 6-12 months of age
(d) After 1 year of life
6.78 The prophylactic antimicrobial agent for urinary tract infection should have following EXCEPT :
(a) Hiht serum level

(b) High urinary level
(c) Minimal effect on the normal fecal flora
(d) Well tolerated
(e) Low cost
6.79 Which is the most severe consequence of sexually transmitted pelvic diesese in women ?
(a) Pelvic inflammatory disease

(b) Infertility
(c) Ectopic pregnance
(d) Repeated abortions
6.80 What is the average incubation period for gonococcal infection ?
(a) 1-2 days

(b) 3-4 days
(c) 5-6 days
(d) 7-8 days
6.81 Which part of the male urethral not sensitive gonococcal infection ?

(b) Pendulous and bulbar
(c) Membranous
(d) Posterior
6.82 Following are the complications of acute epididymitis EXCEPT :
(a) Abscess formation

(b) Testicular infarction
(c) Development of chronic pain
(d) Infertility
(e) Tuberculosis
6.83 In which part of the epididymis, the inflammation and swelling begins in acute epididimitis :
(a) Head
(b) Body
(c) Tail
6.84 Probably, which is the most accurate method of diagnosis of torsion the testis :
(a) Physical examination

(b) Radionuclide scanning
(c) Doppler ultrasound
(d) Testicular arteriography
6.85 Which of the following is characteristic of nonspecific vaginitis?
(a) Epithelial cells with distint borders

(b) Clue cells
(c) Pseudomycelia
(d) Yeast cells
6.86 Following serotypes in C. Trachomatis can cause lymphogranuloma venereum EXCEPT :
(a) L1
(b) L2
(c) L3
(d) L4
6.87 Which is the best means of controlling HIV infection ?
(a) To avoid exposure to the virus

(b) Vaccines
(c) Antiviral chemotherapy
(d) To increase resistance in the host
6.88 Which of the following is not advised for collection of urine culture in men?
(a) Suprapubic puncture

(b) Urethral catheterization
(c) Mid stream urine
6.89 Which of the following is not a synomym of tuberculosis ?
(a) Consumption
(b) Scorfula
(c) Koch’s lesion
(d) Rosacea
6.90 In which of the following age groups, genitourinary tuberculosis is more prevalent :
(a) 15-25 yrs

(b) 25-40 yrs
(c) 40-60 yrs
(d) 60-80 yrs
6.91 What is the average time lag between pulmonary and genitourinary tuberculosis ?
(a) 2 yrs
(b) 8 yrs
(c) 12 yrs
(d) 16 yrs
6.92 Which is the commonest route of infection in genitourinary tuberculosis ?
(a) Haematogeneous
(b) Ascending
(c) Descending
(d) Lymphatic
6.93 In which part of the nephron are the tuberelehacilli trapped :
(a) Proximal convaluted tubule

(b) Glomerulus
(c) Loop of the henle
6.94 How many percent of cases of milliary tuberculosis will have positive urine culture for
mycobacterium tuberculosis ?
(a) 5%
(b) 10%
(c) 15%
(d) 20%
6.95 Which is the commonest site of stricture of ureter in genitourinary tuberculosis?
(a) Pelviureteric junction

(b) Upper 1/3 of the ureter
(c) Middle 1/3 of the ureter
(d) Lower 1/3 of ureter
6.96 Which is the commonest cause of stricture of lower 1/3 of ureter ?
(a) Congenital
(b) Due to passage of calculus
(c) Tuberculosis
(d) Tumour
6.97 At what juncture may steriods be used to reduce fibrosis and stricture formation in a case of
genotourinary tuberculosis cystitis ?
(a) Before chemotheraphy

(b) Along with chemotheraphy
(c) After chemotheraphy
6.98 Which part of the bladder does not contract in tuberculous cystitis ?
(a) Dome
(b) Anterior wall
(c) Lateral wall
(d) Trigone
6.99 Which is the commonest cause of a hard nodule in the prostate in 60 yrs old men ?
(a) Carcinoma
(b) Tuberculosis
(c) Calculi
(d) Chronic prostatitis
6.100 Which of the following is usually free of disease in genitourinary tuberculosis ?
(a) Kidney
(b) Ureter
(c) Testis
(d) Epididymis
6.101 The diagnosis of genitourinary tuberculosis is confirmed by :
(a) Symptoms
(b) Radiological features
(c) Presence of the tubercle bacilli is rinc
(d) ESR
6.102 Which urine sample is ideal for the demonstration of tubercle bacilli ?
(a) 24 hrs urine

(b) 12 hrs urine
(c) Is voided urine in the morning
(d) Voided urine any time of the day
6.103 In a case of genitourinary tuberculosis, overdistension of renal pelvis during retrograde

pyelogram may result in :
(a) Dissemination of infection to the blood

(b) Rupture of renal pelvis
(c) Haemorrhage
6.104 Which is the surest and preffered investigation for confirming the diagnosis of GUTB ?
(a) Bladder biopsy

(b) AFB smear
(c) AFB culture and sensitivity
(d) AVP
6.105 The following facts about bladder biopsy in cases of GUTB are corect EXCEPT ?
(a) In case of negative urine AFB, the bladder biopsy may be positive
(b) Ulcers /nodules adjacent to the ureteric orifices need not be biopsied
(c) Only ulcers a way from the ureteric orifices need be biopsied as they may be ca-in-situ
(d) It is contraindicated in tuberculosis cystitis
6.106 Which of the following is not desirable in an tubercular chemotherapy ?
(a) Single drug therapy

(b) Multiple drug therapy
(c) Long term therapy
(d) Short term therapy
6.107 Single drug chemotherapy is not used in genitourinary tuberculosis due to :
(a) Cost of drug

(b) Duration of treatment
(c) Complication of drugs
(d) Development of drug resistance
6.108 Which of the following drug is used throughout the full course of multiple drug therapy
genitourinary tuberculosis ?
(a) Ethambutol
(b) Isonex
(c) Streptomycin
(d) Rifampicin
(e) Pyrazinamide
6.109 What is the dose of isonex in a adult patient in milligrams per day ?
(a) 100
(b) 200
(c) 300
(d) 400
6.110 The following drugs are bacterial for tuberclebacilli EXCEPT :
(a) Rifampicin
(b) Isonex
(c) Streptomycin
(d) Kanamycin
6.111 The following are reason why GUTB can be cured in 4 months of antibubercular treatment
EXCEPT :
(a) Renal tubercular lesions are calcified

(b) There are fewer organims in renal than in pulmanary lesions
(c) Kidney has a very good blood supply
(d) High concentrations of drug in urine
(e) Drugs penetrate closed cavities in lethal concentrations
6.112 Gow’s regime of antitubercular therapy for GUTB comprises the following drugs EXCEPT :
(a) Pyrazinamide
(b) Para amino salicylte (PAS)
(c) Rifampicin
(d) Isoniazid
6.113 Which of the following is the least potent sterlising drug in GUTB ?
(a) Rifampicin
(b) Pyrazinamide
(c) Isoniazid
(d) Streptomycin
6.114 In which bacterial popilation, pyrazinamide acts in GUTB :
(a) Continous dividing bacilli

(b) Intermittent metabolisers
(c) Organims acid environment in macrophages
(d) Dormant oganisms
6.115 How many percent of administered isoniazid is excreted by the kidneys ?
(a) 60 percent
(b) 70 percent
(c) 80 percent
(d) 90 percent
6.116 What is the MIC value of rifampacin againts M. Tubeculosis ?
(a) 0.10 microgram/ml

(b) 0.20 microgram/ml
(c) 0.30 microgram/ml
(d) 0.40 microgram/ml
6.117 What is the usual MIC value of pyrizinamide agains M.tuberculosis :
(a) 10 microgram/ml
(b) 15 microgram/ml
(c) 20 microgram/ml
(d) 25 microgram/ml
6.118 What is the half life of pyrizinamide :
(a) 6 hours
(b) 7 hours
(c) 8 hours
(d) 9 hours
6.119 Which is the key bactericidal drug againts M. Tuberculosis ?
(a) Rifampicin
(b) Isoniazid
(c) Pyrizinamide
(d) Streptomycin
Match the complications of antituberculous drugs :
6.120 Isonex (a) Visual disturbances

6.121 Rifampicin (b) 8th nerve damage
6.122 Ethambutol (c) Polyneuritis
6.123 Streptomycin (d) Liver damage
6.124 PAS (e) Gastrointestinal disturbances
6.125 What should be the duration of anti TB drugs before a patient is considered for surgery in
GUTB :
(a) No relation
(b) 1 week
(c) 6 weeks
(d) 6 months
6.126 In GUTB all of the following are indication of neprectomy EXCEPT :
(a) Associated with hypertension

(b) Kidney having a calcified polar lesion
(c) Tuberculosis kidney co existing with carcinoma
(d) Grossly diseased nonfunctioning kidney
6.127 The following parasites commonly in volve urogenital tract EXCEPT :
(a) Schistosomia haematobium

(b) Wuchereria
(c) Trichomonas vaginalis
(d) Strongyloides strecoralis
6.128 In which of the following S.haematobium worm pair in human :
(a) Bladder mucusa

(b) Detrusor mucle
(c) Perivesical fascia
(d) Perivesical venous plexus
6.129 S. Haematobium infection is diagnosed by :
(a) Detected of terminally spined eggs of S. Haematobium

(b) Cystoscopy
(c) Radiology
(d) Radionuclear studies
6.130 Which of the following sample of urine is preferable to demonstrate eggs of S. Haematobium ?
(a) 24 hrs urine

(b) 1st volded urine in the morning
(c) Mid day urine
(d) Mid night urine
6.131 Presence of a calcified bladder appears like a fetal head resting in the pelvis is pathognomonic
of :
(a) Tuberculosis
(b) Schistosomiasis
(c) Malignancy
(d) Chronic cystitis
6.132 In case of schistosomiasis intravenous urography can reveal :
(a) Hydrouretr
(b) Hydronephrosis
(c) Ureteral stenosis
(d) Bladder and ureteral filling defect
6.133 Which is the drug of choice for S. Haematobium infection in its endemic setting:
(a) Metifonate
(b) Hycanthone mesylate
(c) Praziquantel
(d) Niridazole
6.134 Which is the drug of choice in combined S. Mansoni and S. Haemotobium infections?
(a) Metrifonate
(b) Hycanthone mesylate
(c) Praziquantel
(d) Niridazole
6.135 The involvement of which of the following results in the most common and dangerous sequale
of urinary schistosomiasis:
(a) Kidney
(b) Ureter
(c) Bladder
(d) Urethra
6.136 In which part of the ureter schistosomal lesions are more common :
(a) Upper ureter

(b) Middle ureter
(c) Pelviureteric junction
(d) Juxtavesicular ureter
6.137 Which type of hydroureter is associated with schistosomiasis ?
(a) Segmental (Le. Cylindrical or fusiform)

(b) Tonic
(c) Atonic
6.138 In which part of ureter , egg accumulation begins in active schistosomiasis :
(a) Lamina propria

(b) Muscle layers
(c) Mucus membrane
(d) Perivesical
6.139 Microfilaria can present in :
(a) Peripheral smear

(b) Chylous urine
(c) Hyrocele fluid
(e) None of the a bove
6.140 Which is the most common parasite accounts for human lymphatic filariasis?
(a) W. Bancrofti
(b) Brugia malayi
(c) Brugia timori
(d) Onchocerca volvulus
6.141 Which is the method of choice for diagnose is of filaria infection ?
(a) Detection of microfilaria

(b) Lymph node biopsy
(c) Lymphangiography
(d) Immunologic test
6.142 Which is the most common urban vectors of W. Hancrofti ?
(a) Anopheles
(b) Culex
(c) Aedes
(d) Mansonella
6.143 Which is the drug choice in the menagement of filariasis ?
(a) Benocide
(b) Arsenal compounds
(c) Antimalarial drugs
(d) Metrifonate
7
CALCULOUS DISEASE
7.1 Which is a low incidence area for calculous disease ?
(a) British isles

(b) Scandinavia
(c) Nothern india
(d) Afrika
7.2 Which statement about calculous disease is false ?
(a) Stonesn from Great Britain, Scotland and Sudan are siliar and are composed primarilly of
mixed calcium oxalete and calcium phosphate
(b) In other areas of the world upper urinary tract calculi are composed mainly of magnesium
ammonium phosphate (struvite)
(c) Struvit stone are not primary associated with UTI in female
(d) Bladder calculi from Thailand mostly contain ammonium acid urate ir calcium oxalate or
both
7.3 In which geographical are, the upper urinary tract calculi cointan lesser amount of uric acid ?
(a) Czechoslavakia
(b) Israel
(c) Chicago
(d) India
7.4 During which of the foloowing months, the incedenceof urinary calculi is high :
(a) January, February, March

(b) April, May, June
(c) July, August, September
(d) October, November, December
7.5 Which of the following are important factors in the etiology of calculous disease ?
(a) Climatic and seasonal variation

(b) Water intake
(c) Diet
(d) Occupation
7.6 Intake of which the following results in increased urinary excretion of substances that produce
stones :
(a) Purines
(b) Oxalates
(c) Calcium
(d) Anly B & C
7.7 Worcestershire sause countains large amount of :
(a) Purines
(b) Oxalates
(c) Calcium
(d) Phosphates
7.8 High incidence of urinary calculi are found in the following EXCEPT :
(a) Sedentary occupation

(b) Cooks
(c) Engine room personnel
(d) Active group of wokers
7.9 Which of the following is wrong regarding supersaturation/crystallization theory of etiology of

calculon disease ?
(a) pH and temperature are important for crystals to form

(b) In urine, when the concentration of a substance reaches the point at which saturation would
occur in water, crystalization does occur as expected
(c) urine has the ability to hold more solute in solution than pure water
(d) citrate in urine combines with calcim to form a sluble complex
7.10 The lumen of nephron is smallest at the level of :
(a) proximal convoluted tubule

(b) loop of the henle
(c) distal convoluted tubule
(d) collecting duct
7.11 How many micro the diameter of collecting duct ?
(a) 50-200
(b) 200-400
(c) 400-600
(d) 600-900
7.12 The majority of ureteral calculi which cause symotms have a size greater than :
(a) 0.5 mm
(b) 1.0 mm
(c) 1.5 mm
(d) 2.00 mm
7.13 What is the weight of the largest vesical calculus reported ?
(a) 1 kgm
(b) 2 kgm
(c) 5 kgm
(d) 10 kgm
7.14 Which of the following are urinary inhibitors of crystallization ?
(a) Peptides
(b) Matrix
(c) Amino acids
(d) Citrate
7.15 Stone matrix contains the following EXCEPT :
(a) Sialic acid

(b) Protein
(c) Hexose
(d) Hexosamine
(e) Water
7.16 What is the percentage of hexosamine in matrix stone on chemical analysis ?
(a) 35%
(b) 45%
(c) 55%
(d) 65%
7.17 Stone matrix originates the :
(a) Proximal tubule

(b) Glomerulus
(c) Collecting ducts
7.18 Which of the following statement are TRUE regarding etimology of calculous disease ?
(a) Renal function must be adequate for the excretion of excess amount of cystailizable
substances
(b) The kidney must be able to adjust its pH excretion substance
(c) Urine must have a complete or relative absence of a number of inhibitors of crystallization
(d) The crystal mass must reside in the urine system for a time sufficient to allow for its growth
or aggregation
7.19 At which of the following sites, since become impacted :
(a) Galyx
(b) Pelviureteric junction
(c) In the ureter near the pelvic brim
(d) Only b and c
7.20 Nausea and vomiting are commnly associated with renal colic because :
(a) Autonomic nervous system transmits pain

(b) Stone is ipacted in kidney or ureter
(c) The coliac ganglion serves both kidneys and stomach
(d) Urinary tract infection is associated with hyperacidity
7.31 Which of the following is the indication of surgery in calculous disease ?
(a) Evidence of significant obstruction

(b) Progressive renal deterioration
(c) Refractory pyelonephritis
(d) Ureminiting pain
7.32 Which of the following is a contraindication for percutaneus nephrolithotomy ?
(a) Pelvic stones

(b) Solitary kidney
(c) Bleeding disorders
(d) Calyceal stones
7.33 Which of the following is relative contraindication for percutaneous stone removal ?
(a) Horse-shoe kidney

(b) Solitary kidney
(c) Ectopic pelvic kidney
7.34 Which of the following an indication for emergency surgery in calculous disease ?
(a) Stone in an infection kidney

(b) Stone in a single kidney
(c) Stone in a ureter
(d) Stone in both kidney
7.35 Until how many weeks of obstruction recovery of renal function occurs on relief of complete
obstruction of kidney due to calculous.
(a) 8 weeks
(b) 16 weeks
(c) 32 weeks
(d) 48 weeks
7.36 Which of the following pathologic change occur in the ureter in presence of calculous ?
(a) Desquamation of epithelium

(b) Ulceration of calculous
(c) Fibrosis
(e) A&C
7.37 All of the following lesion can result in infection is superimposed on calculous disease EXCEPT :
(a) Pyelonephritis
(b) Pyohydronephrosis
(c) Perinephritis
(d) Xanthogranulomatous pyelonephritis
(e) Papulary necrosis
7.38 Complications of neglected long standing calculi include all of the following EXCEPT :
(a) Pyelonephritis
(b) Chronic renal failure
(c) Squamous cell carinoma
(d) Renal TB
7.39 Regarding infection stones which of the following statement is correct :
(a) They are caused primarily by urea spliiting bacteria in the urine with subsequent evation of
urinary PH and formation of stone crystal.
(b) They are caused by any bacteria in the urine, with subsequent elavation of pH
(c) They are caused primarily by urea-splitting bacteria in the urine with lowering of urinary pH
and formation of struvite crystals
(d) They are caused primarily by urea-splitting bacteria in the urine, with subsequent elevation
of urine pH and formation of calcium oxalate crystals
7.40 Which of the following stones most commonly form in acidic pH ?
(a) Calcium oxalate

(b) Uric acid
(c) Calcium phosphate
(d) Magnesium ammonium phosphate
7.41 Persistent excretion of urine below what pH cobtributes increased concentration of the
relatively isoluble uric acid :
(a) 7.25
(b) 6.50
(c) 5.75
(d) 5.00
7.42 Marked changes in urinary pH can result from all of the following EXCEPT :
(a) Ingestion of foods containing acid or alkali

(b) Environmental changes
(c) Presence or absence of respiratory-cardiac disease
(d) Association with klinefelter syndrome
7.43 Which of the following factors are involved in formation of uric acid calculi ?
(a) A relative hyperuricosuria or chronic oversaturation of urine with uric

(b) A tendency toward excretion of excessive acidic urine
(c) Relatively reduced volume of urine
(e) A&B
7.44 Theraphy of uric acid calculi includes the following EXCEPT :
(a) Increase in daily intake of fluid

(b) Alkalinisation of the urine
(c) Decrease in excessive excretion of uric acid drugs
(d) Surgery
(e) Change of environment
7.45 Which of the following statement is wrong in relation to idiopathic uric acid lithiasis ?
(a) They do not ave hyperuricemia

(b) They amount of urinary excretion of uric acid per day is within normal range
(c) Urine pH remains alkaline throughout the day
(d) In patients with chronic diarrhoeal states, those with ileostomy may be included in this
category
7.46 In management of uric acid lithiasis, the urine pH should be between :
(a) 5.5-6.0
(b) 6.0-6.5
(c) 6.5-7.0
(d) 7.0-7.5
7.47 Cystinuria is an inherited defect in renal tubular reabsorption of which of the following amino
acids :
(a) Cystine
(b) Ornithine
(c) Lysine
(d) Arginine
7.48 Cystinuria is inherited as :
(a) Autosomal recessive trait

(b) Autosomal dominant trait
7.49 In cystinuria, the amino acid transport defect exist in ;
(a) Renal tubular cell

(b) Intestinal mucosa
(c) None of them
(d) Both of them
7.50 What is the incidence of clinically evident cystinuria ?
(a) 1:1000
(b) 1:5000
(c) 1:10.000
(d) 1:20.000
7.51 How much cystine is usually excreted in patients with homozygous cystinuria in urine per day ?
(a) 200-300 mgs

(b) 300-400 mgs
(c) 400-500 mgs
(d) In excess of 600 mgs
7.52 Solubility of cystine in urine becomes apparent only at pH levels above :
(a) 5.5
(b) 6.0
(c) 6.5
(d) 7.2
7.53 Which statement about cystincalculi is false ?
(a) There is no family in story of calculous disease

(b) They should be suspected in recurrent calculus disease below the age of 30 years
(c) They have radiographic evidence of slighty dense, laminated ground glass calculi
(d) They have hexagonal crystals in the urine
7.54 Which of the following statement is most appropriate regarding therapy for cystine stones ?
(a) Fluid intake to ensure urine output 3-4 liters/day

(b) Alkalinazation of urine (pH above 7.5)
(c) Occasionally d-pencillamine
(d) A&C
7.55 Which food group provides higher and absolute load by weight ?
(a) Carbohydrates
(b) Fats
(c) Proteins
(d) Vitamines
7.56 Which of the following are infective stones ?
(a) Calcium oxalate

(b) Uric acid
(c) Magnesium amonium calcium phospate (struvite)
(d) Cystine
7.57 What should be the pH of urine for formation of struvite calculi :
(a) 5.5-6.0
(b) 6.0-6.5
(c) 6.5-7.0
(d) Above 7.2
7.58 What is the comparisson majority of the staghorn calculi:
(a) Calcium phosphate

(b) Calcium oxalate
(c) Magnesium Phosphate
(d) Uric acid
7.59 Which is the common urea-splitting organism ?
(a) Peudomonas
(b) Klebseilla
(c) E. Coli
(d) Proteus
7.60 Management of infected stones consits of :
(a) Long term treatment with antibiotics

(b) Ingestion of large amount of fluids
(c) Restriction of dietary phosphates
(d) Decrease in intestinal absorption of phosphates by administration of aluminium hydroxide
gel
7.61 Incidence of infected stones is high in patients with following EXCEPT :
(a) Persistan infection

(b) Foreign bodies
(c) Neurogenic bladder
(d) Hyperparathyroidism
7.62 Solution G contains all of the following EXCEPT :
(a) Citric acid monohydrate 2.5 gm

(b) Anhydrous magnesium oxide 3.84 gm
(c) Anhydrous sodium carbohidrate 4.37 gm
(d) Distilled water 100 ml
7.63 Solution M contains all of the following EXCEPT :
(a) Citric acid monohydrate 32.5 gm

(b) Anhydrous magnesium oxide 3.84 gm
(c) Anydrous sodium carbonate 8.84 gm
(d) Normal saline 1000 ml
7.64 What is the pH of solution G ?
(a) 3.95
(b) 4.50
(c) 5.00
(d) 5.50
7.65 Which is the solution of choice for dissolution of phosphate calculi ?
(a) Solution G
(b) Solution M
(c) Hemiacidrin (Reacidin)
7.66 Which is the drug of choice in management of infected stones ?
(a) Allopurinol
(b) Acetohydroxamic acid (aha)
(c) D-pencilamine
(d) Aluminium hydroxide gel
7.67 How many percentage of total calcium is present in free ionic form
(a) 25%
(b) 45%
(c) 65%
(d) 75%
7.68 How many percentage of total calcium is protein bound ?
(a) 45%
(b) 55%
(c) 65%
(d) 75%
7.69 Which form of calcium is filtered through the glomerulus ?
(a) Free ionic form

(b) Protein bound
7.70 Which of the following is false about hyperparathyroidism ?
(a) Serum calcium levels are raised

(b) Serum parathormone levels are raiesed
(c) Bone density is low
(d) Resting urinary calcium levels are raised
(e) Intestinal absorption of calcium is decreased
7.71 Which of the following statement is false about absorptive hypercalciuria ?
(a) Intestial absoption of cakium is increase

(b) Bone density is normal
(c) Fasting urine calcium levels are normal
(d) Serum calcium levels are increased
7.72 Which of the following is false about renal hypercalciuria ?
(a) Serum calcium levels are normal

(b) Fasting urine calcium levels are raised
(c) Intentinal absoption of calcium is increased
(d) Urine cyclin AMP is raised
7.73 Serum calcium levels are regulated by all of the following EXCEPT :
(a) Parathyriud hormone

(b) Thyrocalciton in
(c) Vit. D
(d) 1.25 dihydroxycholecalciferol
(e) Serum alkaline phsophatase
7.74 Which of the following is false about parathyoid hormone ?
(a) It is relatively small polypeptie with a molecular weight of 900

(b) It is produced by the parathyroid gland
(c) It has both calcium mobilizing and renal phosphaturic actions
(d) There is norma reabsoption of calcium from the intestine
7.75 ‘Parathyroid crisis’ usually occurs when serum calcium levels approach :
(a) 10mg/100ml
(b) 13mg/100ml
(c) 15mg/100ml
(d) 17mg/100ml
7.76 Parathyroid crisis is characterised by following EXCEPT :
(a) Slow pulse

(b) Progressive lethargy
(c) Nausea, vomitting, abdominal discomfort
(d) Azotemia
7.77 “Parathyroid” crisis is managed by :
(a) Parathyroidectomy
(b) Inorganic phosphate
(c) Inorganic sulphate
7.78 The following drugs can reverse hypercalcemie EXCEPT :
(a) Frusemide
(b) Etharycnic acid
(c) Corticosteroids
(d) Mithramycin
(e) Insulin
7.79 Which of the following is a rapid way to reverse hypercalcemia ?
(a) Frusemide
(b) Corticosteroids
(c) Haemodialysis
(d) Estrogens
7.80 Renal tubular acidosis is characterised by all of the following EXCEPT :
(a) Fluid overload

(b) Hyperchioremia
(c) Hypokalemla
(d) Metabolic acidosis
(e) Nophrocalcinosis
7.81 Distal renal tubular acidosis is known as all of the following EXCEPT :
(a) Hyperchloremic acidosis

(b) Butter albright syndrome
(c) Light-wood’s syndrome
(d) Idiopathic acidosis
(e) Osgood schlatter syndrome
7.82 Which of the following statement is flase regarding renal tubular acidosis ?
(a) It results in an inability to excrete acidic urine

(b) The fasting urinary pH always exceeds 5.5
(c) There are two form of the disease
(d) Proximal renal tubular acidosis is associated with renal calculi
7.83 Which of the following statement is false regarding distal renal tubular acidosis ?
(a) These oatuebts di bit excrete netabolic acids normaly

(b) Distal tubular secration of potassium is decreased
(c) Increased amount of calcium is excreted in the urine
(d) Increased amount of sodium is excreted in the urine
7.84 Renal tubular acidosis is characterised by the following biochemical abnormalities EXCEPT :
(a) Reduced carbon dioxide combining power

(b) Decreased PCO and serum pH
(c) Hypochloremia
(d) Hypokalemia
(e) Normal calcium and phosphate levels
7.85 What is the composition of calculi in distal renal tubular acidosis ?
(a) Calcium oxalate

(b) Calcium phosphate
(c) Calcim magnesium ammonium phosphate
(d) Uric acid
7.86 What are the objectives of the medical management of renal tubular acidosis ?
(a) To relieve acidosis

(b) To reduce hyperchloremia
(c) To reduce hypercalciuria
(d) To improve renal reabsoption of calcium
7.87 What is the upper limit of normal urinary excretion of oxelate ?
(a) 15mg/day
(b) 25mg/day
(c) 35mg/day
(d) 45mg/day
7.88 Which of the following statement is false regarding primary hyperoxaluria ?
(a) It is a congenital iilness

(b) It is characterised by endogenous formation of excessive amounts of oxalates in tissues
(c) It is associated with pyrodoxine deficiency
(d) There are two types of primary hyperoxaluria
7.89 Which of the following enzymatic deficiency occurs in type II hyperoxaluria ?
(a) 2 oxoglutarate
(b) Glyoxylate carbolinase
(c) D-glyceric dehydrogenase
7.90 Which of the following statements is false regarding calculous disease due to primary
hyperoxaluria ?
(a) Usually occurs in adults

(b) There is extensive nephrocalcinosis
(c) Renal failure usually occurs
(d) Most die prior to the age of 30 years
7.91 Acquired hyperoxaluria occurs due to all of the following EXCEPT :
(a) Regional ileitis

(b) Colitis
(c) Intestinal bypass surgery
(d) Increased saccharine intake
7.92 Acquired hyperoxaluria occurs due to all of the following EXCEPT :
(a) Rapid intestinal transit

(b) Achlorhydria
(c) Lack of bacterial activity
(d) Inadequate bowel length
7.93 How many times the effect of urinary oxalate on crystallization is greater than the effect of
calcium ?
(a) 5 times
(b) 10 times
(c) 15 times
(d) 20 times
7.94 Which of the following is not a cause of acquired hyperoxaluria ?
(a) Methoxyflurance anaesthersia

(b) Ethylene glycol poisoning
(c) Vit. D intoxication
(d) Pyridoxin deficiency
7.95 What is the treatment of hypercalcemia and hypercalciuria with elevated parathormone ?
(b) Thiazides
(c) Neutral phosphates
(d) Allopurinol
7.96 What is the treatment of choice for hypercalcaemia with hypervitaminosis D ?
(a) Exercise large fluid output low calcium diet

(b) Neutral phosphate
(c) Stop exccesive vit. D
(d) Thiazides
7.97 What is the treatment of choice for absortive hypercalciuria ?
(b) Allopurinol
(d) Thiazides
7.98 What is the treatment of choice for hypercalciuria with renal leak ?
(b) Allopurinol
(d) Thiazides
7.99 What is the treatment for hypercalciuria with magnesium deficit ?
(a) Allopurinol
(b) Magnesium oxide
(c) Neutral phosphate
(d) Thiazides
7.100 What is the treatment for hyperuricemia with hyperuricosuria with calcium urolithiasis ?
(a) Magnesium oxide

(b) Neutral phosphates
(c) Thiazides
(d) Allopurinol
7.101 What is the treatment for intestinal hyperabsoptive hyperoxaluria ?
(a) High calcium diet

(b) Very low oxalate diet
(c) Cholestyramine
(e) B and C
7.102 Which of the following is not an indication for stone removal ?
(a) Obstruction
(b) Infection
(c) Mild pain only
(d) Severe pain
7.103 Which of the following statement is false regarding matrix calculi ?
(a) They are found predominantly in individuals with infection

(b) Infection is due to urease production organisms like protease species
(c) They are composed of coagulated mocoids with very little crystalline components
(d) They are quite radio-opaque
(e) They usually occur in alkaline urine
7.104 Which of the following is a common complication of neutral phosphate ?
(a) Hypokalema
(b) Diarrhoea
(c) Hyperuricemia
(d) Weakness
7.105 All of the following are complications of the thiazides EXCEPT :
(a) Hypokalemia
(b) Hyperuricemia
(c) Diarrhoea
(d) Weakness
7.106 What is the average adult dose of allopurinol for uric acid lithiasis ?
(a) 100mb/day
(b) 200mg/day
(c) 300mg/day
(d) 400mg/day
7.107 Which of the following is a common side effect of Allopurinol ?
(a) Diarrhoea
(b) Hypokalemia
(c) GI disturbances
(d) Activation of gout
7.108 Which of the following is a contraindication for Allopurinol ?
(a) Previous sensitivity

(b) Renal failure
(c) Urinary infection
(d) Hypokalemia
Match teh Following
7.109 Neutral calcium (a) Increase magnesium decrease calcium
7.110 Magnesium oxide (b) Inhibits epitaxy
7.111 Methylene oxide (c) Inhibits calcium nucleation
7.112 Allopurinol (d) Increase solubility of calcium

7.113 The ureteric stones are common in which age group :
(a) Middle age

(b) Infancy
(c) Childhood
(d) Old age
7.114 Which of the following statement is FALSE regarding ureteric calculi ?
(a) This is essentially a disease of middle age

(b) Occur more often in woman than men
(c) They oriniate in the kidney and then pass in the ureter
(d) Equally frequent on right and left side
7.115 Which is the common site for the majority of impacted ureter al stone ?
(a) Upper 1/3 rd of ureter

(b) Middle 1/3 rd of ureter
(c) Lower 1/3 rd of ureter
(d) Equal on all sites
7.116 Which of the following is characteristic of phleboliths on the plain X-ray ?
(a) They are round

(b) They cast dense shadows lateral to the course of the ureter
(c) Their centres are often radiolucent
(e) A and B
7.117 Which is the treatment of choice for small ureteric calculi not associated with infection and
progressive hydronephrosis ?
(a) Expectant theraphy

(b) Endoscopic manipulation
(c) Surgical removal
(d) Nephrostomy
7.118 Which of the following is NOT advisable in the management of large ureteric calculi associated
management of large ureteric calculi associated with infection ?
(a) Expectant therapy

(b) Ureteric catheterization
(c) Surgical removal
(d) Nephrostomy
7.119 Which of the following factors influence management of ureteric calculi ?
(a) Size
(b) Infection
(c) Obstruction
7.120 Which is the most serious complication of stone basketting ?
(a) Perforation of the ureter

(b) Ureteral avulsion
(c) Ureteral stricture
(d) Stone basket incarceration
7.121 In which part of the world, bladder calculi are commonly seen in children ;
(a) USA
(b) UK
(c) Europe
(d) Thailand and Indonesia
7.122 Which of the following statement is FALSE regarding vesical calculi ?
(a) It is predominently a disease of females

(b) In USA, it occur in men over the age of 50 years
(c) In elderly, it is associated with lower urinary tract obstruction
(d) The composition influenced by pH and degree of saturation of urine
7.123 Which of the following statement is CORRECT regarding true prostatic calculi ?
(a) they develop in the tissue or acini of the gland

(b) they are present in the dilated prostatic urethra
(c) they are present in the pouch of the urethra
(d) they are present in an abscess caviry connected to the urethra
7.124 Which of the following statement is false regarding prostatic calculi ?
(a) They are rarely observed in boys

(b) There are common in men of less than 40 years of age
(c) They are usually multiple
(d) They are mainly composed of calcium phosphate
7.125 Which of the following is most usefull to distiguish between prostatic calculi and carcinoma
prostate ?
(a) Acid phosphatase concentration

(b) Needle biopsy of the prostate
(c) Prostate specific antigen
(d) Ultrasound
7.126 Which of the following is FALSE regarding pathogenesis of preputial calculi ?
(a) Calculi arise from inspissated smegma

(b) Calculi form in the stagnant urine retained in the sac because of phimosis
(c) Calculi are expelled from the bladder via the urethra in to the preputial sac
(d) Usually associated with prolonged immobilisation
7.127 Which of the following statement is FALSE regarding upper urinary tract calculous disease in
children ?
(a) Three times greater incidence in males than females

(b) Likely to be associated with urinary tract infection or metabolic disease
(c) Diagnosis is similar to that in adults
(d) Treatment is similar to that in adults
8
UROONCOLOGY
Match various phase of division of cells :
8.1 G1 (a) Period of incorporation of radiolabbeled thymidine or thymidine

analoque in DNA synthesis
8.2 G (b) Phase of mitosis
8.3 G2 (c) Gap between mitosis and cell division
8.4 M (d) Gap between S phase amd ,mitosis
8.5 The following cytotoxic agents are M phase specific EXCEPT :
(a) Vincristine
(b) Vinblastine
(c) Colchicine
(d) Methotrexate
8.6 Which of the following cytotoxic agent is S phase specific ?
(a) Methotrexate
(b) Vincristine
(c) Cisplatin
(d) Alkylating drugs
8.7 The selection of chemotherapy as the soletherapy in patients with advanced cancer disease is
known as :
(a) Salvage chemotherapy

(b) Induction chemotheraphy
(c) Adjuvent chemotherapy
(d) Neo adjuvent chemotheraphy
8.8 Which is the most common benign renal mass lesion ?
(a) Adenoma
(b) Cyst
(c) Hamartoma
(d) Fibroma
8.9 Approximately, which size of renal cortical adenoma has little propensity for metastasis :
(a) Less than 3 cms

(b) 3-4 cms
(c) 4-5 cms
(d) 5-6 cms
Match the histological features with the type of benign renal tumour :
8.10 Cortical adenoma (a) Large cosinophilic cells with a granular cytoplasm and
typical polygonal form
8.11 Renal oncocytoma (b) Sheets of fibroblasts or a loose myxomatous stroma
8.12 Renal hamartoma (c ) Uniform fat cells with peripherally placed nuclei
surrounded by plasma membrane
8.13 Fibroma (d) Uniform acidophilic or clear cells with monotonous

nuclear and cellular characteristic
8.14 Lipoma (e) Unusual abnormal blood vessels clusters of adipocytes

and sheets of smooth muscles
8.15 Which of the following statement is wrong about renal oncocytoma ?
(a) Almost invariably benign clinical behavior

(b) Occurs more commonly in females than males
(c) Spoke wheel pattern in the arterial phase of the angiogram
(d) Radical nephrectomy is the safest method of therapy unless contraindicated by other factors
8.16 Renal cell carcinoma accounts for approximately how many percent of adult malignancies :
(a) 1 percent
(b) 2 percent
(c) 3 percent
(d) 4 percent
8.17 Hypernephroma arises from :
(a) Renal tubular epithelium

(b) Renal capsule
(c) Intra-renal adrenal rests
(d) Renal medulla
8.18 Tumors of immature renal parenchyma include all of the following EXCEPT :
(a) Nephroblastoma
(b) Embryonic carcinoma
(c) Papillary cystadenocarcinoma
(d) Sarcomas
8.19 All of the following can predispose to kidney malignancy EXCEPT :
(a) Hamartoma
(b) Adnoma
(c) Haemangiopericytoma
(d) Renal cyst
8.20 “Beak sign” in selective renal arteriogram signifies :
(a) Hypernephroma
(b) Wilm’s tumor
(c) Renal cyst
(d) Hamartoma
8.21 On CT scan, the density of hypernephroma as compared to normal renal tissue is :
(a) Increase
(b) Same
(c) Decrease
8.22 Tuberous sclerosis is characterised by all of the following EXCEPT :
(a) Mental retardation

(b) B/L renal hamartomas
(c) Adenoma sebaceum
(d) Juxtaglomerular cell and adnoma
8.23 On renal angiography, the neovascularisation and tortuous irregular vessels can suggest all of
the following EXCEPT :
(a) Hypernephroma
(b) Secondaries to kidney
(c) Hamartoma
(d) Wilm’s tumor
8.24 Which is the single most important factor for determining prognosis in hypernephronma :
(a) Grade of tumor

(b) Stage of tumor
(c) Cell type of tumor
(d) Sex of the patient
8.25 Which is the most common primary renal sarcoma ?
(a) Lipoma
(b) Leiomyosarcoma
(c) Fibrosarcoma
(d) Rhabdomyosarcoma
8.26 Histologically, the best prognosis in adenocarcicoma of kidney is associated with :
(a) Spindle-cell
(b) Giant cell
(c) Granular-cell
(d) Clear cell
8.27 Approximately in how many percent of cases, bilateral renal cell carcinoma occurs either
synchronous or asynchronous :
(a) 1 percent
(b) 2 percent
(c) 3 percent
(d) 4 percent
8.28 “Staufer syndrome” is described with which of the following :
(a) Transitional cell carcinoma bladder

(b) Transitional cell carcinoma renal pelvis
(c) Renal cell carcinoma
(d) Adenonacarinoma prostate
8.29 Hypercalcemia is reported in how many percent of cases of renal cell carcinoma :
(a) 5 percent
(b) 7 percent
(c) 10 percent
(d) 15 percent
8.30 Aspirate from the benign renal cyst has following characters EXCEPT :
(a) Clear fluid

(b) No malignant cells
(c) High fat and protein content
(d) Low LDH levels
8.31 Which are the most common metastatic lesions of the kidney ?
(a) Ovary
(b) Bowel
(c) Breast
(d) Lymphoma
(e) Lymphomablastoma
8.32 Secondary tumors to the kidney are usually characterised by al of the following EXCEPT :
(a) Haematuria in 70-80% of cases

(b) No distortion of pelvicalyceal system
(c) No discrete mass lesions
(d) No discrete neovascularity on arteriography as compared to primary tumors
8.33 The term ‘Angiomyolipoma’ is a synonym of :
(a) Haemangioma kidney

(b) Haemangiopericytoma
(c) Hamartoma kidney
(d) Hypernephroma
8.34 Von-Hippel lindau syndrome includes all of the following EXCEPT :
(a) Angiomatous cerebellar and retinal cysts

(b) Multiple hypernephromas
(c) Facial assymetry
(d) Cysts of pancreas
8.35 In hypernephroma, involvement of renal vein can cause all of the following EXCEPT :
(a) Haematuria
(b) Nephrotic syndrome
(c) Varicocele
(d) Non-Opacification on IVP
8.36 Following are cause of anemia in hypernephroma EXCEPT :
(a) Depression of erythropoietin

(b) Bone marrow metastasis
(c) Blockage of inferior vena cava by thrombus
(d) Haematuria
8.37 After radical nephrectomy for stage I hypernephroma, all of the following parameters can
regrets EXCEPT :
(a) Carcino-embryonic antigen

(b) Alkaline phosphatase
(c) Urinary spermin levels
(d) Serum bilirubin (unconjugated)
(e) Prothrombin time
8.38 Osteoblastic lesions in the bones are caused by all of the following EXCEPT :
(a) Adeno carcinoma prostate

(b) Paget’s disease of bone
(c) Prolonged intake of fluoride
(d) Mastocystosis
(e) Transitional cell carcinoma of renal pelvis
8.39 Renal pelvic tumours accounts for approximately how many percent of all renal tumours :
(a) 5-10 percent

(b) 10-15 percent
(c) 15-20 percent
(d) 20-25 percent
8.40 What is the mean age of occurence of upper tract urothelial tumours ?
(a) 60 years
(b) 65 years
(c) 70 years
(d) 75 years
8.41 Approximately, upper tract urothelial tumours account for how many percent of all urothelial
tumours ?
(a) 5 percent
(b) 10 percent
(c) 15 percent
(d) 20 percent
8.42 In how many percent of sporadic upper tract iransitional cell carcinoma, bilateral involvement
(Synchrous or Metachronous) can occur :
(a) 1-2 percent

(b) 2-5 percent
(c) 5-10 percent
(d) 10-15 percent
8.43 Which of the following study is NOT advisable in patients suspected of having upper tract
transitional cell carcinoma ?
(a) Ultrasound
(b) Intravenous urography
(c) Retrograde pyelography
(d) Antegrade pyelography
8.44 In which segment of ureter, transitional cell carcinoma is most common :
(a) Pelviureteric junction

(b) Upper 1/3
(c) Middle 1/3
(d) Lower 1/3
8.45 ‘Balkan nephropathy’ is characterised by all of following EXCEPT :
(a) Multiple multifocal tumors

(b) Fast-growing tumours
(c) Accompanied by nephropathy
(d) May be bilateral
8.46 Invasion of the renal parechyma by the tumor of the renal pelvis signifies :
(a) Stage A
(b) Stage B
(c) Stage C
(d) Stage D
8.47 Multiple radiolucent defects in the ureter on IVP can signify all of the following EXCEPT :
(a) Multiple ureteral tumors

(b) Air bubbles
(c) Ureteritis cystica
(d) Ureteral varices
(e) Multiple radiolucent stones
8.48 The “goblet sign” indicating a papillary ureteral tumor, is usually seen on :
(a) IVP
(b) Retrograde bulb ureterogram
(c) Antegrade ureterogram
(d) Selective arteriogram
(e) In (A), (B) and (C)
8.49 ‘Napkin Ring’ sign in the ureter on IVP signifies :
(a) Benign ureteral polyp

(b) Polypoid ureteral tumor
(c) Ca-in situ of the ureter
(d) Infilirating ureteral tumor
8.50 All of the following are causative factors of transitional cell carcinoma of renal pelvis EXCEPT :
(a) Long standing impacted calculus

(b) Carcinogens
(c) Balkan nephropathy
(d) Prolonged analgesic abuse
8.51 What is the treatment of choice in patient shaving grade I, localized ureteral tumor with
negative cytology and known exposure to chemical carcinogens ?
(a) Concervative segmental surgery

(b) Nephroureterectomy
(c) Nephroureterectomy with cuff of bladder
(d) Chemotherapy
8.52 In how many percent of patients with tumors of renal pelvis have associated bladder tumour at
some stage of their life ?
(a) 10%
(b) 20%
(c) 40%
(d) 80%
8.53 Secondary metastasis to the ureter are most ofted located in :
(a) Upper 1/3rd

(b) Middle 2/3rd
(c) Lower 1/3rd
(d) All levels with an equal frequency
8.54 Approximately, how many percent of bladder cancers are low grade superficial tumours :
(a) 50 percent
(b) 60 percent
(c) 70 percent
(d) 80 percent
8.55 How many percent of bladder cancer patients can have upper tract tumours ?
(a) 2-4 percent

(b) 4-6 percent
(c) 6-8 percent
(d) 8-10 percent
8.56 Which of the bladder cancer patients are appropriate candidates for upper tract monitoring ?
(a) Multiple tumours

(b) Recurren tumours
(c) Tumours involving ureteral orifices
8.57 In men, bladder cancer accounts for how many percent of cancer :
(a) 5 percent
(b) 10 percent
(c) 15 percent
(d) 20 percent
8.58 Which is the most common cancer of the urinary bladder ?
(a) Sacrcona
(b) Transitional cell carcinoma
(c) Adenocarcinoma
(d) Squamous cell carcinoma
8.59 The following are high risk factors for development of carcinoma urinary bladder EXCEPT :
(a) Chemical carcinogens

(b) Cigratte smoking
(c) Artificial sweetens
(d) Coffe drinking
(e) Alcohol drinking
8.60 Which type of of cancer bladder may develop in schistosomiasi ?
(a) Transitional cell carcinoma

(b) Squamous Cell carcinoma
(c) Adenocarcinoma
8.61 Schistosomiasis leads to carcinoma bladder due to the following reasons EXCEPT :
(a) Chronic irritation and relustant eqithelial proliferation

(b) Chronic foreign body reaction
(c) Schistosomal infestation alone
(d) Bacterial infection leading to production of nitrosamines
8.62 Squamous metaplasia is more common in patients who are catheterised for a period of :
(a) One year

(b) Three years
(c) Five years
(d) More than 10 years
8.63 Increased incidence of bladder cancer has been reported following the use of :
(a) Cyclophosphamide
(b) Cisplatinum
(c) Bleomycin
(d) Vincristine
8.64 The risk of recurrence and progression of carcinoma bladder associated with the following
factors EXCEPT :
(a) Tumor grade

(b) Site
(c) Initial tumor multicentricity
(d) Presence of vaious epithelial changes in bladder mucosa
8.65 Which is the commonest site of vascular metastasis from carcinoma bladder ?
(a) Liver
(b) Lung
(c) Bone
(d) Adrenal gland
(e) Intestine
8.66 Which is the most common histologic type in urachal carcinoma ?
(a) Adenocarcinoma
(c) Squamous cell carcinoma
(d) Rhabdomyosarco
Match the Following
Cellular changes Type of tumor
8.67 Epithelial Hyperplasia in absence of dysplasia (a) Superficial low grade tumor
8.68 Occurence of hyperplasia and dysplasia together (b) High grade papillary
8.69 Occurence of dysplasia aline in absence of hyperplasia (c) Flat carcinoma insitu
8.70 Increase in number of cell layers without nuclear or

architectural abnormalities (d) Epithelial hyper plasia
8.71 Progression of superficial bladder tumour can be predicted by the following EXCEPT :
(a) Tumour multicentricity and grade

(b) Site of tumour
(c) Absence of suface blood group antigens
(d) Presence of marker chromosomes
8.72 Which of the following factors indicate more aggresive tumor diathesis ?
(a) High grade

(b) Lamina propria invasion
(c) Diffuse carcinoma in situ
8.73 Which the commonest presenting symptom of carcinoma bladder ?
(a) Frequency of micturition

(b) Dysuria
(c) Haematuria
(d) Hesitancy
8.74 Which is the mainstay for the diagnosis of carcinoma urinary bladder ?
(a) Symtoms
(b) Intravenous urography
(c) Urine cystology
(d) Cystoscopy and transurehral biopsy
8.75 The reliability of urine cytology depends upon :
(a) Extent of tumour diathesis

(b) Degree of cellular anaplasia
(c) None of them
(d) Both of them
8.76 Which of the following is related to severity of haematuria in carcinoma bladder ?
(a) Number of lesions

(b) Size of tumor
(c) Stage of disease
8.77 In those instances in which visible tumor remains elusive despite persistently postive urine
cytology for transitional cell carcinoma, the source of neoplastic cell can be from all of the
following EXCEPT :
(a) Kidney
(b) Upper ureter, pelvis and calyces
(c) Prostate gland
(d) Prostatic urethra
(e) Portions of the bladder that might be inaccessible to direct visualisation
8.78 The following investigation are usefull for the staging of carcinoma bladder EXCEPT :
(a) Ultrasonography
(c) CT scan
(d) Magnetic resonance imaging
(e) Fractional cystography
8.79 Which is the commonest finding in intravenous urogram in cases of carcinoma bladder ?
(a) Nonfunctioning kidney

(b) Hydroureterophrosis
(c) Filling defect in bladder
(d) Significant residual urine
8.80 In pedal lymphangiography, the characteristic features of pelvic lymph node metastasis are the
following EXCEPT :
(a) A lack of lympnode filling 24 hours after injection of contrast

(b) Peripheral defects in the lymph nodes
(c) Central defects in the lymph nodes
(d) Enlargement of lymph nodes with foamy apperance
8.81 The first lymph node metastasis from bladder tumors usually appear in the :
(a) External iliac

(b) Internal iliac
(c) Obturator
(d) Inguinal
8.82 The following are the tumor markers for carcinoma urinary bladder EXCEPT :
(a) Monoclonal antibodie

(b) Serum acid phosphatase
(c) Carcinoembryonic antigen
(d) Rheumatoid factor
According to marsnall’s modification of jewett-strong staging for carcinoma bladder, match the
following :
8.83 Stage B (a) Mucosa
8.84 Stage D (b) Submucosa
8.85 Stage C (c) Muscle
8.86 Stage O (d) Perivesical fat
8.87 Stage A (e) Lymph nodes
8.88 Which is the mainstay for the treatment of superficial bladder cancer ?
(a) Trasurethral resection

(b) Intravesical chemotherapy
(c) Radiotherapy
(d) Cystectomy
8.89 The following are the indication for intra-vesical chemotherapy in superficial bladder cancer
EXCEPT :
(a) Rapid tumor recurrence

(b) Single tumor
(c) Development of high grade lesion
(d) Multi tumors
8.90 Which of the following statement is false regarding thiotepa ?
(a) It is an alkylating agent

(b) Usual dose is 30 mgs intravesically weekly for 8 weeks than monthly for 2 years
(c) There is no restriction of fluid before intravesical instillation
(d) Toxicity of thiopeda includes leucopenia thrombocytopenia, anemia, occasional cystitis and
fever
8.91 Which of the following statement is false regarding intravesical mitomycin therapy ?
(a) This compund is obtained from streptomyces caspitosus

(b) It can be used after failure of thiotepa treatment
(c) Its absoption is more that thiotepa
(d) It can achieve 50% complete response and 30% partial response in management of
superficial bladder cancer
8.92 Regarding intravesica chemotherapy which of the following has achieved best complete
response in management of superficial bladder cancer :
(a) Thiotepa
(b) Miomycin
(c) Adriamycin
(d) BCG
(e) Interferon
8.93 Which of the following statement is false regarding laser therapy in management of superficial
bladder cancer ?
(a) Laser coagulates blood vessels, kills tumor cells and leads to sloughing of cectrotic tumour
tissue
(b) It can eradicate recurrent or multiple superficial tumor without the need for anaesthesia
(c) After therapy, tissue is available for histopathology
(d) Its major disadvantage gas been inacessibility of some tumors
8.94 BCG intravesical therapy NOT given in the following situations EXCEPT :
(a) Patients having anaphylactic reactions

(b) Patients with vesico ureteral reflux
(c) Immunocompromised patients
(d) Patients after traumatic catheterization
8.95 The following are used for systemic prophylaxis of superficial tumors EXCEPT :
(a) Cyclophosphamide
(b) Pyridoxine
(c) Retinoic acid
(d) Vitamin-c
8.96 Which of the follwong is most accurate in detection of tumour recurrence the follow up of
carcinoma urinary bladder ?
(a) Urinary cytology

(b) Ultrasonography
(c) Check cystescopy
(d) Intravenous urography
8.97 The following are indications of segmental cystectomy EXCEPT :
(a) Solitary neoplasm at least 3 cm distant from bladder neck

(b) Inaccessibility of the lesion to transurethral resection
(c) Recurrent or multiple tumor
(d) Location of tumor in a vesical diverticulum
8.98 Which of the following statement is FALSE regarding segmental cystectomy ?
(a) Tumour spill should be avoided

(b) Cystotomy should be done as far away from the tumour as possible
(c) Ureter in proximity to the tumour should be reimplanted
(d) Suprapubic catheter drainage is preferrable to urethral catheter is preferrable to urethral
catheter drainage
8.99 Which of the following statement is FALSE regarding integrated radiation and cystectomy for
management of B2C tumours ?
(a) Irradiation kill tumour cells disseminated either locally or systemically at the time of surgery
(b) Irradiation eradicate microscopic pelvic disease already present
(c) Irradiation destroy transected peripheral tumour extension or tumour cells left behind at the
time of surgery
(d) Incidence of distant metastasis to bone, lungs and liver are same as in case treated without
irradiation
8.100 What is the incidence of primary transitional cell carcinoma of the prostate ?
(a) Less tahn 4%

(b) 4-10%
(c) 10-15%
(d) 15-20%
8.101 In how many percent of case involvement of prostate occurs in transitional cell carcinoma of
bladder :
(a) 5-10%
(b) 10-15%
(c) 15-20%
(d) 20-25%
8.102 In which group of patients, prognosis is poor in cases of bladder cancer with prostate
involvement :
(a) In situ disease

(b) Ductal involvement
(c) Combined ductal and acina involvement
(d) Associated with stromal infilration
8.103 What is the incidence of urethral metastasis in cases of carcinoma bladder with prostatic
involvement ?
(a) 10%
(b) 20%
(c) 30%
(d) 40%
8.104 Which of the following statement is FALSE regarding transitional cell carcinoma in bladder
diverticula ?
(a) A higher incidence of transitional cell cancer has bben reported to occur within bladder
diverticulum than in normal bladder
(b) Tumours in the diverticulum have better prognosis than comparable tumour with in the
normal bladder
(c) Careful examination of any diverticulum is mandatory
(d) Tumour excision requires open diverticulectomy with removal of generous rim of
peridiverticular bladder tissue
8.105 The following are the common sites of metastasis of carcinoma bladder EXCEPT :
(a) Bone
(b) Lung
(c) Thyroid
(d) Liver
8.106 Which of the following statement is FALSE regarding metastasis of carcinoma bladder ?
(a) Distant metastasis occur largely in bone, lung and liver

(b) Atleast 50% of patients with muscle invasive cancer have demonstrable metastasis within 2
years after cystectomy
(c) Repeated transurethral resection of tumours have been associated
(d) Several cytotoxic agents have been found to be effective eitr in controlling progression or in
inducting partial regression of disease
8.107 Which of the following statement is FALSE regarding cisplatinum therapy in metastatic
carcinoma bladder ?
(a) It is an alkylating agent that inhibits DNA replication

(b) Serum half like has bben found to be approximately 60-70 hours
(c) 25 percent of the drug is excreted in the urine every 24 hours
(d) Usual intravenous dosage ranges between 1 and 1.6 mg per kg, every 3 weeks
(e) Over all response rate is 100%
8.108 Which of the following are common side effects of cisplatinum chemotherapy ?
(a) Anorexia, nausia, vomitting

(b) Nephrotoxicity and ototoxicity
(c) Peripheral neuropathy, reynaud’s phenomenom
(d) Hypomagnesemia
8.109 Adenocarcinoma accounts for how many percent of bladder cancer :
(a) 1 percent
(b) 2 percent
(c) 3 percent
(d) 4 percent
8.110 The following can develop into adenocarcinoma of the urinary bladder EXCEPT :
(a) Cystitis cystica

(b) Exstrophy bladder
(c) Urachal remnant
(d) Prostatic carcinoma infiltrating baldder
8.111 Which of the following statement is FALSE regarding adenocarcinoma bladder ?
(a) Its origin is either at the base or at the dome

(b) Non urachal adenocarcinoma that invades muscle has been usually treated by radical
cystectomy
(c) CT scan may be particularly helpful in nonurachal tumours
(d) Radiation or chemotheraphy has been found to be equally effective
8.112 In which bladder cancer, carcinoma in situ is most common :
(a) Sarcoma
(c) Adenocarcinoma
(d) Squamous cell carcinoma
8.113 The following characterize carcinoma in situ of the urinary bladder EXCEPT :
(a) Cystocopic presence of tumour

(b) Positive urine cystology
(c) Microhaematuria/irritative symptoms in patients expose to carcinogens
(d) Best diagnosed by multiple cold cup cup biopsies of bladder
8.114 What is the treatment of choice for localised well differentiated carcinoma in situ of the
urinary bladder ?
(a) Segemntal cystectomy

(b) Radical cystectomy
(c) Intravescial BCG therapy
(d) Radiotheraphy
8.115 Wow many percent of males with invasive bladder cancer can develop urethral carcinoma ?
(a) 9%
(b) 18 %
(c) 27 %
(d) 36 %
8.116 Squamous cell carcinoma of urinary bladder can develop from all of the following EXCEPT :
(a) Squamous metaplasia in women

(b) Schistosomiasis
(c) Vesical diverticulum
(d) Vesical calculus in diverticulum
8.117 Which of the folowing statement is FALSE regarding squamous cell carcinoma of the bladder ?
(a) It represents only 5-8% of bladder tumours

(b) It has been associated etiologically with chronic inflammation
(c) Squamous metaplasia alone can develop in to squamous cell carcinoma
(d) Results of combined radiotherapy and surgery are better then than surgery
8.118 Which of the following statement is FALSE regarding formalin theraphy ?
(a) It cause precipitation of cellular protein of the bladder mucosa and fixes and occludes
telangiectatic and capillary vessels
(b) With concertation of less than 4%, complications have been minimal and control of
hacmomhage in usually achieved
(c) No anesthesia is recquired
(d) Preliminary cystogram is necessary to rule out reflux
8.119 Which of the following statement is FALSE regarding palliative management of bladder cancer
(a) For helmstein disetnsion theraphy, contious epidural anaesthesia is required

(b) Instillation of 1-2% siver nitrate by contious flow is useful for control of haemorrhage
(c) Less than 4% formalin isused intravesically
(d) Embolization of hypogastric arteries is very effective in controlling haemorrhage
(e) Urinary diversion without cystectomy may permit bladder decompression and prevent
astrigent effects of urine on the source of haemorrhage
8.120 Bladder pheochromocytoma accounts for how many percent of all bladder tumours :

(b) 2 percent
(c) 3 percent
(d) 4 percent
8.121 Which is the treatment of choice for patients with bladder pheochromocytoma ?
(a) Transurethral resection

(b) Partial cystectomy
(c) Radical cystectomy
(d) Integarated preoperative radiation therapy and cystectomy
8.122 Which is the most common malignancy in men in the 15-25 year age group ?
(a) Wilm’s tumour

(b) Testicular cancer
(c) Trabsitional cell carcinoma bladder
(d) Renal cancer
8.123 Germinal tumours constitute how many percent of all primary testicular malignancies :
(a) 40-50%
(b) 50-60%
(c) 70-80%
(d) 90-95%
8.124 The nongerminal ements, accounts for approximately how many percent of all primary
testicular neoplasm :
(a) 5 percent
(b) 7 percent
(c) 10 percent
(d) 12 percent
8.125 Which is the most frequent testicular tumour in patients over 50 years of age ?
(a) Seminoma
(b) Yolk sac tumour
(c) Adenomatoid tumour
(d) Reticulorndothelial neoplasm
8.126 Germinal neoplasm of the testis include all of the following EXCEPT :
(a) Yolk cell tumour

(b) Seminoma
(c) Leydig cell tumour
(d) Choriocarcinoma
8.127 Which of the following is consider least important factor in causation of testicular tumours ?
(a) Undescended testis

(b) Trauma
(c) Hormones
(d) Atrophy
Match age group with histologic type of testicular tumour
Histologic type Age group
8.128 Seminal (a) 25-35 years
8.129 Embryonal carcinoma (b) over 5o years
8.130 Choricarcinoma (c) 35-39 years
8.131 Malignant lymphoma (d) 20-30 years
8.132 Germinal neoplasms of the testis usually do not reproduce testicular tissure EXCEPT :
(a) Teratoma
(b) Seminoma
(c) Yolk sac tumour
(d) Choriocarcinoma
8.133 In approximately, how many percent of cases of testicular cancer has tendency to develop a
contralateral tumour :
(a) 1 percent
(b) 2 percent
(c) 3 percent
(d) 4 percent
8.134 Approximately how many percent of testicular tumours are bilateral :
(a) 2-3 percent

(b) 5-6 percent
(c) 7-8 percent
(d) 9-10 percent
8.135 Which of the following statement is FALSE regarding testicular tumours ?
(a) Complete spontaneous regression are common

(b) All germinal testicular tumour in adults should be regarded as malignant
(c) The tunica albuginea is a natural barrier to local growth
(d) Lymphatic metastasis is common to all forms of germinal tumours
(e) Extranodal distant metastasis results from either direct vascular invasion or tumour emboli
from lymphatic metastasis
8.136 Which of the following statement about testicular tumour is TRUE ?
(a) Testicular tumours most commonly affect males in extremes of life

(b) Their malignant components have been shown experimentally undergo transofrmation in
benign phenotype
(c) They do not screte tumour markers
(d) Even with current therapeutic modalities, their prognosis remains bleak
8.137 Which of the following factor play a causative role for delevopment of cancer in the
cryptorchid malignant ?
(a) Abnormal germ cell morphology/gonadal dysgenesis

(b) Elevated temperature
(c) Interference with blood supply
(d) Endocrine dysfuntion
8.138 Approximately how many percent of patients with testicular tumour have a prior history of
cryptorchidism develops malignancy in the contra lateral normally descended gonad ?
(a) 7-10 percent

(b) 15-20 percent
(c) 20-25 percent
(d) 25-30 percent
8.139 How many percent of patients with history of cryptorchidism develops malignancy in the
contra lateral, normally descended gonad ?
(a) 5-10 percent

(b) 10-15 percent
(c) 15-20 percent
(d) 20-25 percent
8.140 On an average, the probality of a neoplasm occuring in an undescended testis in how many
times greater than in a normally descended testis :
(a) 5 times
(b) 10 times
(c) 40 times
(d) 80 times
8.141 Which is the more common side of the testicular tumours ?
(a) Right
(b) Left
(c) Equal on both side
8.142 Which is the commonest histologic type in bilateral testicular tumours ?
(a) Seminoma
(b) Teratoma
(c) Embryonal cell carcinoma
(d) Yolk sac tumour
8.143 Which is the most common site of origin of extragonadal germ cell tumours ?
(a) Mediastinum
(b) Retroperitoneum
(c) Sacrococcygeal region
(d) Pineal gland
8.144 The primary first echelon nodes draining the testis are usually at the level of :
(a) Inquinal canal

(b) Obturator canal
(c) Level or L2 – L3
(d) Bifurcation of common iliac artery
8.145 Involvement of inquinal lymph nodes in testicular tumour indicates :
(a) Normal lymphatic spread

(b) Involvement of epididymis
(c) Scrotal involvement by the tumour
(d) Retrograde spread from the pelvic lymph nodes
(e) C and D
8.146 Which of the following need not be a routine investigation in a case of testicular cancer ?
(a) Aortography
(b) Tumour markers
(c) CT scan
(d) Histopathology of the involved testis
(e) X ray chest
8.147 Which of the following is germinal neoplasm of the testis ?
(a) Adenomatoid tumour

(b) Adronal rest tumour
(c) Anaplastic seminoma
(d) Adenocarcinoma of rete testis
8.148 Embryonal carcinoma of testis arises from totipotent germ cells. Which of the following
intraembryonic differentiation of embryonal carcinoma gives rise :
(a) Teratoma
(b) Seminoma
(c) Yolk sac tumour
(d) Choriocarcinoma
8.149 After retroperitoneal lymph nodes, which is the next common site of spread of NSGCT :
(a) Liver
(b) Lung
(c) Brain
(d) Bone
(e) Kidney
Match the following regarding staging system for testicular tumour :
Stage Organs involved

8.150 I (a) Supradiaphragmatic node involvement
8.151 II (b) Extralymphatic disease
8.152 III (c) Disease confined to testis
8.153 IV (d) Infradiaphragmatic node involvement
8.154 In which of the following alphafetoprotein is raised :

(a) Primary hepatoma
(b) Pregnancy
(c) Choriocarcinoma
(d) A and B
(e) Pure seninoma
8.155 The following are useful markers for testicular tumours EXCEPT :
(a) Fibrinogen degradation product (FDP)

(b) Alphafetoprotein (AFP)
(c) Human chorionic gonadrotrophin (HSG)
(d) Placenta alkaline phosphatase (PLAP)
8.156 Serum assays of alphafetoprotein (AFP) and human chorionic gonadotrophin (HCG) are
routinely used to :
(a) Stage testicular tumours

(b) Monitor response to treatment
(c) Detect relapse
(e) A & B only
8.157 Which of the following statement is FALSE regarding alphafetoprotein (AFP) ?
(a) AFP is a glycoprotein of molecular weight 63-70.000 D

(b) It is secreted by yolk sac elements within the tumour
(c) The appoximate half life is 10 days
(d) Damaged liver can produce low levels of AFP
8.158 Which of the following statement is FALSE regarding Human chorionic gonadotrophin (HCG) ?
(a) It is synthesised by syncytiotrophoblastic cells

(b) The alpha subunit is shared with FLS<LH and TSH
(c) It is principally a marker of trophoblastic neoplasm
(d) The half life of HCG is 2 hours
8.159 What is the risk of developing germinal tumour in the contralateral testis after the removal of
other testis having germ cll tumour ?
(a) Same
(b) 5 times greater
(c) 10 times greater
(d) 20 times greater
8.160 Which histologic variety of seminoma has poorest prognosis ?
(a) Classic seminoma

(b) Anaplastic seminoma
(c) Spermatocytic seminoma
8.161 What can be the histopatholagy of the metastasis from an anaplastic seminoma ?
(a) Anaplastic seminoma

(b) Non-seminomatous
(c) Both seminoma and non seminoma
8.162 A uniformly enlarged non-capsulated testis whose cut surface reveals bulging, greyish white
glistening tissue with infrequent haemaonhagic spots suggests :
(a) Seminoma
(b) Teratoma
(c) Yolk cell tumour
(d) Leydig cell tumour
8.163 Which is the most rodiosensitive testicular tumour ?
(a) Seminoma
(b) Embryonal cell carcinoma
(c) Teratoma
(d) Yolk sac tumour
8.164 The following steps must be performed while doing orchietomy in a suspected case of
testicular tumour EXCEPT :
(a) Inquinal skin incision

(b) Soft on the cord at the internal ring before examination of the testis
(c) Enbloc ligation of vas and vessels at the internal ring
(d) Enblock removed of spermatic cord contens of inquinal canal and testis with its attached
tunica on suspicion
8.165 Which is the preferable adjuvent therapy for stage I seminoma ?
(a) Radiotherapy to the abdominal nodes and ipsilateral pelvic nodes

(b) Retroperitoneal lymphnode dissection
(c) Chemotherapy
(d) Combined radiotherapy and chematherapy
8.166 In patients with stage II a seminoma, irradiation should be directed to :
(a) Retroperitoneum and ipsilateral external iliac region

(b) Retroperitoneum and ipsilateral and ipsilateral common iliac regions
(c) Retroperitoneum and mediastinum
(d) Retroperitoneum, ipsilateral external iliac and bilateral common iliac regions
8.167 Which is the preferable therapy for stage III and IV seminoma ?
(a) Radiotherapy
(b) Chemotherapy
(c) Combined chemotherapy and radiotherapy
(d) None of the a bove
8.168 Which of the following is a preferable treatment for stage I teratoma after orchiectomy ?
(a) Surveillance
(b) Chemotherapy
(c) Radiotherapy
(d) Retroperitoneal lymph node dissection
8.169 Which of the following is a contraindication for surveillance for stage I teratoma ?
(a) MTU histology with vascular invasion

(b) Tran scrotal needle biopsy
(c) Scrotal lorchiectomy
(d) Prior orchiopexy
8.170 Which is the preferred treatment for stage III nonseminomatous germ cell tumour of the
testis ?
(a) Chemotherapy
(b) Chemotherapy followed by irradiation
(c) Chemotherapy followed by surgery
(d) Surgery followed by chematherapy
8.171 Which of the following is the choice of combination chematherapy for metastatic teratoma ?
(a) Actinomycin d-Methotrexate-Cchlorambucil

(b) Cisplatinum-Vinblastin_Bleomycin
(d) Bleomycin-Etoposide-Cisplatinum
(e) Vinblastin-Bleomycin
8.172 Which is the commanest secondary neoplasm of the testis ?
(a) Prostate
(b) Reticulo-endothelial tumours
(c) Malignant melonoma
(d) Lung
(e) Gastrointestinal
8.173 Which of the following statement is FALSE regarding leyding cell tumours of the testis ?
(a) They are germinal tumours

(b) They are fast growing tumours
(c) On gross examination, the testis contain soft, brownish, well circumscribed tumours
(d) They secrete androgens
8.174 Which of the following are common testicular tumours is childhood ?
(a) Teratoma in children

(b) Teratocarcinoma
(c) Embryonal cell carcinoma
(d) Choriocarcinoma
8.175 Which is the commonest testicular tumours of infancy and childhood ?
(a) Choriocarcinoma
(b) Adenomatoid tumour
(c) Yolk cell tumour
(d) Reticuloendothelial neoplasm
8.176 Which of the following statement about yolk sac tumour is FALSE ?
(a) Occurs in prepubertal testis

(b) Histologically similar tumours have been described in ovary and extragonadal sites
(c) Also called as entodermal sinus tumour
(d) Never occurs in adult testis
8.177 The following statement about Yolk sac tumours are TRUE EXCEPT :
(a) It secrets alpha fetoprotein

(b) It is seen in all age groups
(c) Younger the patient, worse is the prognosis
(d) In infants, it is pure, while in adults it accurs in association with other germinal elements
8.178 The presence of terotoma favourably influences the clinical behaviour of embryonal
carcinoma and choriocarcinoma. This statement is :
(a) True
(b) False
8.179 Which of the following statement about yolk sac tumour is FALSE ?
(a) Children are usually under 3 years of age

(b) It is the commonest pediatric testicular tumour
(c) 80% of metastasis appear within first year following orchiectomy
(d) Metastasis is usually by the lymphatic route
8.180 Which is the most common tumour of the paratesticular tissues ?
(a) Mesothelioma
(b) Cystadenoma
(c) Adenomatoid
8.181 Following are the common sites of condyloma acumination EXCEPT :
(a) Prepuse
(b) Penile shaft
(c) Glans
(d) Urethra
8.182 The following statement about condyloma acumination are true EXCEPT :
(a) Rarely accurs prior to puberty

(b) Caused by papovirus
(c) Is found only on the penis
(d) Is transmissable
(e) Can invoice the urethra in 5 % cases
8.183 All of the following modes of therapy can be used for condyloma acuminate EXCEPT :
(a) Podophyllin application

(b) Circumcision and fulgration of lesions
(c) Partial penectomy
(d) 0.1% bleomycin
8.184 All of the following are TRUE about giant condyloma acumination EXCEPT :
(a) It is also called Buschke-Lowenstein tumour

(b) In penetrates and desroys adjacent tissue
(c) It is benign condition with premalignant potential
(d) Treatment is by podophylline
8.185 Which is the treatment of choice for giant condyloma acumination ?
(a) Surgical excision

(b) Podophyllin
(c) 5-fluorouracil
(d) Radiation therapy
8.186 The following have a predilection for the glans and prepuce. They are most common amongst
the uncircumcised and may precede or coincide with carcinoma of penis EXCEPT :
(a) Bowen’s disease

(b) Paget’s disease
(c) Cutaneous naevi
(d) Leukoplakia
8.187 Which of the following do not have premaligment potential in the penis ?
(a) Hirsutoid papillomas

(b) Condyloma acuminatum
(c) Bushke-lowenstein tumour
(d) Erythroplasia of queyrat
(e) Balanitis xerotica obliterans
8.188 The following statements of Erythroplasia of Queyrat’s are TRUE EXCEPT :
(a) Is similiar to Bowen’s disease of penis on histology

(b) Represents carcinoma in situ changes
(c) Multiple biopsies should be done prior to initiating therapy
(d) Local excision of area is the adequate therapy
(e) Topical podophyllin therapy is the treatment of choice
8.189 If a middle aged man presented with a white patch on the glans extending around the urethral
meatus resulting in some degree of meatal stenosis causing pain, pruitis and discharge, he is
most likely suffering from :
(a) Verrucous carcinoma

(b) Cutaneous naevi
(c) Cutaneous horn
(d) Balanitis xerotica obliterans
Match the following
Lesion Treatment
8.190 Balanitis Xerotica obliterence (a) Bleomycin topically

8.191 Condyloma acuminate (b) 5-F topically
8.192 Giant condyloma acuminatum (c) Steroid topically
8.193 Eryhroplasia of Queyrat (d) Podophylline topically
8.194 Circumcision at birth has been establised as a prophylactic measure that almost eliminates the
occurence of penile carcinoma. This statement is :
(a) True
(b) False
8.195 Which is the single most factor affecting prognosis in carcinoma penis ?
(a) Tumour grade

(b) Presence of inquinal metastasis
(c) Microscopic features of the tumour
(d) Size of the penile tumour
8.196 Penile carcinoma is most frequent on the following sites EXCEPT :
(a) Glans
(b) Coronal sulcus
(c) Meatus
(d) Prepuce
8.197 Which is the most frequent site of initial involvement in carcinoma penis ?
(a) Glans
(b) Meatus
(c) Shaft
(d) Buck’s fascia
8.198 Which is the predominent histologic type of carcinoma penis ?
(a) Transitional cell

(b) Squamous cell
(c) Adenocarcinoma
(d) Embryonal
8.199 No consitant etiologic relationship of penile carcinoma is found to the following EXCEPT :
(a) Syphilis
(b) Granuloma inquinale
(c) Chancrom
(d) Phimosis
8.200 Which of the following statement is FALSE about penila carcinoma ?
(a) The rate of growth of the papilary and ulcerative lesions are quite similar
(b) The flat ulcerative tumour has a tendency to early nodal metastasis and is associated with
poorer 5 year survival rate
(c) Spontaneous remission is known
(d) Most frequent on the glans, coronal sulcus and prepuce
8.201 In penile carcinoma, which of the following factor affect the prognosis most :
(a) Tumour grade

(b) Gross appearance
(c) Microscopic pattern
(d) Presence of inguinal metastasis
8.202 Which is the strongest prognostic indicator for survival in penile cancer ?
(a) Grading of the tumour

(b) Loss of cell surface blood group antigen
(c) Poldy analysis
(d) Presence of absence of nodal metastasis
8.203 In penile carcinoma, the likelyhood of metastatic disease within palpable adenopathy is
increased in the following situation EXCEPT :
(a) When primary lesion is sizable

(b) High grade tumour
(c) When primary lesion is inflammod
(d) When primary lesion show stromal, vascular or lymphatic invasion
(e) When the regional lymphadenopathy is massive
8.204 In penile carcinoma, approximately in how many percent of patients with initially uninvolved
nodes develop metastatic adenopathy or harbour metastasis at prophylactic
lymphadenopathy :

(b) 5-20 percent
(c) 20-35 percent
(d) 35-50 percent
8.205 In penile carcinoma, in how many percent of cases, metastasis will be present contralaterally,
if positive nodes are detected ipsilaterally :
(a) 45 percent
(b) 50 percent
(c) 55 percent
(d) 60 percent
8.206 Which of the foloowing is the commonest site of metastasis in carcinoma penis ?
(a) Lung
(b) Lymph node
(c) Liver
(d) Bone
(e) Brain
8.207 Which of the following statement is false regarding carcinoma penis ?
(a) It is usually with a small llesion that gradually extends to invoice the entire glans, shaft and
corpora
(b) Busk’s facia acts as a temporary natural barrier protecting corparal bodies from invasion of
neoplasm
(c) Penile lymphatic drainage is bilateral to both inquinal areas
(d) Distant metastasis in the absence of regional node metastasis are usual
8.208 Which of the following represent a relative barrier to spread of carcinoma penis ?
(a) Septum between corpora cavernosa

(b) Tunica albuginea
(c) Dartos fascia
(d) Prepuce
8.209 Involvement of lymph nodes in carcinoma penis can be :
(a) Unilateral
(b) Bilateral
(c) Contralateral
8.210 Carcinoma penis matastasize to which group of lymph nodes :

(a) Superficial inquinal
(b) Deep inquinal
(c) Presymphyseal
(d) Hypogastric
8.211 Which of the following is the first group of superficial inquinal lymph nodes involve in
carcinoma penis ?
(a) Superomedial
(b) Superolateral
(c) Inferomedial
(d) Inferolateral
8.212 The sentinel node which represents in the majority of cases the first site lymphatic metastasis
in carcinoma belongs to which group of lymph nodes :
(a) Superficial femoral

(b) Deep femoral
(c) Nodes along the spermatic cord
(d) Prepubic
8.213 Which of the following factors govern the management of carcinoma penis ?
(a) Soft tissue margins

(b) Patients acceptance
(c) Previous therapy
(d) General condition
8.214 Which of the following is mandatory prior to therapy for penile carcinoma ?
(a) Circumcision
(b) Dorsal slit
(c) Biopsy
(d) Antibiotics
8.215 Which of the following statement regarding treatment of carcinoma penis is FALSE ?
(a) In frankly malignant tumours on clinical examination, biopsy is not mandatory and may even
be undesirable because of fear of dissemination
(b) In clinically non palpable inquinal nodes, excision biopsy sentinel nodes be done rountinely
(c) In sentinel node biopsy is positive, an ipsilateral inquinal lymphadenectomy should be done
(d) In cases of unilateral papable positive inquinal nodes a bilateral inquinal lymphadenectomy
should be done
8.216 The following are indications for radiation therapy in penile carcinoma EXCEPT :
(a) Young males with superficial non invasive cancers

(b) Patients refusing surgery
(c) Mid penile shaft cancers not involving skin
(d) Patients with inoperable or distant metastasis who express desire to retain penis
8.217 The following are TRUE about radiotherapy in penile carcinoma EXCEPT :
(a) In cause urethral stenosis, stricture, fistula etc

(b) Squamous cell tumours are radiosensitive
(c) Lengthy treatment schedule is followed by prolonged morbidity
(d) Recurrences are common following radiotherapy
(e) The infection accompanying penile carcinoma decreases efficacy of radiotherapy
8.218 In which location of carcinoma penis, circumcision is indicated in the management :
(a) Glans
(b) Prepuce
(c) Shaft
8.219 What is the management of in situ lesions of carcinoma penis ?
(a) Topical chemotherapy

(b) Excisional biopsy
(c) Radiotherapy
8.220 Which is the treatment of choice for regional nodal deposites of carcinoma penis ?
(a) Surgery
(b) Radiotherapy
(c) Chemotherapy
(d) Immunotherapy
8.221 Which is the treatment of choice for T4, N0, M0, lesions of carcinoma penis ?
(a) Topical chematherapy

(b) Circumcision
(c) Radiotherapy
(d) Surgery
8.222 Blood supply of the skin of inquinal region is derived from :
(a) Superficial external pudential artery

(b) Superficial cinumflex iliac artery
(c) Superficial epigistric artery
(e) A and B
8.223 Which is the incision of choice for enbloc excision of ilioinquinal lymph nodes ?
(a) Vertical
(b) S-shaped
(c) Oblique
(d) Double incision
8.224 In carcinoma penis, what should be the time interval between surgery of the penile lesion and
the regional lymphadenectomy :
(a) 1-2 weeks

(b) 2-4 weeks
(c) 4-8 weeks
(d) 8-12 weeks
8.225 Which of the following can be the benign lesions of the seminal vesicle ?
(a) Fibromas
(b) Myomas
(c) Cystic adenomas
8.226 Which is the commonest malignant tumour of the seminal vescle ?
(a) Adenocarcinoma
(b) Sarcoma
(c) Transitional cell
(d) Squamous cell
8.227 Which of the following statement is WRONG about malignant tumours of the seminal visicle ?
(a) Usually patients are older than years of age

(b) Initial haematuria is a common symptom
(c) Bladder outlet obstruction is common
(d) Haemospermia is common
8.228 In malignant lesions of the seminal vesicle, seminal vesiculography can reveal which of the
following :
(a) Obliteration
(b) Deformity
(c) Filling defect
(e) A and C only
8.229 Which is the treatment of choice for malignant tumours of seminal vesicle ?
(a) Chemotherapy
(b) Surgery
(c) Radiotherapy
(d) Immunotherapy
8.230 Wilm’s tumour has all of the following synonyms EXCEPT :
(a) Nephroblastoma
(b) Adencarcinoma of kidney
(c) Embryoma of kidney
(d) Adenomyosarcoma of kidney
8.231 Wilm’s tumour is charaterised by all of the following EXCEPT ?
(a) It is never found in adults

(b) Metastasis are usually blood borned
(c) Staging can not always be completed till abdominal exploration has been done
(d) It is radiosensitive
8.232 Which of the following statement is FALSE about Wilm’s tumour ?
(a) Younger the child better is the outlook

(b) Postoperative radiotherapy does not help in children less than 3 years of age group with
stage I desease
(c) Presence of metastasis when a patient is first seen is a contraindication for nephrectomy
(d) Of those who die, 98% are within 2 yearsof onset of treatment
8.233 Which of the following statement is FALSE regarding Wilm’s tumour ?
(a) This is the most common malignant neoplasm of the urinary tract in children
(b) The peak age incidence is between 3-4 years
(c) The male to female ratio is 2:1
(d) The common associated anomalies are aniridia, hemihypertrophy, visceromegaly,
musculoskeletal and genitourinary
8.234 The following are the common presentation of Wilm’s tumour EXCEPT :
(a) Abdominal mass

(b) Increasing of abdominal girth
(c) Abdominal pain
(d) Gross haematuria
8.235 Which is the most important prognostic factor in Wilm’s tumour ?
(a) Histology
(b) Haematogenous metastasis
(c) Lymph node involvement
(d) Tumour extension at the site of the primary tumour
8.236 Which is the most common site of haematogenous metastasis of Wilm’s tumour ?
(a) Lung
(b) Liver
(c) Bone
(d) Brain
8.237 The following factors are associated with a better prognosis in Wilm’s tumour EXCEPT :
(a) Age at diagnosis more than 2 years

(b) More tubular structure on histology
(c) Absence of haematuria
(d) If the patient has completed 2 years after treatment
8.238 Which statement is FALSE regarding management of Wilm’s tumour ?
(a) Tumour should be biopsied prior to surgery

(b) Transperitoneal trandabdominal route is optional for nephrectomy
(c) Plane of disection should be outside the gerota’s fascia
(d) If a tumour invades colon, that segment of colon should also be removed with the kidney, if
possible
8.239 Which is the most suitable statement regarding the efficacy of chemotheraphy in Wilm’s
tumour ?
(a) It reduces the size of primary tumour prior to surgery

(b) Destroys metastasis and micrometastasis
(c) Prolongs survival
(d) Enhances tumour cell kill effect of radiotherapy
8.240 Which of the following statement is FALSE regarding radiotheraphy for Wilm’s tumour ?
(a) Radiation therapy generally is begun 1 to 3 days after surgery

(b) A dose of 2000 cGy is delivered to the flank of all children with unfavourable histology
(c) A dose of 1000 cGy is delivered to the flank of chilfren with stage I and II with favourable
histology
(d) A dose of 1000 cGy is delivered to the flank of all children with stage III with favourable
histology
8.241 Which is the mainstay of treatment for children with metastasic or recurrent Wilm’s tumour,
who have recieved only actinomycin D and vincristine ?
(a) Doxorubicin
(b) Cyslophosphamide
(c) Cisplatinum
(d) Dimethyltriazeno-imidazole carboxamide (DITC)
8.242 Which of the following statement is FALSE regarding bilateral Wilm’s tumour ?
(a) Tumours are usually unifocal

(b) Mothers of these children are usually older
(c) Children tend to present at a younger age
(d) Associated anomalies are more frequent than unilateral tumours
8.243 In Wilm’s tumor, the pelvicalyceal system is often splaed enlarged and displaced, while
adenocarcinoma tends cause localised distrotion/oblitration of the collection system. This
statement is :
(a) True
(b) False
8.244 Which is the most common type of Rhabdomysarcoma in children ?

(a) Embryonal
(b) Alveolar
(c) Pleomorphic
(d) Mixed
9
NEUROVESICAL DYSFUNCTION
9.1 Which is the principal function of the urinary bladder ?
(a) Storage of urine

(b) Evacuation of urine
(c) Both of them
(d) None of them
9.2 Approximately, what is the capacity of the newborn’s bladder :
(a) 1-2 ounces

(b) 2-3 ounces
(c) 3-4 ounces
(d) 4-5 ounces
9.3 Comparatively, which is the most indistensible part of the urinary bladder :
(a) Dome
(b) Lateral walls
(c) Trigone
(d) Internal meatus
9.4 Distensibility of which of the following assures the capacity for bladder urine storage :
(a) Epithelium
(b) Muscles
(c) Connective tissue
9.5 The origin of the trigonal musculature of the bladder is :
(a) Wholly ureteral

(b) Wholly vesical
(c) Both ureteral and vesical
(d) Wholly urethral
9.6 Beta-adrenergic receptors are most abundantly fount in :
(a) Bladder body

(b) Bladder neck
(c) Prostatic urethra
(d) Membranous urethra
9.7 The efferent nerve supply of the external urethral sphincter is via the :
(a) Adrenergic autonomous nervous system

(b) Cholinergic autonomous nervous system
(c) Somatic nervous system
(d) Central nervous system
9.8 Which of the following carries parasympathetic fibres to the urinary bladder ?
(a) Pugendal nerves

(b) Pelvic nerves
(c) Presacral nerves
(d) Posterior gluteal nerves
9.9 All of the following are true about the effects of sympathetic nervous system on bladder function
EXCEPT :
(a) It relaxes bladder muscles

(b) It promotes bladder emptying
(c) It stimulates adrenergic receptors in the urethra causing rise in intarurethral pressure
(d) It does not effect the external urethral sphincter
9.10 Which of the following is a neurohormonal transmitter for symphathetic post ganglionic
imervation of the urinary bladder ?
(a) Epinephrine
(b) Adrenaline
(c) Noradrenaline
(d) Norepinehrine
9.11 Which of the following is considered representative of the nerve supply and function integrity
of the pelvic floor ?
(a) Ability to achieve erction

(b) External anal sphincter tone
(c) Deep abdominal reflex
(d) Superficial abdominal reflex
9.12 Which of the following is FALSE regarding the tone of the external anal sphincter and the
patient’s ability contract it ?
(a) Presence of both tone and ability to contract indicates integrity of innervation of pelvic floor
(b) Present of tone but inability to contract indicates a suprasacral lesion
(c) Absence of both indicates a sacral or peripheral nerve abnormality
(d) It is not a good test to assess the tone of the external urethral sphincter
9.13 Which of the following is FALSE about the internal sphincter ?
(a) It is an anatomic sphincter at the bladder neck

(b) Comprises of a portion of the collapsible posterior urethra and blader neck
(c) It is extention of the detrusor muscle fibres in to the proximal urethra
(d) It is basically a physiologic sphincter
9.14 The following are TRUE about the external urethral sphincter EXCEPT :
(a) It maintains continence following prostatectomy

(b) Pathology hyperactivity can produce severe functional obstruction
(c) It is necessary for urinary continence in normal men
(d) The verumontanur aalways overlies the externl sphincter
9.15 The proprioceptive sensation of the urinary bladder include all of the following EXCEPT :
(a) First sensation of filling

(b) Sensation of fullness
(c) Pain
(d) Urge to void
9.16 Which is the centre for reflexcoordination between bladder contraction and sphinter relaxtion ?
(a) Cereble cortex

(b) Pons
(c) Suprasacral spinal cord
(d) Sacral spinal cord
9.17 In innervation of bladder and urethra , lumbar preganglionic contribution to pelvic ganglion is
from the following segments EXCEPT :
(a) T10
(b) T11
(c) T12
(d) L1
(e) L2
9.18 In innervation of bladder and urethra, sacral preganglionic contribution to the pelvic ganglions
is from the following segments EXCEPT :
(a) S1
(b) S2
(c) S3
(d) S4
9.19 Synaptic transmission from preganglionic to postganglionic cell is made by the release of :
(a) Epinephrine
(b) Acetylcholine
(c) Norepinephrine
9.20 Regarding the nerves supply of the urinary bladder, the pelvic nerves carriers of :
(a) Sympathetic fibres

(b) Parasympathetic fibres
(c) Autonomic fibres
9.21 Sympathetic receptors are most abundantly found in the :
(a) Bladder (lateral walls)

(b) Internal meatus and prostatic urethra
(c) Membranous and bulbas urethra
(d) Dome of the bladder
9.22 Which is the location of proprioceptive nerve endings in the urinary bladder ?
(a) Urothelium
(b) Detrusor
(c) Perivescal fascia
9.23 Which is the location of the exteroceptive nerve ending s in the urinary bladder ?
(a) Urothe lium

(b) Detrusor
(c) Perivesical fascia
9.24 In which part of the frontal lobe, the detrusor muscle area in the cerebral cortex is localized :
(a) Superomedial
(b) Inferomedial
(c) Superolateral
(d) Inferolateral
9.25 The exteroceptive sensory fibres travel in the :
(a) Reticulospinal tract

(b) Spinothalamic tract
(c) Posterior column
9.26 The proprioceptive sensory fibres travel in the :
(a) Reticulospinal tract

(b) Spinothalamic tract
(c) Posterior column
(d) Spinocerebellar tract
9.27 In normal men and in nulliparous women, inferior border of the bladder base flat and lies at or
above the symphysis pubis. On upright position or on straining, the bladder base :
(a) Undergoes no furher descent

(b) Decends 1 cms
(c) Descends 2 cms
(d) Descends 3 cms
9.28 In normal men, voiding occurs when the urethral closure pressure falls to :
(a) 15 cm of water
(b) 10 cm of water
(c) 5 cm of water
(d) 20 cm of water
9.29 In a normal male on standing cystogram, continence level will be demonstrated at the :
(a) Vesical neck

(b) Veru montanum
(c) External sphincter
(d) Bulbous urethra
9.30 Which of the following most unlike theory in the etiology of stress incontinence ?
(a) Defect in urethral length

(b) Defect in diameter pelvic outlet
(c) Defect in vesico urethral angle
(d) Defective transmission of increased intra abdominal pressure to the proximal urethra
9.31 If in normal person, the exernal (striated ) urethral sphincter is demaged, it leads to :
(a) Total incontinence

(b) Stress incontinence (varing degree)
(c) Overflow incontinence
(d) No effect on continence
9.32 Which is the best test for integrity of the sacral neural pathways i.e, the conus medullaris,
cauda eqina and peripheral sacral nerves ?
(a) Bulbocavernosus reflex by sacral evoked response

(b) Cystometrogram
(c) Urethral pressure profile
(d) Electromyography
9.33 The following are the most common and potentially serious upper tract abnormalities that
occur in neurogenic bladder EXCEPT :
(a) Vasico ureteral reflux

(b) Hydronephrosis
(c) Chronic pyelonephritis
(d) Renal calculi
(e) Renal tumours
9.34 “Funtional length of the urethra” means :
(a) Distance from internal meatus to verumontanum

(b) Length of the urethra where the urethral pressure is greater that the vesical pressure
(c) Distance from internal meatus to penoscrotal angle
(d) Distance from internal meatus to external meatus
9.35 What is the funtional length of the male urethra ?
(a) 1-2 cms

(b) 6-7 cms
(c) 9-10 cms
(d) 11-12 cms
9.36 All of the following are true about bulbocavernosus reflex EXCEPT :
(a) It is used to include all perical striated muscle reflexes

(b) It is mediated by sacral segments
(c) It is elicited by squeezing glans penis and looking for contraction of external anal sphincter
(d) It is not present in females
9.37 It is common knowledge that the female urethra is shorter than the male urethra. But, is the
female urethral sphincter zone is also shorter than the male :
(a) Yes
(b) No
9.38 The following are important data to record during filing cystometry EXCEPT :
(a) First sensation of bladder filling

(b) First sensation of fullness
(c) Urge to void
(d) Pain during micturition
(e) Feeling of imminent micturition
9.39 The following can give a falsely positive bethanecol supersensitivity test EXCEPT :
(a) Urinary tract infection

(b) Azotemia
(c) Decompensated bladder
(d) Deterusor hypertrophy
(e) Emotional stress
9.40 The phenomenon of supersensitivity of a derirvated smooth muscle to its nature

neurotransmitter is called :
(a) Cannon’s law

(b) Starling’s low
(c) Lapid’s low
9.41 lapide’s test includes injecting 2.5 mg of bethanecol chlorid subcutaneously and doing a
repeated CMG after 30 mnts at the same rate of filling. It is considered to be a positive test if
the increase in the basal pressure is more than :
(a) 5 cm of H2O
(b) 15 cm of H2O
(c) 30 cm of H2O
(d) 40 cm of H2O
9.42 Urethral pressure profile determines all of following EXCEPT :
(a) Funtional length of urethra

(b) Intravesical pressure
(c) Total urethral pressure
(d) Presence of uninhibited contractions of bladder
(e) Closure pressure
9.43 What os the “Maximum urethral closure pressure” ?
(a) The maximum pressure elicited in the urethra

(b) The maximum pressure in the urethra when the bladder neck is closed
(c) The difference between the maximum urethral pressure and the intravesical pressure
(d) The urethral pressure during maximum urine flow rates
9.44 The high pressure in the male urethra is
(a) Internal meatus

(b) Prostatic urethra
(c) Membranous urethra
(d) Proximal bulbar urethra
(e) Distal bulbar urethra
9.45 Persistence of EMG activity during bladder contractions signifies :

(b) Detrusor sphincter dyssynergia
(c) Coordinated sphincters
(d) Hyporeflexic bladder
9.46 Distension or stretching of urinary bladder with known volumes of gas or fluid and
simultaneous recording of changes in the intravesical pressure is known as :
(a) Flow electromyography

(b) Pheumocystography
(c) Cystometry
(d) Fractionated cystogram
9.47 While performing cystometrogram, zero reference for pressure is taken as ?
(a) Superior surface of symphysis pubis

(b) Level of table top
(c) Mid way between A and B
(d) Mid axillary line
9.48 While performing cystometry, if the rate of bladder filling is 10 ml?mnt, it is called ?
(a) Slow-fill cystometry

(b) Medium-fill cystometry
(c) Rapid-fill cystometry
(d) Natural-fill cystometry
9.49 What is the normal voiding pressure in boys ?
(a) 35-60 cm H2O

(b) 45-70 cm H2O
(c) 55-80 cm H2O
(d) 65-90 cm H2O
9.50 What is the normal flow rates in young males ?
(a) 20-55 cm H2O

(b) 30-65 cm H2O
(c) 40-75 cm H2O
(d) 50-85 cm H2O
9.51 What is the normal flow rates in young males ?
(a) 5-10 ml/sec

(b) 15-25 ml/sec
(c) 25-35 ml/sec
(d) 50-60 ml/sec
9.52 What should be the minimum voided urine for obtaining accurate information from uroflow
rates?
(a) 50-100 ml
(b) 100-150 ml
(c) 150-200 ml
(d) 200-250 ml
9.53 What is the normal voiding contraction pressure of detrusor to produce a uroflow rate of 20-25
ml/second ?
(a) 10-20 cm of H2O

(b) 20-40 cm of H2O
(c) 40-60 cm of H2O
(d) 60-80 cm of H2O
9.54 What is the normal closure pressure in male urethra ?
(a) 40-50 cm of water

(b) 60-70 cm of water
(c) 90-100 cm of water
(d) 110-120 cm of water
9.55 Urethral closure pressure is increased in the following conditions EXCEPT :
(a) Bladder filling

(b) Coughing and sneezing
(c) During act of mucturition
(d) On standing up
9.56 What is the physiologic rate of urine production ?
(a) 1 ml/mnt
(b) 3 ml/mnt
(c) 5 ml/mnt
(d) 7 ml/mnt
9.57 About which of the following, the electromyographic test (EMG) gives information :
(a) Extermal urethral sphinchter

(b) Internal sphincter
(c) Bladder contractions
(d) Funtional segment of urethra
9.58 Which is the most accurate method of recording electromyography of the external urethral
sphincter ?
(a) Surface anal plugs

(b) Needle electrodes placed in the external anal sphincter
(c) Electrodes in a urethral catheter
(d) Needle electrodes placed in the external urethral sphincter
9.59 In urethral pressure profilometry, the length of that segment of the urethra where urethral
pressure exceeds the bladder pressure is known as :
(a) Functional length of urethra

(b) Continence zone of urethra
(c) Continence line of urethra
(d) Anatomical length of urethra
9.60 In urethral pressure profilometry as the catheter is withdrawn from the bladder neck outwards,
there comes a point at which fluid flows from the urethral meatus. This point is termed as :
(a) Region of external striated sphincter

(b) Veru montanum
(c) Continence line of urethra
(d) Bulbopenile junction
9.61 The bulbocavernosus reflex, mediated by S2-S4 segment, can be elicited by any of the following
EXCEPT :
(a) Stroking the medical side of the thigh causing retraction of testis
(b) Pinching peri-anal skin thus causing contracting of external sphicter
(c) Squeezing glans penis thus causing contraction of external anal sphicter
(d) Squeezing the glans and looking for reflex contraction of bulbocavernous and
ischiocavemosus muscles
Match the Following
9.62 Striated external sphincter activity only (a) Anal plugs
9.63 Intra abdominal pressure (b) Sleep CMG
9.64 Combined external and internal sphicter activity (c) CMG
9.65 Total detrusor and intra-abdominal pressure (d) urethral pressure profile
9.66 Enuresis (e) EMG
9.67 The loo I is :
(a) Brain stem-sacral circuit

(b) Cerebral-brain stem circuit
(c) Vesical-scaral-sphicter circuit
(d) Cerebral-sacral circuit
9.68 The loop III is
(a) Brain stem-sacral circuit

(b) Cerebral-brain stem circuit
(c) Vesical-sacral sphincter circuit
(d) Cerebral sacral circuit
9.69 The coordination of the detrusor contraction and external urethral sphincter relaxtion during
voiding in the funtion of :
(a) Loop I
(b) Loop II
(c) Loop III
(d) Loop IV
9.70 In relation to central innervation of the detrusor muscle and periurethral striated muscle, an
open loop is defined as one in which :
(a) The end is interposed in the reflex arc

(b) A reflex arc consists entirely of neural elements
9.71 All of the following reflex arcs are open loop EXCEPT :
(a) Loop I
(b) Loop II
(c) Loop III
(d) Loop IV
9.72 About loop I, which of the following statement is FALSE :
(a) It consists of axonal pathways to and from the detrusor motor area in the frontal lobes to
the detrusor motor are in the potine-mesencephalic reticular formation
(b) It is an open loop
(c) This pathway rclays to and from the thalamus basal ganlion and limbic system
(d) It provides neural subtratc for volitional control of the detrusor reflex
9.73 Interruption of loop I circuit results in :
(a) Detrusor hyperreflexia

(b) Detrusor hypereflexia
(c) No change
9.74 Interruption of loop I pathways may resuts from all of the following EXCEPT :
(a) Cerebrovascular disease

(b) Brain tumour
(c) Head injury
(d) Parkinsorism
(e) Diabetes mellitus
9.75 Which of the following statement about loop II is WRONG :
(a) It is an open loop

(b) It consits of spinal neurai pathway arising from sensory endings in detrusor muscle and
motor axon pathways to the intermedio-lateral cell column
(c) It is composed of exteroceptive sensory pathway
(d) It is necessary for the delepment of intravesical contents
9.76 Interruption of loop II can occur from all of the following EXCEPT :
(a) Spinal cord injury

(b) Multiple sclerosis
(c) Spinal cord tumours
(d) Brain tumours
9.77 Which of the following statement about loop III is FALSE :
(a) It is an open loop

(b) It is composed of afferent sensory axons from the detrusor muscle coursing to impinge
synaptically upon pudendal motor neurones
(c) The sensory impulses generated in this loop result in relaxation of periurethral striated
muscle
(d) The detrusor and urethral funtion is not coordinated by the loop
9.78 Integrity of the loop III funtion can be tested by :
(a) Cystometry
(b) Sphincter electromyography
(c) Both of them
(d) None of them
9.79 The dysfuntion of loop III can be due to all of the following EXCEPT :
(a) Spinal cord injury

(b) Spinal aracnoiditis
(c) Diabetes mellitus
(d) Cerebro-vascular disease
9.80 The dysfuntion of loop III will be manifested in electromyographic recording as :
(a) Detrusor sphicter dyssynergia

(b) Uninhibited sphincter relaxation
(c) Either of the above
9.81 Which of the following statement is WRONG about Loop IV ?
(a) This loop consists of supraspinal and segmental innervation of periurethral striated muscle
(b) This loop has greater significance in females
(c) The supraspinal component of this loop includes sensory pathways in the posterior columns
that arise from muscle spindles and tendon organs in the pelvic floor musculature
(d) The integritu of this loop can be tested by spincter electromyography
9.82 The volitional control of detrusor contraction mediated by axons connecting centres in cerebral
cortex to the pontine mesencephalic reticular formation in the brain stem is represented by :
(a) Loop I
(b) Loop II
(c) Loop III
(d) Loop IV
9.83 Production of a detrusor contraction of suffictient temporal duration to allow total avacuation
of intravesical contents are mediated via :
(a) Loop I
(b) Loop II
(c) Loop III
(d) Loop IV
9.84 The following are the causes of sensory neurogenic bladder EXCEPT :
(a) Diabetes mellitus

(b) Tabes dorsalis
(c) Herpes loster
(d) Pernicious anaemia
9.85 The following are the causes of motor paralytic bladder EXCEPT :
(a) Extensitive pelvic surgery

(b) Extensitive pelvic trauma
(c) Herpes zoster
(d) Tabes dorsalis
9.86 A 60 years man having tremors and skeletal regidity along with frequency and urency of
micturotion. Urodynamic studies reveals detrusor hyper reflexia with evidence of striated
sphincter denervation of motor unit electromyography. Which of the following is the most
probable diagnosis :
(a) Parkinson’s disease

(b) Shy-Drager Sydrome
(c) Cerebellar Ataxia
(d) Multiple sclerosis
9.87 Lesion above the spinal cord level of T7 or T8 (spinal comumn level of T8) results in to the
following EXCEPT :
(a) Detrusor hyperreflexis

(b) Absent sensation belum the level of the lesion
(c) Smooth sphincter synergia
(d) Striated sphincter dyssynergia
9.88 Vesico ureteral reflux is more common in which of the following group of neurovesical
dysfuntion :
(a) Cerebrovascular accidents

(b) Supra sacral spinal cord injury
(c) Sacral spinal cord injury
(d) Diabetes melitus
9.89 A clicinal condition of bladder hyporeflexia with non-relaxing external urethral sphicter can
occur in all of the following EXCEPT :
(a) Abdominoperineal resection of rectum

(b) Intervertebral disc prolapse at L2
(c) Radical hysterectomy
(d) Radical pelvic surgery
9.90 In which of the following is the pathology in parkinson’s disease :
(a) Cerebrum
(b) Thalamus
(c) Basal ganglia
(d) Cerebellum
9.91 Which is the most common urodynamic findings in parkisonism ?
(a) Detrusor hyperrexia with vesicosphincter dyssnergia

(b) Detrusor hyperreflexia with smooth sphincter dyssynergia
(c) Detrusor hyperreflexia with coordinated sphincters
(d) Detrusor hypereflexia with coordinated sphincters
9.92 The following are the typical urodynamic findings in Diabetes mellitus EXCEPT :
(a) Impaired bladder sensation

(b) Increased cystomethic capacity
(c) Increased bladder contractility
(d) Impaired uroflow
9.93 What type of neurogenic bladder is usually found in a patient with transverse myelitis of the
spinal cord at the T12-L1 segment ?
(a) Detrusor hyperreflexia eith striated sphincter dyssynergia

(b) Detrusor hyperreflexia with coordinated sphincters
(c) Detrusor hyperreflexia with smooth sphincter dyssynergia
(d) Detrusor hyporeflexia with coordinated sphincter
9.94 A 35 year old man present with the complains of long standing obstructive and irritative
symptoms. He has a normal prostate on rectal examination, a negligible residual urine and a
norman endoscopic bladder appearance. Video orudynamics and cystourethrography revealed
obstruction at the level of bladder neck. Which is the most probable diagnosis :
(a) Detrusor sphincter dyssynergia

(b) Smooth sphincter dyssynergia
(c) Striated sphincter dyssynergia
(d) Non neurogenic/neurogenic bladder
9.95 What is the diagnosis in a neurogenically obstructed patient, if the obstruction is relieved on
giving alpha blockers ?
(a) External sphincter dyssynergia

(b) Non-relaxing external sphinter
(c) Smooth sphincter dyssynergia
(d) Denevated external sphincter
9.96 All of the following can cause neurologically mediated urinary retention EXCEPT :
(a) Detrusor hyperreflexia with coordinated sphincters

(b) Detrusor hyperreflexia with vesicosphincter dyssynergia
(c) Detrusor hyporeflexia with coordinated sphincters
(d) Detrusor hyporeflexia with nonrelaxing sphincters
9.97 All of the following can cause neurologically mediated in continence EXCEPT :
(a) Bladder hyperreflexia with coordinated sphincters

(b) Bladder hyporeflexa with non-relaxing sphincters
(c) Bladder hyperreflexia with non-relaxing sphincters
9.98 All of the following are true about autonomic dysreflexia EXCEPT :
(a) Usually occurs most often with bladder distension

(b) Treatment is phenoxybenzamine
(c) It occurs in spinal lesions below T7
(d) Symptoms consist of hypertension, headache, flusing and sweating
9.99 Which of the following results during the stage of spinal shock following total interruption of
spinal pathways due to trauma ?
(a) Detrusor hyperreflexia with periurethral striated muscle spasticity

(b) Detrusor hyperreflexia with periurethral striated muscle flaccidity
(c) Detrusor areflexia with periurethral striated muscle spasticity
(d) Detrusor areflexia with periurethral striated muscle flaccidity
9.100 Detrusor hyperreflexia with detrusor-sphincter dyssynergia can be caused by all of the
following EXCEPT :
(a) Spinal cord transection

(b) Spinal cord multiple sclerosis
(c) Parkinsonism
(d) Transverse myelitis
9.101 “Balanced bladder” has all of the following characteristic EXCEPT :
(a) Crede’s manoeuvre

(b) Trigger zones
(c) Parasympathomimetic drugs
(d) Electrical stimulation of bladder
Match the following
9.102 Increas intravesical pressure (a) Pudendal nerve

9.103 Decrease outlet resistance (b) Electric stimulation of pelvic cord
9.104 Inhibits bladder contractility (c) Electric stimulation of spinal cord
9.105 Increases outlet resistance (d) Sacral rhizotomy
9.106 Use of monitoring instruments (usually electronic) to detect and amplify internal physiologic
processes so as to make this ordinarily unavailable information available to the patient is
called :
(a) Autosuggestion
(b) Extra-sensory perception
(c) Biofeed back
(d) Autoregulation
9.107 Intermittent catheterisation is a very acceptable form of urinary bladder grainage. In the
following condition, continous catheterisation is preferred to intermittent EXCEPT :
(a) Low pressure vesico ureteral reflux

(b) Hyporeflexix large capacity bladder without VU reflux
(c) Bilateral hydrouteronephrosis with renal failure
(d) Acute pyelonephritis associated with vesicoureteral reflux
9.108 The following are the contraindications of intermittent self catherisation EXCEPT :
(a) Structure abnormality of urethra

(b) Periurethral abcess
(c) A clean but not sterile centre
(d) Severe urethritis
9.109 is the drug of choice in :
(a) Prostatism
(b) Enuresis
(c) Urgency-frequency syndrome
(d) Vesico-ureteric reflux
9.110 All of the following drugs can be tried in the management of vesical hyperreflexia EXCEPT :
(a) Plavoxate
(b) Oxybutynin chloride
(c) Urecholine
(d) Propantheline bromide
9.111 Which is the most potent oral anticholinergic drug available to day ?
(a) Oxybutysin
(b) Glycopyrrolate
(c) Hyoscyamine
(d) Probanthin
9.112 Which is the ideal pharmacotheraphy for a patient having urinary obstructive symptoms due
to an underlying neurologic vesical hyporeflexia with spastic uretral smooth muscles ?
(a) Oxybutynin
(b) Bethanechol chloride
(c) Diazepam
(d) Bethanechol chloride phenoxybenzamine
9.113 Which is the most commonly used anticholinergic agent for inhibiting bladder contractility ?
(a) Atropine
(b) Propantheline
(c) Methantheline
(d) Glycopyrrolate
9.114 Following are the musculotropic relaxants EXCEPT :
(a) Oxybutineine
(b) Probanthine
(c) Disyclomine
(d) Flavoxate
9.115 “Trigger Voiding” is attempted to induce relex voiding in patients suffering from :

(b) Hyporeflexic bladder
(c) Areflexic bladder
(d) Urethrotrigonal syndrome
9.116 What is “Crede’s Manoeuvre” ?
(a) Increasing intra-vesical pressure by blowing with the nose and mouth closed
(b) Tickling the posterior pharyngeal wall to induce vomitting
(c) Tying the gauge piece knot on a stretched indwelling urethral catheter to check venous
haemorrhage from the prostatic fossa
(d) Manual pressure in suprapublic region to induce voiding
9.117 “Crede’s manoeuvre” is used to induce reflex voiding in patients suffering from :

(b) Hyporeflexic bladder
(d) Urge incontinence
9.118 The following are contraindications for Crede’s manoeuvre EXCEPT :
(a) Hyporeflexic bladder

(b) Spastic sphincter associated with upper motor neurone lesions
(c) Vesico urethral reflux
(d) Hyperreflexic bladder
9.119 “Kegel exercises” are used to cure female patients suffering from :
(a) Total incontinence

(b) Stress incontinence
(c) Urgency-frequency syndrome
(d) Obesity
9.120 “Triple voiding is one of the conservative methods used in the management of :

(b) Vesico urethral reflux
(d) Stress incontinence
9.121 Oxybutinin chloride a commonly used drug in hyperreflexic bladder all of the following actions
EXCEPT :
(a) Anticholinergic
(b) Polysynaptic inhibitor
(c) Smooth muscle relaxant
(d) Local anaesthetic action
9.122 All of the following cause contraction of the detrusor EXCEPT :
(a) Enkephaline
(b) Histamine
(c) Prostaglandin
(d) 5-hydroxytryptamine
9.123 The following drugs relax striated external sphincter EXCEPT :
(a) Diazepam
(b) Dantrolene
(c) Baclone
(d) Bethanechol
9.124 Which is the most common drug used for relaxation of the striated musculature of the pelvic
floor ?
(a) Benzodiazepines (Diazepam)

(b) Baclofen (Lioresall)
(c) Dantrolene (Dantrium)
(d) Alpha blocker (Prazocin)
9.125 How many percent of patients will develop bacteriuria, if a catheter is kept indewelling for 4
days ?
(a) 25%
(b) 50%
(c) 75%
(d) 100%
9.126 Which is the preferred form of treatment in the spinal shock phase of spinal trauma ?
(a) Suprapubic cystostomy

(b) Indwelling urethral catheter
(c) Intermittent self catheterization
(d) Condom drainage
9.127 Increasing intravesical pressure by sacral nerve stimulation is most effective when the
stimulation is applied to :
(a) S1
(b) S2
(c) S3
(d) S4
9.128 Which is the drug of choice in the management of autonomic dysreflexia ?
(a) Phentolamine
(b) Diazepam
(c) Propranolol
(d) Urecholine
9.129 The following meets the criteria of “Balanced Bladder” EXCEPT :
(a) Does not need any drug therapy

(b) Vesico ureteric reflux present
(c) Adequate storage capacity
(d) Minimal uninfected residual residual urine (less than 125 ml)
9.130 Oxybutynin chloride acts on the bladder by its :
(a) Cholinergic action

(b) Anti-cholinergic action
(c) Adrenergic action
(d) Anti-cholinergic and smooth muscle relaant action
9.131 Diazepam, given alow intravenous, is used to treat :

(b) External sphincter spasm
(c) Smooth sphincter spasm
(d) Hyporeflexic bladder
9.132 Nocturnal enuresis is defined as nightwetting beyond the age of :
(a) 6 months
(b) 2 years
(c) 4 years
(d) 6 years
9.133 what is the meaning of “Encopresis” ?
(a) Painful enuresis

(b) Involuntery defaecation
(c) Involuntary erections
(d) Enuresis during day time only
9.134 During which phase of sleep, the primary enuretics usually do bed wetting :
(a) Rapid eye movement sleep

(b) Non rapid eye movement sleep
9.135 Which of the following theories have been incriminated inthe etiology of enuresis ?
(a) Maturation lag

(b) Genetic facyors
(c) Psychlogic factors
9.136 In enuresis, the following characteristic can be present EXCEPT :
(a) Hyporeflexic bladder

(b) Small functional bladder capacity
(c) Abnormal sleep cystometrogram
(d) Normal anatomic bladder capacity
9.137 Which is the drug choice for enuresis ?
(a) Propantheline
(b) Imipromine
(c) Diazepam
(d) Ephedrine
9.138 Following are the mechanisms of action of imipromine in treating enuresis EXCEPT :
(a) Anticholinergic effect on bladder muscles

(b) Decrease time spent in REM sleep
(c) Increase time spent in deep NON-REM sleep
(d) Alpha-adrenergic effect on vesical neck
9.139 What is the optimal disage of imipramine in the treatment of Enuresis ?
(a) 0.4-0.1 mg/kg/day

(b) 0.9-1.5 mg/kg/day
(c) 2.0-2.5 mg/kg/day
(d) 2.5-3.2 mg/kg/day
9.140 Which is the ideal site for external sphincterotomy ?
(a) 12 o’clock
(b) 6 o’clock
(c) 5-7 o’clock
(d) 3-6 o’clock
9.141 Which is the primary indication for external sphincterotomy ?
(a) Detrusor-striated sphincter dyssynergia

(b) Detrusor-smooth sphincter dyssynergia
(c) Hyporeflexic bladder with coordinated sphincter
(d) Hypereflexic bladder with coordinated sphincter
9.142 Failure following external sphincterotomy is attributed to the following EXCEPT :
(a) Age of the patient

(b) Inadequate surgical procedure (extent or depht)
(c) Inadequete detrusor function
(d) Unrecognised bladder neck obstruction
9.143 “Milking of the urethra” is a term used to denote :
(a) Inability to outline prostatic urethra during retrograde urethrogram

(b) Trying to milk a urethral calsulus back in to the bladder
(c) Trying to spread the anaesthetic jelly throughout the urethra by finger massage prior to
dilatation under local anaesthesia
(d) During micturating cystourethrogram under fluoroscopy when the normal male is asked to
stop voiding, there accurs retrograde movement of contrast media from posterior urethra
into the bladder. This ocurs due to contraction of external sphincter
10
PROSTATIC DISORDERS
10.1 In which week of embryonic life, the prostatic starts to develop ?
(a) 8
(b) 10
(c) 12
(d) 14
10.2 By which week of gestation, five groups of tubular form of lobes of the prostate appears :
(a) 12
(b) 14
(c) 16
(d) 18
10.3 The prostate is a :
(a) Alvcolar gland

(b) Tubular gland
(c) Compound tubuloalveolar Gland
10.4 There are how many clinically recognizable lobes in the prostate gland :
(a) 4
(b) 5
(c) 6
(d) 7
10.5 Approximately what is the vertical dimension of the prostate in adults :
(a) 1.5 cms

(b) 2.5 cms
(c) 3.5 cms
(d) 4.5 cms
10.6 In adults, the prostate measure transversely about :
(a) 1.5 cms

(b) 2.5 cms
(c) 3.5 cms
(d) 4.5 cms
10.7 In adults, the anteroposterior dimension of the prostate is about :
(a) 1.5 cms

(b) 2.5 cms
(c) 3.5 cms
(d) 4.5 cms
10.8 The primary artery of the prostate is a branch of :
(a) Pudendal
(b) Inferior vesical
(c) Superior vesical
(d) Obturator
10.9 Which of the following arteries supplying the prostate gland should be dealt at the time of
prostatectomy ?
(a) Ascending branch of prostatic artery

(b) Descending branch of prostatic artery
(c) Capsular arteries
(d) Branches from middle haemorrhoidal artery
10.10 The nerve supply of the prostate is derived from :
(a) Sympathetic fibres from hypogastric

(b) Medullated fibres from 3rd sacral nerves
(c) Medullated fibres from 4th sacral nerves
10.11 The prostate is held fimly in position by which of the following :
(a) Deep layer of urogenital diaphragm

(b) Puboprostatic ligaments
(c) Pubococcygeus muscles
(e) A and B
10.12 “Denonvillier’s fascia” seprates the prostates from :
(a) Extraperitoneal portion of the rectum

(b) Intraperioneal portion of the rectum
(c) Both of them
10.13 What is the normal weight of the prostate in adults ?
(a) 14 gms
(b) 16 gms
(c) 18 gms
(d) 20 gms
10.14 Approximately, what is the weight of muscular mass in the normal prostate gland :
(a) 10 percent
(b) 20 percent
(c) 30 percent
(d) 40 percent
10.15 How many percent of the prostate gland is constituted by the central and peripheral zone ?
(a) 65
(b) 75
(c) 85
(d) 95
10.16 Benign prostatic hyperplasia originates from which zone of the prostate gland :
(a) Central zone

(b) Transition zone
(c) Peripheral zone
10.17 The centra zone of the prostate originates from :
(a) Urogenital sinus

(b) Wolffian duct
(c) Mulleria duct
(d) Mesonephric duct
10.18 In MRI, the zonal anatomy of the prostate is well delineated on :
(a) T1 weighted images

(b) T2 weighted images
(c) Both
(d) None
10.19 What is the pH of the prostatic fluid ?
(a) 5.4
(b) 6.4
(c) 7.4
(d) 7.8
10.20 The following are the symptoms of acute prostatitis EXCEPT :
(a) Sudden onset of moderates to high fever

(b) Chills and rigours
(c) Urinary frequency, urgency nocturia
(d) Haematuria
(e) Low-back and perineal pain
10.21 Which is the most common causative organism in bacterial prostatitis ?
(a) Enterococcus fecalis

(b) E. Coli
(c) Proteus
(d) Klebsiella
10.22 Which is the most common gram positive bacteria in the etiology of prostatitis ?
(a) Enteroccus fecalis

(b) Coagulase negative staphylococci
(c) Streptococci
(d) Micrococci
10.23 Which of the following is most important in the pathogenesis of bacterial prostatitis ?
(a) Ascending urethral infection

(b) Lymphogenous spread
(c) Haematogenous infection
(d) Intra prostatic reflux of urine
10.24 Which of the following is NOT important in the diagnosis of prostatitis ?
(a) Urine culture

(b) Examination of semen
(c) Prostatic blopsy
(d) Examination of prostatic expressate
10.25 Which of the following can give FALSE rise of excessive leucocytes in the prostatic expressate ?
(a) Urethral disease

(b) Prostatic calculi
(c) Following sexual intercourse and ejaculation
10.26 Normally, how many WBC per high power field ae present in the prostatic fluid :
(a) Less than 10

(b) 10-15
(c) 15-20
(d) 20-25
10.27 Presence of which of the following in the prostatic expressate is most convincing sign of
prostatic inflammation :
(a) Leukocytes
(b) Macrophages containing fat (oval bodies)
(c) Both of them
(d) None of them
10.28 Which antigen specific immunoglobulin levels are raised in acute bacterial prostatitis ?
(a) IgG
(b) IgA
(c) IgM
10.29 Which antigen specific immunoglobulin levels are raised in chronic bacterial prostatitis ?
(a) IgA
(b) IgG
(c) IgM
(d) A&B
10.30 Which antimicrobial agent achieves highest levels in prostatic fluid ?
(a) Erythromycin
(b) Trimethoprim
(c) Fluoroquinolone
(d) Cephalexin
10.31 Treatment failure in bacterial prostatitis by trimethoprim is due to the following EXCEPT :
(a) Inadequate levels of trimethoprim in prostatic tissue

(b) Patients with infectet calculi
(c) Inadequate penetration of drugs in to the prostatic ducts and acini
(d) Inadeuate secretion
10.32 The treatment of acute prostatitis consists of the following EXCEPT :
(a) Antibiotics
(b) Analgesics
(c) Urethral catheter
(d) Bed rest
10.33 What should be the duration of treatment of acute bacterial prostatitis to prevent chronic
bacterial prostatitis ?
(a) 7 days
(b) 14 days
(c) 21 days
(d) 30 days
10.34 Which is the best management of acute retention of urine in a case of acute bacterial
prostatitis ?
(a) Urethral catheterization

(b) Transurethral resection of prostate
(c) Suprapubic cystostomy
10.35 Which of the following is NOT a common symptom of prostatic abscess ?
(a) Acute retention

(b) Frequency and dysuria
(c) Fever
(d) Haematuria
10.36 Which is the most appropriate therapy for infected prostatic calculi ?
(a) Medical therapy

(b) Radical transurethral prostatectomy
(c) Radical prostatovesiculectomy
(d) Transvesical prostatectomy
10.37 Which is the most common type of prostatitis syndrome ?
(a) Acute bacterial prostatitis

(b) Chronic bacterial prostatitis
(c) Non-bacterial prostatitis
(d) Prostatodynia
10.38 Which is the most probable diagnosis in a patient with symptoms of prostatitis in whom
cultures and documented UTI are negative despite the presence of excessive leucocytes and
macrophages conctcining fat in the prostatoc expressate ?

(b) Chronic bacterial prostatitis
(c) Non bacterial prostatitis
(d) Prostatodynia
10.39 What is the prostate growth rate between puberty to third decade of life ?
(a) 0.6 gm per year

(b) 1.6 gm per year
(c) 2.6 gm per year
(d) 3.6 gm per year
10.40 What is the prostate growth rate between the age of 31 to 90 years ?
(a) 0.1 gm per year

(b) 0.2 gm per year
(c) 0.3 gm per year
(d) 0.4 gm per year
10.41 What is the doubling time of hyperplastic prostatic tissue in men of 31 to 50 years age ?
(a) 2.5 years

(b) 3.5 years
(c) 4.5 years
(d) 5.5 years
10.42 What is the doubling time of hyper plastic prostatic tissue in men of 55 to 70 years age ?
(a) 6 years
(b) 8 years
(c) 10 years
(d) 12 years
10.43 The following preoperative investigations are mandatory in every case of benign prostatic
hyperplasia EXCEPT :
(a) Complete blood studies

(b) Urine analysis and culture sensitivity
(c) Ultrasonography
(d) X ray chest and ECG
(e) Intravenous urography
10.44 In which group of patients of benign prostatic hyperplasia, preoperative cystometrogram, is

commonly indicated :
(a) In every patient

(b) In patients pressenting with urinary retention
(c) In patients with associated neurologic disease
(d) In patients presenting with haematuria
10.45 The following are absolute indication of prostatectomy EXCEPT :
(a) Azotemia
(b) Hydronephrosis
(c) Bladder decompensation with overflow incontinence
(d) Bladder instability
10.46 A 71 years old man presented with the history of chronic retention of urine with overflow
incontinence. He had dysuria amd frequency of urination since last many years. His blood urea
was 100 mgs% and serum creatinine was 4.5 mgs%. There is no history of any systemic disease.
Which of the following is the most probable diagnosis :
(a) Stricture urethra

(b) Benign prostatic hyperplasia
(c) Carcinoma bladder
(d) Vesical calculus
10.47 Which of the following is the initial treatment of choice ?
(a) Continous indewelling catheterization

(b) Suprapubic cystostomy
(c) Bilateral nephrostomy
(d) Emergency prostatectomy
(e) Cystolithotripsy
10.48 Which of the following is the investigation of choice ?

(b) Ultrasonography
(c) Renal scan
(d) Flow cytometry
10.49 After initial treatment, blood urea and serum creatinine returned to normal.
Cystopanendoscopy revealed moderate enlargement of prostate. Which is the preferable
method of prostatectomy :
(a) Transvesical
(b) Retropubic
(c) Perineal
(d) Transurethral
10.50 Which of the following is most important factor for deciding route of prostatetomy ?
(a) Sieze of the prostate gland

(b) Sieze of the patient
(c) Experience of the surgeon
(d) Associated medical disease
10.51 Which of the following is a relative contraindication for transurethral resection of prostate ?
(a) Severe stricture of the posterior urethra

(b) Marked limitation of the bladder capacity
(c) Ankylosis of the hips preventing lithotomy position
10.52 The morbidity and mortality of prostatectomy increases in patients with :
(a) Advancing age

(b) Renal failure
(c) Urinary tract infection
10.53 Perineal prostatic surgery is indicated for :
(a) Early carcinoma prostate

(b) Benign prostatic hyperpalsia
(c) Prostatic calculi
(d) Prostatic abscess
10.54 In which group of patients, perineal prostatic surgery is preferable :
(a) With narrow pelvic outlet and thin perineum

(b) With narrow pelvic outlet and thick perineum
(c) With wide pelvic outlet and thin perineum
(d) With wide pelvice outlet and thick perineum
10.55 In which type of prostatectomy, retrograde ejaculation is a frequent occurance :
(a) Transvesical
(b) Retropubic
(c) Perineal
(d) Transurethral
10.56 In which type of prostatectomy, the incidence of stricture urethra is more common :
(a) Transvesical
(b) Retropubic
(c) Perineal
(d) Transurethral
10.57 In which type of prostatectomy, the incidence of incontinence of urine is more common :
(a) Transvesical
(b) Retropubic
(c) Perineal
(d) Transurethral
10.58 Injury to which of the following will give rise to post prostatectomy incontinence
(a) Baldder neck and prostatic urethra above the verumontanum

(b) Fibroelastic and smooth muscles of the urethra below the verumontanum
(c) External sphincter
(d) Skeletal muscle of the pelvic
10.59 Which of the following maintain continence after prostatectomy
(a) Internal pshincter

(b) External urethral sphicnter
(c) External urethral and remaining part of internal sphincter
(d) External sphicter and urethral resistance of distal urethra
10.60 Following post-prostatectomy incontinence, objective assessment of voluntary sphicter
funtion can be achieved by :
(a) Gystometrogram
(b) Urethral pressure profile
(c) Measuring anal sphicter tone
(d) Uroflowmetry
10.61 What should be the duration of non surgical expectant theraphy following post-prostatectomy
?
(a) 1-3 month

(b) 3-6 month
(c) 6-9 month
(d) 9-12 month
10.62 Which pharmacologic agent is used for the management of postprostatectomy incontinence ?
(a) Beta adreanergic simulators

(b) Alpha adrenergic blockers
(c) Alpha adrenergic simulators with cholinoytic agents
(d) Benzodiazepines
(e) Prostaglandins
10.63 In which of the following, the relsult of surgery for postprostatectomy incontinence will be
poor :
(a) Previous incontinence surgery

(b) Urethral stricture
(c) Local irradiation
(d) Chronic obstructive pulmonary disease
10.64 Which of the following is the commonest complication following surgery for post-
prostatectomy incontinence ?
(a) Infection
(b) Transient retention of urine
(c) Prolonged retention of urine
(d) Urethral erosion
(e) Osteomyelitis
10.65 The following drugs are used for the management of benign prostatic hyperplasia EXCEPT :
(a) Phenoxybenzamine
(b) Prazocin
(c) Urecholine
(d) Finesteride
10.66 Which adrenoceptors are blocked by prazocin ?
(a) Alpha 1
(b) Alpha 2
(c) Both
(d) None
10.67 Which of the following statement is FALSE regarding prazocin ?
(a) It is selective alpha-1 adrenoreceptor antagonist

(b) The results are better than surgery for BPH
(c) The clinical effecs are similiar to phenoxybenzamine
(d) It has few adverse reaction than phenoxybenzamine
10.68 Which is the mode of action of bromocriptin ?
(a) Alpha receptor antagonist

(b) Beta receptor-stimulant
(c) Prolactin inhibitor
(d) Direct action on the prostate gland
10.69 Which of the following statement is FALSE regarding Bromocriptin ?
(a) It is a semisynthetic ergot alkaloid

(b) It inhibits prolanctin secretion
(c) It imprves urine flow rate
(d) It is effective in the treatment of acute retention of urine
10.70 The post operative poor result of detrusor instability with bladder outflow obstruction can be
predicted preoperatively by which of the following :
(a) High flow rate

(b) Normal voiding pressure
(c) Presence of detrusor instability
(d) Low flow rate
10.71 Approximately what is the incidence of detrusor instability associated with bladder outflow
obstruction due to BPH :
(a) 10 percent
(b) 20 percent
(c) 30 percent
(d) 50 percent
10.72 Which is the commonest cause of death by cancer, in men older than 55 years ?
(a) Cancer prostate

(b) Cancer lung
(c) Cancer colorectum
(d) Cancer pancreas
10.73 Which of the following provide significant barrier for extension of carcinoma prostate ?
(a) Urethra
(b) Prostatic capsule
(c) Baldder
(d) Rectum
10.74 Which of the following has worst prognosis in carcinoma prostate :
(a) Extension to prostatic capsule

(b) Invasion of prostatic capsule
(c) Penetration of prostatic capsule
(d) Invasion of prostatic urethra
10.75 Which is the site of earliest evidence of invasion of cancer prostate ?
(a) Prostatic urethra

(b) Prostatic calsule
(c) Perineural spaces
(d) Seminal vesicles
10.76 What is the incidence of incidental adenocarcinoma after open prostatic adenectomy ?
(a) 1-5 percent

(b) 6-12 percent
(c) 13-18 percent
(d) 18-24 percent
10.77 Acid phosphatase is present in the following normal tissue EXCEPT :
(a) Liver
(b) Prostate
(c) Platelets
(d) Kidney
(e) Stomach
10.78 In which of the following, there is lowest acid phosphatase content in the prostatic tissue :
(a) Normal prostate

(b) Benign hypertrophy of prostate
(c) Well-differentiated carcinoma prostate
(d) Poorly-differentiated carcinoma prostate
10.79 Which of the following statement is FALSE regarding prostate specific antigen ?
(a) It is a lipoprotein
(b) It is produced only by prostatic epithelial cells
(c) It hydrolyzes (lyses) the coagulum of the ejaculate
(d) Its funtion is related to male fertility
10.80 Which of the following statement is FALSE regarding prostate specific antigen (PSA) ?
(a) It is organ specific

(b) Serum elevation of PSA occurs only in cancer patients
(c) PSA is an important prognostic marker for monitoring patients with prostatic cancer
(d) There is relationship between serum PSA level to the volume of intracapsular prostate
cancer
10.81 What is an overall average rate of PSA level rise for intracapsular cancer prostate ?
(a) 2.5 ng/ml

(b) 3.0 ng/ml
(c) 3.5 ng/ml
(d) 4.0 ng/ml
10.82 What is an average rate of PSA level rise in BPH ?
(a) 0.2 ng/ml

(b) 0.3 ng/ml
(c) 0.4 ng/ml
(d) 0.5 ng/ml
10.83 There is a rise in serum PSA level in the following conditions EXCEPT :

(b) Non bacterial prostatitis
(c) Following digital rectal examination
(d) Following cystoscopic examination
10.84 Following biopsy of the prostate, how long one should wait before measuring serum PSA level
(a) 1 week
(b) 2 week
(c) 3 week
(d) 4 week
10.85 Which type of osseous secondaries are most common from the cancer prostate ?
(a) Osteolytic
(b) Osteoblastic
(c) Osteolytic and Osteoblastic mixed
(d) Osteoporotic
10.86 How much of bone must be replaced by tumour tissue before it can be detected
radiographically ?
(a) 5-10%
(b) 10-15%
(c) 30-50%
(d) 70-80%
10.87 Which of the following investigation is most sensitive for detection of metastasis in carcinoma
prostate ?
(a) Bone scientigraphy

(b) Radiographic survey
(c) Prostate acid phosphatase
(d) Prostate specific antigen
10.88 Synthesis of proteins by the prostate cell is dependent upon :
(a) Oestrogen
(b) Progesterone
(c) Androgen
(d) Anti-androgen
10.89 All of the following can cause an area of prostate induration EXCEPT :
(a) Prosatatic infaction

(b) Post-operative change in prostate
(c) Focal regions benign hyperplasia
(d) Acute prostatic
10.90 Which of the following is characteristic of transitional cell carcinoma of the prostate ?
(a) Elevated serum acid phosphatase (SAP) osteoblastic secondaries

(b) Normal SAP and osteoblastic seconderies
(c) Normal SAP and osteolytic seconderies
(d) Elevent SAP and osteolytic seconderies
10.91 Which is the commonest site of lymphatic metastasis in carcinoma prostate ?
(a) Obturator
(b) Hypogastric
(c) Illiac
(d) Presacral
(e) Para-aortic
10.92 Which of the following statement regarding metastasis of carcinoma prostate is TRUE ?
(a) Osseous metastasis accur first

(b) Lymphatic metastasis occur first
(c) Osseous and lymphatic metastasis accur together
(d) Osseous and lymphatic metastasis occur independently
10.93 Which are the most common sites of haematogenous metastasis from carcinoma prostate ?
(a) Visceral
(b) Osseous
(c) Neural
(d) Lymphatic
10.94 Which is the commonest site for osseous metastasis from carcinoma prostate :
(a) Thoracic spine

(b) Ribs
(c) Femur
(d) Lumbar spine
(e) Pelvis
10.95 Which cranial nerve is most frequently involved either alone or in combination in cases of
metastasis carcinoma prostate to the calivarium ?
(a) 3rd
(b) 5rd
(c) 7rd
(d) 9rd
10.96 What is the incidence of lymphatic metastasis among the patients of carcinoma prostate in
whom tumour is contined to the prostate ?
(a) 10%
(b) 25%
(c) 40%
(d) 60%
10.97 Which of the following statement is FALSE regarding lymphangiography for the diagnosis of
carcinoma prostate ?
(a) The hypogastric and obturator lymph nodes are not consistently visualised
(b) Micronetastasis can not be detected
(c) Small discreet ill defined defects are diagnostic of tumour
(d) There is difficully in differentiating between fatty infiltration and tumour
10.98 Which of the following group of carcinoma prostate cases have adverse influence on the
recurrence of desease, who have ?
(a) No blood transfusion

(b) Transfusion of whole blood
(c) Autologous blood transfusions
(d) Tranfusion of red blood cells washed free of plasma and white cell debris
10.99 Which is the treatment of choice for stage A1 adenocarcinoma prostate in a men of 70 years ?
(a) Observation and close follow up

(b) Radical prostatectomy
(c) Radiation therapy
(d) Hormone therapy
10.100 By which mechanism, oestrogen lowers plasma testoterone levels :
(a) Inhibition of LH release from pirultary

(b) Inhibition of testicular steroidogenesis
(c) Inhibition of metabolism of prostatic cells
(d) Decreasing levels of free plasma
10.101 What is the minimal dose of diethylstilboesterol required for the consistent suppression of
plasma testosterone levels to the range seen after castration ?
(a) 1 mg/day
(b) 3 mg/day
(c) 5 mg/day
(d) 10 mg/day
10.102 Following bilateral orchiectomy, there is an abrupt fall in plasma testosterone levels to :
(a) 200ng/ml
(b) 150 ng/ml
(c) 100 ng/ml
(d) 50 ng/ml
10.103 How long after definitive radiotherapy, prostatic biopsy be performed for accurate results ?
(a) 1 month
(b) 3 month
(c) 6 month
(d) 1 year
10.104 What is the incidence of impotence in patients of carcinoma, prostate undergoing definitive
radiotherapy ?
(a) 10-20%
(b) 20-30%
(c) 40-50%
(d) 60-70%
10.105 Which is the most potent antiandrogen drug ?
(a) Spironolactone
(b) Cyproterone acetate
(c) Aminoglutethemide
(d) Diethylstilboesterol
10.106 Which of the following statement is FALSE regarding gynaecomastia due to endocrine
therapy in patients of carcinoma prostate ?
(a) 1000-1500 rads locally are used to prevent gynaecomastia

(b) Established gynaecomastia can be cured by radiotherapy
(c) Orchiectomy does not cause gynaecomastia
(d) Single dose radiotherapy locally affords adequatepalliation
10.107 In which of the following, carcinoma prostate has poor prognosis :
(a) Patient less than 50 years age

(b) Patients more than 50 years age
(c) No difference
10.108 What is the treatment of choice for early transitional cell carcinoma prostate ?
(a) Simple prostatectomy

(b) Radical prostatectomy
(c) Hormonal therapy
(d) Radical radiotherapy
10.109 A patient underwent transurethral resection of prostate and the histopathology revealed
stage A2 cancer. What time interval is recommended between TUR-P and subsequent radical
surgery :
(a) Immediate post-op

(b) After 6 days
(c) After 6 weeks
(d) After 6 months
10.110 In which of the following group of patients, radical retropubic prostatectomy for carcinoma
prostate is absolutely contraindicated :
(a) Patients younger than 70 years of age

(b) Stage B1 or B2
(c) Stage A2 and grade III nuclear aplasia
(d) Stage C
(e) Presense of multinodal metastasis in pelvic lymph nodes
10.111 Following are the advantages of radical retropubic prostatectomy over radical perineal
prostatectomy EXCEPT :
(a) It can be done in conjunction with pelvic lymphadenectomy without alterin, the patients
position
(b) It gives view of pelvic anatomic structures
(c) It is advantageous in removal of large prostate gland with subvesical extention
(d) Vesieourethral anastomosis is easy with less intraoperative blood loss
11
ANDROLOGY
11.1 In humans, on which aspect of urogenital ridge, an indifferent gonad capable of ovary or testis
can be identified :
(a) Ventromedial
(b) Ventrolateral
(c) Dorsomedial
(d) Dorsolateral
11.2 In humans, in which week of gestation, an indifferent gonad capable of developing in to either
an ovary or testis can be identified :
(a) 1-3 weeks

(b) 3-5 weeks
(c) 5-7 weeks
(d) 7-9 weeks
11.3 What is the origin of the cortex of the primitive gonad ?
(a) Endothelium
(b) Coelomic epithelium
(c) Mesonephric blastema
11. 4 What is the origin of the medulla of the primitive gonad ?
(a) Endothelium
(b) Coelomic epithelium
(c) Mesonephric blastema
11.5 Which of the following element dominate if the gonad becomes testis ?
(a) Cortex
(b) Medulla
11.6 A testis develop when a Y-chromosome is present and an ovary develops when there is no Y-
chromosome. There are no exceptions to this rule. This statement is :
(a) True
(b) False
11.7 By which week of gestation, sexual differentiation become apprent :
(a) 4 weeks
(b) 5 weeks
(c) 6 weeks
(d) 7 weeks
Match the following in relationship to development of testis and genetalia :
11.8 Primordial germ cells (a) Primitive gonad
11.9 Sex cords (b) Spermatogonia
11.10 Rete testis (c) Wolffian duct
11.11 Ductuli efferentes (d) Seminiferous tubules
11.12 Epididymis,vadeferns,seminal vesicle (e) Mesonephric tubules
11.13 In which month of gestation differentiation of internal genitalia begins :
(a) First
(b) Second
(c) Third
(d) Fourth
Match the following regarding development of external genetalia :
11.14 Glans penis (a) Genital folds
11.15 Shaft of penis (b) Genital tubercle
11.16 Scrotum (c) Genital swellings
11.17 Which is the of production of Gonadotrophin releasing hormone (GnRH) ?
(a) Hypothalamus
(b) Pituaitary
(c) Adrenal gland
(d) Testis
11.18 What is the average frequency of one pulse for GnRH release in to the portal circulation ?
(a) 40-60 mnts

(b) 50-70 mnts
(c) 60-80 mnts
(d) 70-90 mnts
11.19 What is the half life of GnRH in the blood ?
(a) 2-5 mnts

(b) 5-7 mnts
(c) 8-10 mnts
(d) 10-12 mnts
11.20 In which month of development in utero, the intersitial (leyding) cells make their appearance :
(a) 6th or 7th

(b) 7th or 8th
(c) 8th or 9 th
(d) 10th or 11 th
11.21 The septa compartmentalize the testes into how many lobules :
(a) 100
(b) 200
(c) 300
(d) 400
11.22 What is the percentage of interstitial tissue in the total testicular volume ?
(a) 10-20 percent

(b) 20-30 percent
(c) 30-40 percent
(d) 40-50 percent
11.23 The arterial supply to the human testis and epididymis is derived from :
(e) Internal sprematic artery

(f) Deferential artery
(g) External spermatic or cremasteric artery
(h) All of the a bove
11.24 Approximately how many million leyding cells are present in a testis of a 20 year old man :
(a) 500
(b) 600
(c) 700
(d) 800
11.25 What is the percentage of leyding cells in the total volume of the human testis ?
(a) 5-12
(b) 12-17
(c) 17-22
(d) 22-27
11.26 During which week of gestation, peak level of testosterone occurs in the blood of the human
fetus :
(a) 6-12
(b) 12-18
(c) 18-24
(d) 24-30
11.27 Approximately how many millilitre of blood is provided per 100 gm of testicular tissue per
minute :
(a) 7
(b) 9
(c) 11
(d) 13
11.28 During which decade of life, testosterone reaches the maximum concentration :
(a) 1st decade

(b) 2-3rd decade
(c) 4-5th decade
(d) 5-6th decade
11.29 Approximately, how many days are recquired for the entire spermatogenic process in men :
(a) 54
(b) 59
(c) 64
(d) 69
11.30 What is the lenght of a convoluted seminiferous tubule, in feet, when fully stretched ?
(a) 1
(b) 1.5
(c) 2
(d) 2.5
11.31 Approximally, what is the lenght of ductus deference :
(a) 20-25 cms

(b) 25-30 cms
(c) 30-35 cms
(d) 35-40 cms
11.32 Approximately, what is the diameter of the human of the tubule :
(a) 0.05 cm
(b) 0.02 cm
(c) 0.10 cm
(d) 0.20 cm
11.33 Approximately, what is the lenght of the human spermatozoon :
(a) 30 micrometer
(b) 40 micrometer
(c) 50 micrometer
(d) 60 micrometer
11.34 Normally, what is the lenght of the human spermatozoal head :
(a) 1-3 microns

(b) 3-5 microns
(c) 5-7 microns
(d) 7-9 microns
11.35 Normally, what is the width of the human spermatozoal head :
(a) 1-2 micron

(b) 2-3 micron
(c) 3-4 micron
(d) 4-5 micron
11.36 What percentage of the length of human sperm is constituted by the tail of the sperm ?
(a) 80 percent
(b) 85 percent
(c) 90 percent
(d) 95 percent
11.37 Which of the following statement is FALSE in relation to spermatogenesis ?
(a) Testicular sperms are fertile

(b) 12% of caput sperms demonstrate tail movement
(c) 34% of caudal sperms exhibit progressive motility
11.38 How many microns per second is the average velocity of the ejaculated sperm ?
(a) 25 percent
(b) 50 percent
(c) 75 percent
(d) 100 percent
11.39 Foolowing are the function of the epididymis EXCEPT :
(a) Sperm tranport

(b) Sperm storage
(c) Sperm maturation
(d) Sperm differentiation
11.40 In which part of the epididymis , maximum, spermatozoa are stored in human :
(a) Caput
(b) Corpus
(c) Caudal
(d) Equally distributed
11.41 Sperm movement in the epididymis is due to :
(a) Positive fluid pressure from the rete testis

(b) Fluid currents estabilished by movement of cilia
(c) Peristaltic contractions of the efferent ducts
11.42 Which of the following statement is FALSE regarding decapacitation factor (DF) ?
(a) In hibits the capacitation of sperm

(b) It is present in the male reproductive tract
(c) The inhibition is irreversible
(d) The female reproductive tract destroys or eliminates decapacitation factor
11.43 Which is the commonest site for the aberrations in growth and infections, within the sex
accesory tissues ?
(a) Prostate
(c) Bulbourethral glands (Cowper’s gland)
(d) Epididymis
11.44 How many percent of the total semen volume is constitutedby the testis and epididymis ?
(a) Less than one percent

(b) 2 percent
(c) 3 percent
(d) 4 percent
11.45 How many percent of the total galndular tissue is contained in the peripheral zone of the
normal prostate ?
(a) 65
(b) 70
(c) 75
(d) 80
11.46 How many percent of the typical secretary cells decrease in total number after androgen
ablation ?
(a) 75
(b) 70
(c) 85
(d) 90
11.47 How many percent of the typical secretary cells shrink in cell volume after androgen ablation ?
(a) 60
(b) 70
(c) 80
(d) 90
11.48 How many percent of the typical secretary cells decrease in cell height after androgen ablation
?
(a) 60
(b) 70
(c) 80
(d) 90
11.49 How many percent of circulating serum testosterone is of testicular origin ?
(a) 80
(b) 85
(c) 90
(d) More than 95 percent
11.50 Which is the major source of the resticular androgen ?
(a) Leydig cell

(b) Sertoli cell
(c) Basal cell
(d) Neuro endocrine cell
11.51 What is the concentration of testosterone in the spermatic vein ?
(a) 20-30 microgram/dl

(b) 30-40 microgram/dl
(c) 40-50 microgram/dl
(d) 50-60 microgram/dl
11.52 Which of the following androgens has highest concentration in the spermatic vein ?
(a) Androstenediol
(b) Androstenedion
(c) Dihydroepiandrosterone
(d) Testosternone
11.53 Approximately, what is the mean metabolic clearance for testosterone every 24 hours :
(a) 700 liters

(b) 800 liters
(c) 900 liters
(d) 1000 liters
11.54 What is the plasma half life of the testosterone ?
(a) 10-20 mnts

(b) 20-30 mnts
(c) 30-40 mnts
(d) 40-50 mnts
11.55 How many percent of the total serum testosterone is NOT protein bound ?
(a) 2 percent
(b) 4 percent
(c) 6 percent
(d) 8 percent
11.56 Approximately, what is the concentration of free testosterone in the plasma :
(a) 5 ng/dl
(b) 10 ng/dl
(c) 15 ng/dl
(d) 20 ng/dl
11.57 The following are the sites of formation of dihydrotestosterone from testosterone EXCEPT :
(a) Prostate
(b) Seminal vesicle
(c) Liver
(d) Spleen
11.58 What is the level of dihydrosterosterone per gm wet weight within the prostate gland ?
(a) 1 ng
(b) 5 ng
(c) 10 ng
(d) 15 ng
11.59 To which proteins, maximum amount of testosterone is bound in the plasma :
(a) Human serum albumin

(b) Steroid globumin (TebG or SBG)
(c) Corticosteroid binding globulin (CBG)
(d) Alpha acid glycoprotein (AAG)
11.60 What is the level of dihydrotestosterone in normal peripheral palsma ?
(a) 20-30 ng/dl

(b) 30-40 ng/dl
(c) 40-50 ng/dl
(d) 50-60 ng/dl
11.61 After which age, the mean level of free testosterone decline in men :
(a) 30 years
(b) 40 years
(c) 50 years
(d) 60 years
11.62 Which is the alpha-reductase inhibitor ?
(a) 1-aza steroid

(b) 2-aza steroid
(c) 3-aza steroid
(d) 4-aza steroid
11.63 Approximately, what is the average volume of the normal human ejaculate :
(a) I ml
(b) 2 ml
(c) 3 ml
(d) 4 ml
11.64 Which has the major contribution to the volume of seminal plasma ?
(a) Testis
(b) Seminal vesicle
(c) Prostate
(d) Cowper’s gland
11.65 How many percent of the total volume of ejaculate is provide by the prostate and seminal
vesicles ?
(a) 80 percent
(b) 85 percent
(c) 90 percent
11.66 The first or preejaculatory fraction of semen comes from :
(a) Mucus urethral (litter’s) glands

(b) Bulbourethral (Cowper’s) glands
(c) Skene’s tubule
(d) A&B
11.67 Very small volume ejaculate is due to the following conditions EXCEPT :
(a) Partial retrograde ejaculation

(b) Due to abnormality in the physiology of prostate and seminal vesicle
(c) Bilateral congenital absence of vas and seminal vesicle
(d) Bilateral obstruction
11.68 The first fraction of the human ejaculate is rich in :
(a) Sperms
(b) Citri acid
(c) Both of them
(d) None of them
11.69 Which is the major source of citric acid presen in the human semen ?
(a) Testis
(c) Prostate
11.70 Which is the souce of fructose in human seminal plasma ?
(a) Testis
(c) Prostate
11.71 Which of the following has highest concentrations in the seminal vesicle secretions ?
(a) Fructose
(b) Glucose
(c) Sorbital
(d) Ribose
(e) Fucose
11.72 Approximately, what is the concentration of fructose in human seminal secretion :
(a) 100 mg/dl

(b) 200 mg/dl
(c) 300 mg/dl
(d) 400 mg/dl
11.73 Approximately, what is the leval of fructose in seminal plasma :
(a) 100 mg/dl

(b) 200 mg/dl
(c) 300 mg/dl
(d) 400 mg/dl
11.74 Which of the following statement is FALSE regarding fructose in the ejaculate ?
(a) It is mainly produced in the seminal vesicle

(b) The production is not an androgen dependent proccess
(c) The normal range of concentration in human semen is 120 to 450 mgs/100ml
(d) It is absent in patients with bilateral congenital absence of vas and seminal vesicle
11.75 Concentration of fructose in semen below 120/100 ml is due to all of the following EXCEPT :
(a) Inflammation of seminal vesicles

(b) Androgen deficiency
(c) Partial obstruction of ejaculatory ducts
(d) Incomplete ejaculation
(e) Varicocele
11.76 Which is the source of origin of spermin ?
(a) Testis
(b) Epididymis
(c) Prostate
(d) Seminal plasma
11.77 Which is the richest source of prostagladins ?
(a) Testis
(b) Epididymis
(c) Prostate
(d) Seminal plasma
11.78 Which is the richest source of prostaglandins ?
(a) A
(b) B
(c) E
(d) F
11.79 Which is the primary primary source of origin of zinc in human seminal plasma ?
(a) Testis
(b) Epididymis
(c) Prostate
(d) Seminal vesicle
11.80 What is the level of zinc in human seminal plasma ?
(a) 110 microgram/ml

(b) 120 microgram/ml
(c) 130 microgram/ml
(d) 140 microgram/ml
11.81 Which of the following statement is FALSE regarding zinc levels in seminal secretions ?
(a) The levels are stable or elevated in BPH

(b) The levels are decreased in adenocarcinoma prostate
(c) Oral intake of zinc after zicn levels in prostatic fluid
(d) The levels decreased in prostatic infections
11.82 Following lubricants do NOT affect sperm motility EXCEPT :
(a) K. Y jelly
(b) Keri lotion
(c) Saliva
(d) Pea nut oil
11.83 Following lubricants do NOT affect sperm motility EXCEPT :
(a) Peanut oil

(b) K. Y jelly
(c) Vegetable oil
(d) Raw egg white
11.84 How much time is reuqired following ejaculation for human semen to coagulate in to a
semisolid gel ?
(a) Within 5 mnts

(b) 5-10 mnts
(c) 10-15 mnts
(d) 15-20 mnts
11.85 Which of the following calcium binding substances inhibit coagulation of human ejaculate ?
(a) Sodium citrate

(b) Heparine
(c) None of them
(d) Both of them
11.86 Liquefaction of semen may be induced by the addition of the following EXCEPT :
(a) Seminin
(b) Seminal proteinase
(c) Fructose
(d) Alpha amylase
11.87 Which of the following recquired for human ejaculate to coagulate ?
(a) Prothrombin
(b) Fibrinogen
(c) Factor XII
(d) None of them
11.88 In which of the following, failure of coagulation of semen occurs :
(a) Congenital bilateral absence of vas deference

(b) Obstructive azzospermia
(c) Varicocele
(d) Germinal aplasia
11.89 The following are the causes of absence of emission of ejaculate EXCEPT :
(a) Retrograde ejaculation

(b) Sympathetic denervation
(c) Benign prostatic hyperplasia
(d) Androgen deficlency or drugs
11.90 Testicular volume corretlates well with the semon quality and fertility. This statement is :
(a) False
(b) True
11.91 Approximately, how many percent of cases of male infertility are entirely due to male factor :
(a) 10 percent
(b) 20 percent
(c) 30 percent
(d) 40 percent
11.92 Which of the following is important in the family history of the infertile male ?
(a) Testicular atrophy

(b) Hypoganadotropism
(c) Cyrptorchidism
(d) Congenitai mid line fects
11.93 How many percent of male inferility cases are due to primary hrmonal abnormality ?

(b) 3-6 percent
(c) 6-9 percent
(d) 9-12 percent
11.94 Following endocrine disorders can cause infertility EXCEPT :
(a) Congenital adrenal hyperplasia

(b) Hypothyroidism
(c) Hypogonadotropism
(d) Klinefelter’s syndrome
11.95 How many percent of men with bilateral cryptorchidism can have oligospermia ?
(a) 30 percent
(b) 40 percent
(c) 50 percent
(d) 60 percent
11.96 How many percent of men with unilateral cryptorchidism can have oligopermia ?
(a) 30
(b) 40
(c) 50
(d) 60
11.97 In how many percent of inquinal or prescrotal testis, absence of germ cells is found :

(b) 20-40 percent
(c) 40-60 percent
(d) 60-80 percent
11.98 In how many percent of intraabdominal testis, absence of germ cells is found ;
(a) 60 percent
(b) 70 percent
(c) 80 percent
(d) 90 percent
11.99 Which of the following statement is FALSE in relation to endocrine function of the testis ?
(a) Feedback regulation of LH secretion is directly controlled by testosterone

(b) Estradiol also exerts an inhibitory influence on LH secretion
(c) ‘inhibin’ is produced by seminiferous tubule
(d) FSH concentration have been found to be markedly decreased when testicular germ cells are
depleted
11.100 Which of the following are common degenerative changes of the testis ?
(a) Thickening of the tubule basement membrane

(b) Thickening of the tunica propria
(c) Intratubular fibrosis
11.101 Normaly, testicular temperature is how many degree below the body temperature :
(a) Less than 1 degree

(b) 1-2.5 degree
(c) 2.5-4 degree
(d) More than 4 degree
11.102 A 25 year infertile man presented with a history of frequent respiratory infections, situs
inversus with immotile seprms. Which ithe most probable diagnosis :
(a) Kartgener’s syndrome

(b) Young’s syndrome
(c) Kalimann’s syndrome
(d) Noonan’s syndrome
11.103 The prolacting levels in human blood are elevated with the following EXCEPT :
(a) Estrogens
(b) Tranquilizing drugs
(c) Stress
(d) L-dopa
11.104 Hyperprolactinemia can result in to which of the following :
(a) Impotence
(b) Ifertibility
(c) Either of them
(d) Both of them
11.105 Which of the following is correct in patients with idiopathic hyperprolactinemia ?
(a) Normal gonadotrophin and testosterone levels

(b) Increased gonadotrophin and increased tetosterone levels
(c) Decreased gonadotrophin and increased testosterone levels
(d) Increased gondadotrphins and decreased testosterone levels
11.106 Which of the following is WRONG about hyperprolactinemia ?
(a) It is associated with high circulating testostrone levels

(b) This disorder can have either sexual or reproductive abnormalities
(c) It can be due to prolactin secreting pituitary tumour
(d) It can be treated by bromocriptine or surgical ablanon of the pituitory tumour
11.107 For how many month, spermatogenesis may be impaired following a febrile illness :
(a) Less than 1 month

(b) 1-3 months
(c) 3-6 months
(d) 6-9 months
11.108 During spermatogenesis, which of the following is least susceptible to the chemotherapeutic
agents :
(a) Spermatogonia
(b) Spermatocystes
(c) Dividing spermatids
(d) Mature spermatozoa
11.109 Following chemotherapy, when spermatogenesis may resume :
(a) Within 3 months

(b) Between 3-6 months
(c) Between 6-9 months
(d) After 1 year
11.110 Which radiation dose can result in to azoospermia ?
(a) Less than 10 rads

(b) 10-20 rads
(c) 20-30 rads
(d) More than 50 rads
11.111 Which of the following is more resistant to radiation ?
(a) Spermatids
(b) Spermatogonia
(c) Spermatocytes
(d) No difference
11.112 Which of the following is the most common cause of obstructive azoospermia in India ?
(a) Small pox

(b) Tuberculosis
(c) Mumps
(d) Gonorrhoea
11.113 Approximately in hwo many percent of postpubertal niumps results in orchits :
(a) 10 percent
(b) 20 percent
(c) 30 percent
(d) 40 percent
11.114 Approximately in how many percent of cases of male infertility, ductal obstruction is found :
(a) 7 percent
(b) 10 percent
(c) 14 percent
(d) 17 percent
Match the following
11.115 Low testostemrone, FSH and LH level (a) Isolated germ cell depletion
11.116 Elevated serum FSH and LH level (b) Hypogonadotropic hypogonadism
11.117 LH is normal and FSH is elevated (c) Primary testicular failure
11.118 At what time, post coital test should be performend :
(a) During the menstruation

(b) After the menstruation
(c) Just prior to ovulation
(d) After the ovulation
11.119 Which is the most common cause for an abnormal result of the post coital test ?
(a) Anatomic abnormalities

(b) Inappropriate timing
(c) Semen or cervical antisperm antibodies
(d) Inappropriately performed intercourse
(e) Abnormal semen
11.120 Which of the following investigation is necessary to identify the site of obstruction in a
azzosperic man with normal spermatogenesis ?
(a) Testicular biopsy

(b) Vasography and seminal vasiculography
(c) FSH and LH estimation
(d) Scrotal doppler ultrasound
11.121 The following solutions are used for preservation of testicular biopsy specimen EXCEPT :
(a) Zengker’s
(b) Bouin’s
(c) Formeldehyde
Match the Following in Relation to Testicular Histopathology :
11.122 Obstructive spermia (a) Very small seminiferous tubular diameter,

absence of germ cells and leydig cells
11.123 Germinal Aplasia (b) Disappearance of all germ and sertoli cells
11.124 Klinefelter’s syndrome (c) Normal histologic findings
11.125 Hypogonadotropic hypogonadism (d) Absence of germinal cells in all or most of

seminiferous tubules
11.126 Pressure atrophy of the seminiferous epithelium after vasectomy in men is due to :
(a) Reabsoptive capacity of the epididymis

(b) Less fluid secretion by the testicle
(c) No fluid secretion by the testicle
11.127 Approxiamtely, in how many percent of inferile males, varicoceles are found :
(a) 10 percent
(b) 20 percent
(c) 30 percent
(d) 40 percent
11.128 Approximately, what is the frequency of left sided varicocele :
(a) 60 percent
(b) 70 percent
(c) 80 percent
(d) 90 percent
11.129 Which of the following statement is true regarding varicocele ?
(a) It is more common on the left side

(b) It is more common on the right side
(c) The incidence is equal on both side
11.130 Which of the following mechanism account for the abnormalities in spermatogenesis
associated with varicocele ?
(a) Elevation of intrascrotal temperature

(b) Reflux of venous blood from left adrenal gland
(c) May be associated with epididymal dysfunction
11.131 Which is the most common finding on semen analysis in cases of varicocele ?
(a) Decreased sperm concentration

(b) Decreased sperm motility
(c) Morphologic abnormalities
(d) Stress pattern
11.132 Which is the most common improvement following varicocele repair ?
(a) Sperm motility

(b) Sperm density
(c) Sperm mophology
(d) All are equal
11.133 in infertile men, ductal obstruction can be due to all of the following EXCEPT :
(a) Congenital absence of vas and seminal vesicle

(b) Ducal stricture following infection
(c) Vasectomy
(d) Functional obstruction
(e) Retractile testis
11.134 The following are the features, in congenital absence of vas and seminal vesicle patients
EXCEPT :
(a) Azoospermia
(b) Normal ejaculate volume
(c) Semen that does not coagulate following ejaculation
(d) Absence of fructose in the seminal plasma
11.135 Ductal osbtruction is characterised by the followin EXCEPT :
(a) Azoospermia in association with normal testicular size

(b) Normal leydig cell funtion
(c) Raised FSH level
(d) Normal LH level
11.136 The germinal epithelium may be injured by all of the following EXCEPT :
(a) Alkylating agents

(b) Radiation
(c) Alcohol
(d) Marijuana
(e) Penicillins
11.137 Mumps cause infertility due to the following EXCEPT :
(a) Acute orchitis

(b) Artophy of seminiferous tubules
(c) Ductal obstruction
11.138 Which of the following organisms can cause male infertility ?
(a) Cystomegalovirus
(b) Chlamydia
(c) Herpes
Match the following
Diagnosis Treatment
11.139 Bilateral cryptorochidism (a) None
11.140 Germinal aplasia (b) HCG and FSH
11.141 Hypogonadotropic hypogonadism (c) Vasoepididymal anastomosis
11.142 Obstrictive Azoospermia (d) Surginal exploration and orchiopexy
11.143 Which of the following statement is FALSE regarding human chorionic gonadotropins ?
(a) It is used for stimulation of spermatogenesis in men with hypogonadotropic hypogonadism

(b) It is analogous to FSH
(c) It stimulates leydig cells to secrete testosterone
(d) The usual dose is 2000 IU intramucular three times a week
1.144 Which is the mechanism of action of clomiphene ?

(a) Blocks estrogen receptors in the hypothalamus
(b) Stimulates adrenal gland
(c) Directly stimulates testis for production of testosterone
(d) Converts testosterone in to dihydrostestosterone
11.145 What are the treatment available in cases of bilateral congenital absence of vas ?
(a) Mediacal treatment

(b) Artifical spermatocele
(c) Vasoepididymal anastomosis
(d) Micro aspiration and IVF
(e) B&D
11.146 Which artery primarily supply blood to the penis ?
(a) Intra spermatic artery

(b) Internal pudendal artery
(c) Deferential artery
(d) Inferior vesical artery
11.147 Which statement is FALSE regarding cavernosal (deep) penile artery ?
(a) This is the most important branch of the internal pudendal regarding arectile physiology
(b) They are paired arteries
(c) They pass longitudenally within the corporial bodies in lateral position
(d) They give off tortous terminal branches known as hehcine arteries
11.148 Which arteries recieve more blood during flaccid stage ?
(a) Cavernosal arteries

(b) Dorsal arteries
(c) Bulbourethral arteries
(d) B&C
11.149 Which is the primary vein draining glans penis and the distal portion of the corpora
cavernosa ?
(a) Deep dorsal

(b) Superficial dorsal
(c) Cavernous
(d) Urethral
11.150 Which veins drain base and helium of the corpora cavernosa ?
(a) Deeo dorsal

(b) Superficial dorsal
(c) Cavernous
(d) Urethral
11.151 Which of the following is responsible for penile erection ?
(a) Decrease in corporal vascular resistance

(b) Increase in corporal arterial inflow
(c) Both of them
(d) None of them
11.152 What is the cause of marked reduction in the vascular resistance during erection ?
(a) Arteriolar dilation

(b) Vertoms cpmstroptopm
(c) Sinusoidal relaxation
11.153 Heemodynamic change resulting in normal penile tuinescence include all of the following
EXCEPT :
(a) Increased arterial blood flow through the penis

(b) Opening of contis bolsters
(c) Major venou outflow occlusion resulting in egorgement
(d) Arterio venous shuting is minimal which diverts major blood flow tomards sinuses
11.154 What should be the rate of blood flow into corporacaverosa to cause an erection ?
(a) 10-20 ml/mnt

(b) 20-50 ml/mnt
(c) 60-80 ml/mnt
(d) 80-100 ml/mnt
11.155 What is the venous outflow rate during the penile erect stage in comparision to that of
flaccid stage
(a) ¼ th
(b) Half
(c) Equal
(d) 7 times
11.156 Which is the location of spinal nuclei controlling erection ?
(a) S2 to S4 and T10 to T12

(b) S1 to S5 and T10 to T12
(c) S2 to 4 and T10 to T10
(d) S2 to 4 and T6 to T6
11.157 Which of the following statement is WRONG regarding nervierigetes ?
(a) They are found along the posterolateral aspect of seminal vesicle and prostate
(b) They accompany the membranous urethra through the genitourinary diaphragm
(c) Terminal branches of these nerves innervate helicine arteries and erectile tissue within the
corpora cavernosa
(d) They are found along the lateral aspect of membranous urethra
11.158 Which of the following is impaired by alpha adrenergic blockers ?
(a) Ejaculation
(b) Erection
(c) Libido
(d) Orgasm
11.159 Which nerves carries sensory innervation to the penis ?
(a) Sensory branch of the internal pudendal nerve

(b) Cavernous nerve
(c) Sacral nerve
(d) Corporal nerve
11.160 Which of the following is an important integration centre for sexual drive and penile erection
?
(a) Medial pre optic area (MPOA)

(b) Lateral part of frontal lobe
(c) Temporal love
(d) Thalamus
11.161 In which of the following, tactile stimulation of the external genitalia produces penile
erection :
(a) Normal men

(b) Suprasacral spinal cord lesions
(c) Sacral injury
(d) A&B
11.162 Psychogenic erection is caused by all of the following EXCEPT :
(a) Direct genital stimulation

(b) Visual stimuli
(c) Olfactory stimuli
(d) Fantasy
11.163 Reflex erection is mediated via :
(a) Thoraco-lumbar outflow

(b) Pudendal nerve
(c) Pre-sacral nerve
(d) Cortical sensory pathways
11.164 During which of the following rigid eccur :
(a) Sexual intercourse

(b) Masturbation
(c) Nocturnal erections
11.165 In which of the following pressure is maximum during erection :
(a) Corpus spongiosum

(b) Corpus cavernosum
(c) Dorsal vein
(d) Glans
11.166 During which sleep, nocturnal erections occurs :
(a) Non rapid eye movement (non REM) sleep

(b) Rapid eye movement (REM) sleep
(c) Both of them
(d) None of them
11.167 The following drugs can increase libido EXCEPT :
(a) L-dopa
(b) Amphetamine
(c) Prazocin
(d) Deprenyl (Mono amine oxidase inhibitor)
11.168 What is the echogenic pattern of corpora cavernosum during flaccid stage ?
(a) Homogenous
(b) Variegated appearance
(c) Hyperechoic
(d) Hypoechoic
11.169 Which of the following can relsult due to androgen deficiency ?
(a) Loss of sexual interest

(b) Impaired seminal emission
(c) Decreased frequency and magnitude of nocturnal erections
11.170 Which is called : “Computer of the penis”
(a) Glans penis

(b) Corporal bodies
(c) Corporal arteries
(d) Corporal nerves
11.171 What is the density of alpha-adrenergic receptors in human corpora cavernsal tissue in
relation to that of beta adrenergic receptors ?
(a) Equal
(b) 2 times
(c) 5 times
(d) 10 times
11.172 What is the cavernosal pressure at the time of rigid erection ?
(a) 60 mg Hg
(b) 70 mm Hg
(c) 80 mm Hg
(d) 90 mm Hg
Match the following
Phase of erection Arterial flow and corporal pressure
11.173 Initiation of erection (a) Corporal pressure begins to fall
11.174 Tumescene (b) Pudendal arterial flow begins to increase and corporal
pressure remains unchanged
11.175 Erectile state (c) Pudendal arterial flow still increasing and corporal
pressure begins to rise
11.176 Detumescence (d) Pudendal arterial flow begins to decrease and corporal
pressure rises dramatically
11.177 Which of the following are the phase of process of ejaculation ?
(a) Seminal emission

(b) Ejaculation
(c) Bladder neck closure
(d) A&B
11.178 The phenomenon of expression of semen into the posterior urethra is called :
(a) Erection
(b) Orgasm
(c) Emission
(d) Ejaculation
11.179 emssion and ejaculation are mediated via the :
(a) Thoraco-lumbar outflow

(b) Cranio-sacral outflow
(c) Pelvic nerve
(d) Pudendal nerve
11.180 The following are the common causes of erectile dysfuntion EXCEPT :
(a) Vascular
(b) Endocrine
(c) Neurogenic
(d) Psychogenic
(e) Peyronie’s disease
11.181 The following antihypertensive drugs cause significant erectile dysfuction EXCEPT :
(a) Spironolactone
(b) Propranalol
(c) Methyl dopa
(d) Calcium channel blockers
11.182 The following end organ problems causes erectile dysfuntion EXCEPT :
(a) Stricture urethra

(b) Peyronie’s disease
(c) Microphallus
(d) Chordee
11.183 Which of the following is WRONG in the history of erectile dysfuntion of true organic
etiology?
(a) A sequence of gradual deteriorating funtion with a gradual onset

(b) Loss of nocturnal erections
(c) Lo loss of erections with mastrubation
(d) Normal libido
11.184 Which of the following is important in the evaluation of erectile dysfuntion ?
(a) Cardicvascular history

(b) Sexual history
(c) Family history of hypertension, hear disease, diabetes, cancer, neurologic disease
11.185 The physical examination should relate to which abnormalities in erectile dysfuntion :
(a) Vascular
(b) Neurologic
(c) Endocrine
11.186 The following should be evaluated to rule out varuous endocrinopathies EXCEPT :
(a) Secondary sexual characters

(b) Eye examinations
(c) Examination of neck and breast
(d) Distal pulses
11.187 What is the penile brachial index (PBI) in normal men ?
(a) Greater than 0.5

(b) Greater than 0.6
(c) Greater than 0.7
(d) Greater than 0.8
11.188 Which of the following is WRONG regarding nocturnal penile tumescence (NPT) studies ?
(a) It should be considered in any patient whose etiology for erectile dysfuntion is not clear
(b) This study is 85-90 percent accurate
(c) It measures activity in the final common pathway
(d) It does not give a valid and reliable index of awake erectile capacity
11.189 Which is the indication of arteriorgraphy in erectile dysfuntion ?
(a) Endocrine disease

(b) Vascular disease
(c) Neurologic disease
(d) Psyhogenic
11.190 Which is the investigation of choice for localization of corporal venous shunt ?
(a) Arteriography
(b) Infusion cavernosography
(c) NPT studies
(d) Testosterone estimation
11.191 Which is the complaint in a case of corporal venous shunt ?
(a) No erection
(b) Poor erection with early detumescence
(c) Excellent erection with early detumescence
(d) Excellent erection with delayed deturmescene
11.192 Classically the patients with corporal venous shunts should have the following EXCEPT :
(a) Abnormal doppler studies including testing for steel syndrome

(b) Normal doppler studies including testing for steel syndrome
(c) Abnormal nocturnal penile tumescence testing
(d) Inability to maintain erections
11.193 Which of the following statement is WRONG about vasodilan (isoxsuprine) ?
(a) It is a alpha adrenergic receptor

(b) It has been found effective in erectile dysfuntion
(c) It has rare side effects
(d) It is given as 10 to 20 mgs tid
11.194 Which of the following is worng about yohimbine ?
(a) It is a presynaptic alpha -1 receptor blocker

(b) It is obtained from the bark of yohim tree
(c) It is decreases outflow of blood from the corporeal bodies
(d) It probably works on upper levels in the brain to increase libido
11.195 What is the treatment of choice if the NPT study demonstrate excellent erectile funtion and
the patient has failed medical therapy ?
(a) Psychological therapy

(b) Hormonal therapy
(c) Papaverine injections
(d) Penile prosthesis
11.196 The following treatments of erectile dysfuntion with documented organic dysfuntion EXCEPT
(a) Intracorporeal injections

(b) External vaccum devices
(c) Penile prosthesis
(d) Testoterone therapy
11.197 Which is the action papaverine ?
(a) Venous constriction

(b) Sinusoidal relaxation
11.198 Which statement is WRONG about the effects of papaverine injection in a normal man with
no organic etiology ?
(a) Erection will occur after 5 mnts

(b) There will be increase in length and circumference by at least 33 percent
(c) There will be good rigidity
(d) The erection will last for 1-1.5 hours or longer
Match the following in relation to response after intracoporeal papaverine injection :
11.199 vasculogenic (a) Good response
11.200 Steal syndrome/venous incompetency (b) Onset of erection markedly delayed
11.201 Neurogenic (c) Poor repsonse
11.202 Severe psychogenic problems (d) Develops good erection but duration markedly
reduced
11.203 Who are the best candidates for self intracorporeal injection of papaverine and regitine ?
(a) Neurogenic disease

(b) Vasculogenic
(c) Steal syndrome
(d) Severe psychogenic problem
11.204 In which type of impotence majority of prolonged erections occur following intracavernous
injection therapy ?
(a) Neurogenic
(b) Vasculogenic
(c) Psycogenic
(d) A&B
11.205 Which is the most significant short term complication of papaverine injection ?
(a) Prolonged erections

(b) Cavernosal fibrosis
(c) Vasovagal reactions
(d) Liver toxicity and hear rhythm changes
11.206 What is the treatment of choice in a young patient with local disease documented by internal
pudendal arteriography, sencodary to pelvic trauma on perineal straddle injuries ?
(a) Anastomosis of the inferior epigastric artery to the dorsal penile artery
(b) Arterialization of the penile venous system by the deep dorsal veins
(c) Ligation of deep dorsal veins at the base of the penis
(d) Penile implants
11.207 What is the treatment of choice in a patient who has abnormal venous drainage documented
by infusion cavernosography ?
(a) Anastomosis of the inferior epigastric artery to the dorsal artery

(b) Ligation of the deep dorsal veit at the root of the penis
(c) Penile implants
(d) Intracavernosal injections
11.208 Patients who are candidates for penile prosthesis should have the following EXCEPT :
(a) A poor sexual desire

(b) An awareness that implant will not restore their libido, their ability to ejaculate or penile
sensation
(c) The sexual partner must be willing
(d) No prostate or genitourinary problems
12
RENOVASCULAR HYPERTENSION
12.1 At what age, upper limit of normal blood pressure 130/80 mm Hg reaches
(a) 6-9 years

(b) 9-12 years
(c) 12-15 years
(d) 15-18 years
12.2 In which of the following the juxtaglomerular cells are patient :
(a) Efferent arteriole

(b) Afferent arteriole
(c) Capillaries
12.3 The juxtaglomerular apparatus(JGA) consists of the following EXCEPT :
(a) Juxtaglomerular cells

(b) Renal tubular cells
(c) Macula densa
(d) Sympathetic renal nerves
12.4 The interrelationship of the following is essential for maintenance normal blood pressure :
(a) Renin-angiotensin
(b) Renin-aldosterone
(c) Renin-angiotensin-aldosterone
(d) Aldosterone-angiotensin
12.5 The theories about renin release postulates that it occurs as a result of :
(a) Baroreceptor stimulation

(b) Neurogenic factor
(c) A sodium sensing menchanism in the JGA
12.6 Which mechanism control indirectly renin release from the juxtaglomerlar ceels ?
(a) Baroreceptor
(b) Macula densa
(c) Beta agrenergic
12.7 Which of the following statement is FALSE regarding renin :
(a) It is an aspartyl protease with amolecular weight of 3/200 daltons containing 340 amino
acids
(b) The major source in human is the juxtaglomerular (JG) apparatus in the kidney
(c) The half life of plasma renin is 60-90 minutes
(d) The major site of metabolism of renin is in the liver
12.8 The macula densa is composed of specialised cells of the :

(b) Distal convoluted tubule
(c) Loop of Henle
12.9 “Glodblatt two kidney hypertension” model consists of :
(a) Clipping of one renal arteries

(b) Clipping of one renal artery and other is not disturbed
(c) Clipping of one renal artery ang other kidney is removed
12.10 Which is the most reliable finding in “rapid sequence urogram” in renovascular hypertension ?
(a) Delay in the calyceal appearance on the side of the involved kidney
(b) Disparity in renal size
(c) Hyperconcentration of contrast on the affected side
(d) Notching of the ureter
12.11 Which is the best screening test for renovascular hypertension ?

(b) Diuresis renogram
(c) Capatopril renogram
(d) Plasma renin activity
(e) Renal angiography
12.12 On demonstration of which of the following in the ischaemic kidney, the physiologic basis for
use of split renal function studies (SRFS) in the identifiction of ischaemic renal disease is based:
(a) More sodium absorption

(b) Less sodium and water absorption
(c) More sodium and water absorption
(d) More sodium and potassium absorption
12.13 In a case of renovascular hypertension, renal vein renin ratio (RVRR) is preferable in
comparision split renal function studies in the following condition EXCEPT :
(a) Pyclonephritis
(b) Nonfunctioning kidney
(c) Hydronephrosis
(d) Bilateral renal artery disease
12.14 Which is the commonest site of renal artery atheroclerotic lesions ?
(a) Proximal third

(b) Middle third
(c) Distal third
12.15 In how many percent of cases, atheromatous lesions occounts for reno-vascular hypertension
:
(a) 40-50 percent

(b) 50-60 percent
(c) 60-70 percent-
(d) 70-80 percent
12.16 Which lesions give rise to the typical string of beads pattern renal angiography ?
(a) Atherosclerosis
(b) Intimal fibroplasia
(c) Fibromuscular hyperplasis
(d) Medial fibroplasia
12.17 Which of the following statement is FALSE regarding medial fibraplasia ?
(a) There is true hyperplasia of smooth muscle and fibrous tissue

(b) It gives typical “string of beads” pattern on angiography
(c) It is the most common fibrous lesion, constituting 75-80 percent of the total
(d) Commonly occurrs in women between the age on 20 and 50 years
12.18 Which of the following test is reliable for prediction of results of surgery in a case of
renovascular hypertension ?

(b) Renal arteriography
(c) Combined renal vein renin ratio and split renal function studies
(d) Saralasin test
11.19 In how many percent of cases, a positive renal vein ratio predict a fall in blood pressure
following carrection of the vascular lesion :
(a) 60 percent
(b) 70 percent
(c) 80 percent
11.20 Saralasin is a competitive antagonist of :
(a) Renin
(b) Aldosterone
(c) Angiotensin I
(d) Angiotensin II
11.21 In a case of renovascular hypertension, after saralasin injection, renin level will :
(a) Remian same

(b) Increase
(c) Decrease
11.22 Which of the following group of drugs are mostly effective in renovascular hypertension ?
(a) Diuretics
(b) Antiadrenergics
(c) Converting enzyme inhibitors
(d) Betablockers
11.23 Which of the following drug may be given to a patient for single dose captopril test ?
(a) Diuretics
(b) Beta blockers
(c) Converting enzyme inhibitors
(d) Nonsteroidal anti-inflammatory drugs
11.24 Which is the relative contraindication for percutanous transluminal renal artery angioplasty ?
(a) Fibromuscular dysplasia

(b) Non osteal-nonoccluded atherosclerotic stenosis
(c) Multiple branched lesions
(d) Total renal artery occlusion
In Relation to Renovascular Hypertension
Match the following
12.25 Young adult female (a) Atheromatous lesion
12.26 Old men (b) Angiotensin II
12.27 Howard’s test (c) Fibromuscular dysplasia
12.28 Saralasin test (d) Split renal function studies
12.29 In which of the following group, hypertension is renin dependent :
(a) Essential
(b) Renovascular
(d) Primary aldosterone
12.30 The following statements are correct regarding atherosclerotic renal artery stenotic lesions
EXCEPT :
(a) Predominate in old men

(b) Occur more frequently on the left side
(c) Involve middle and distal part of the renal artery
(d) Associated with atherosclerotic changes in the aorta
12.31 Which type of surgery is preferable in an atheromatous artery stenotic lesion ?
(a) Endoarterectomy
(b) Patch plasty
(c) Bypass procedure
(d) Autotransplantation
13
ADRENAL GLAND
13.1 Which is the following is wrong about adrenal glands ?
(a) They are paired organs

(b) They are small, yellowish, brown, flattened structures
(c) They lie intraperitoneally
(d) They lie within perinephric fascia
(e) They are in close proximity to the upper pole of each kidney
13.2 Which of the following is false statement regarding adrenal glands:
(a) They are paired, yellow orange, solid endocrine glands

(b) They are usually present on superomedial aspect of kidneys
(c) In cases of renal ectopia, the adrenal is usually found in approximately its normal anatomic
position
(d) In cases of renal agenesis the adrenal on the involved is usually absent
13.3 Usually, what is the weight of the adrenal gland per pair :
(a) 6-12 gms-

(b) 12-18 gms
(c) 18-24 gms
(d) 24-30 gms
13.4 Approximately, what percentage of the total adrenal gland is constituted by the adrenal cortex :
(a) 50-60 percent

(b) 60-70 percent
(c) 70-80 percent
(d) 80-90 percent-
13.5 Approximately how many ml per grams of tissue per minute is the blood supply to the adrenal
gland :
(a) 1-2 ml
(b) 3-4 ml
(c) 4-5 ml
(d) 6-7 ml-
13.6 The adrenal arteries arise from the following sources EXCEPT :
(a) Phrenic artery

(b) Aorta
(c) Renal artery
(d) Splenic artery
13.7 In to which of the following the lymphatic of the adrenal glands drains :
(a) Lateral aorta nodes

(b) Superior mesentric nodes
(c) Cysterna chyli
(d) Inferior mesentric nodes
13.8 Which of the following is the outerrmost zone of adrenal cortex ?
(a) Zona reticularis

(b) Zona fasciculata
(c) Zona glomerulosa
13.9 During which week of embryonic life, mesothelial buds appear to develop into adrenal cortex :
(a) 2nd
(b) 3nd
(c) 4nd
(d) 5nd
13.10 Accesory adrenal tissue can occur in the region of :
(a) Kidney
(b) Coelic plexus
(c) Spermatic vessels and testis
(d) Broad ligament and ovary
13.11 What is the origin of adrenal medulla ?
(a) Ectoderm
(b) Mesoderm
(c) Endoderm
13.12 The primitive cell (sympathogonia) of adrenal medulla gives rise to :
(a) Sympathoblast
(b) Pheochromoblast
13.13 In which week of embryonic life, the adrenal modulla is formed :
(a) 5th
(b) 6th
(c) 7th-
(d) 8th
13.14 In which of the following, the organ of zucerkandle is present :
(a) Below the bifurcation of aorta

(b) Just above the bifurcation of aorta
(c) Near superior mesenteric artery
(d) Near inferior mesenteric artery
13.15 What is the size of the adrenal gland during intrauterine life in comparision to adult life ?
(a) Smaller
(b) Larger
(c) Same
13.16 What is the ratio of adrenal gland to kidney size in adult life ?
(a) 1:20
(b) 1:22
(c) 1:25
(d) 1:28
13.17 Which of the following are congenital anomalies of the adrenal gland ?
(a) Bilateral agenesis

(b) Unilateral agenesis
(c) Cyst
(d) Hypoplasia
13.18 What is the normal range for urinary 17 ketosteroinds in adult males ?
(a) 10-25 mgs/24 hours-

(b) 25-40 mgs/24 hours
(c) 40-55 mgs/24 hours
(d) 55-70 mgs/24 hours
13.19 What is the normal range of urinary 17 ketosteroids in adult females ?
(a) 1-5 mgs/24 hrs

(b) 5-15 mgs/24 hrs-
(c) 15-30 mgs/24 hrs
(d) 30-45 mgs/24 hrs
13.20 What is the contributions of the testis in production urinary 17 ketosteroids ?
(a) Full
(b) Half
(c) One third
(d) Nil
13.21 In chronic debilitating illness, production of urinary 17 ketosteroids is :
(a) Same
(b) Less-
(c) More
13.22 In general, disorders assciated with decreased adrenal secretion of cortisol show a low output
of 17 ketosteroids, but an important exception is :
(a) Virilizing adrenal tumours

(b) Adrenogenital syndrome-
(c) Adrenal hyperplasia
(d) Adrenal adenoma
13.23 What are the normal values of urinary 17 hydroxycorticoids in adult males ?
(a) 4-12 mgs/day-

(b) 12-20 mgs/day
(c) 20-28 mgs/day
(d) 28-36 mgs/day
13.24 What are the normal values of urinary 17 hydroxycorticoids in adult females ?
(a) 2-10 mgs/day-

(b) 10-20 mgs/day
(c) 20-30 mgs/day
(d) 30-40 mgs/day
13.25 Which of the following is a highly sensitive methode for estimation of cortisol hypersecretion ?
(a) Urinary 17 ketosteroids

(b) Urinary 17 hydroxycorticoids
(c) Urinary 17ketogenic steroid
(d) Free cartisol in urine
13.26 What are the normal value of urinary 17 ketogenic steroids (17-KGS) ?
(a) 1-8 mgs/24 hr

(b) 8-20 mgs/24 hr-
(c) 20-32 mgs/24 hr
(d) 32-42 mgs/24 hr
13-27 The plasma cortisol levels show diurnal fluctuations with the highest values :
(a) In the evening

(b) At bed time
(c) At midnight
(d) In the morning
13.28 What is the cortisol production rate in normal adults ?
(a) 4±6 mgs/24 hr

(b) 8±6 mgs/24 hr
(c) 12±6 mgs/24 hr
(d) 16±6 mgs/24 hr-
13.29 What is plasma aldosterone level based on 100 m eq sodium 100 mEg potsssium intake ?
(a) 1-5 ng/100ml-

(b) 5-10 ng/100ml ng/100ml
(c) 10-15 ng/100ml
(d) 15-20 ng/100ml
13.30 What is the range of plasma testosterone levels in normal adult males?
(a) 0.3 to 1.0 microgram/100ml

(b) 1.0 to 2.0 microgram/100ml
(c) 2.0 to 3.0 microgram/100ml
(d) 3.0 to 4.0 microgram/100ml
13.31 What is the range for urinary values for testosterone glucuronide in adults males ?
(a) 30-15 microgram/24hr

(b) 150-300 microgram/24hr
(c) 300-450 microgram/24hr
(d) 450-600 microgram/24hr
13.32. Which of the following statement is WRONG about chronic adenocortical insufficiency
(Addison’s) disease
(a) It is not a disease of adult life

(b) It affects males and females equally
(c) It is due to destruction of funtioning adrenocortical tissue
(d) It is due to an autoimmune process
13.33 Which of the following can cause chronic adrenocortical insufficiency ?
(a) Fibrocaseous tuberculosis

(b) Bilateral adrenocortical necrosis
(c) Bilateral metastatic tumour
(d) Amyloidosis
13.34 Which of the following is the test of choice for adrenocortical failure ?
(a) ACTH stimulation test

(b) Delayed water diuresis following an acute water load
(c) Deficient renal regulation of electrolyte excretion
(d) Introduction of hypoglycaemia by prolonged fasting
13.35 Which of the following secrets aldosterone ?
(a) Zona glomerulosa

(b) Zona fasciculata
(c) Zona reticularis
13.36 Aldosterone is a regulator of which of the following ?
(a) Sodium balance

(b) Potassium balance
(c) Sodium potassium balance
(d) Hydrogen ion balance
13.37 Aldosterone in excess cause which of the following ?
(a) Increase in distal renal tubular absorption of sodium and potassium

(b) Increase in distal renal tubular absorption of sodium and increased excretion of potassium
(c) Decreased in distal renal tubular absorption of sodium and increased excretion of potassium
(d) Decreased in distal renal tubular absorption of sodium and decreased excretion of
potassium
13.38 In how many percent of cases of primary aldeosteronism, hypertension is present :
(a) 60 percent
(b) 70 percent
(c) 80 percent
(d) 90 percent
(e) 100 percent
13.39 The following are the common finding in primary and secondary aldosteronism EXCEPT :
(a) Hypertension
(b) Hyperkalemia
(c) Increased aldosterone secretion
(d) Decreased peripheral plasma renin activity
13.40 Primary aldosteronism is characterised by the following EXCEPT :
(a) Hyperkalemia
(b) Alkalosis
(c) Hypernatremia
(d) Hypornagnesemia
13.41 Which of the following is the most common symptom of hyperaldosteronism ?
(a) Paraethesia
(b) Muscle weakness
(c) Paralysis
(d) Tetany
13.42 Which is the treatment of choice for adrenocortical adenoma causing hyperaldosteronism ?
(a) Observation
(b) Medical
(c) Surgical
(d) No treatment
13.43 The adrenal medulla is formed by :
(a) Chromaffinoblast
(b) Neuroblast
(c) Both of them
(d) None of them
13.44 The adrenal medulla innervated by :
(a) Preganglionic adrenergic neurons

(b) Pregangionic cholinergic neurones
(c) Postganglionic adrenergic neurones
(d) Postganglionic cholinergic neurones
13.45 The chromaffinoblasts mature in to :
(a) Chromaffin cell

(b) Sympathetic ganlion cells
(c) None of them
(d) Both of them
13.46 The chromaffin cell show brown intracytoplasmic granules on treatment with :
(a) Sulphates
(b) Oxidants
(c) None of them
(d) Both of them
13.47 What is the molar ratio of catecholamines to ATP :
(a) 1:1
(b) 2:1
(c) 4:1
(d) 6:1
13.48 Tyrosin is converted into which of the following in the biosynthesis of catecholamines :
(a) Hydroxyphenylalanine
(b) Dihydroxyphenylalanine
(c) Tetrahydroxyphenylalanine
13.49 By which enzyme. Dopa is converted to dopamine :
(a) L-dopadecarboxylase
(b) Dopamine-beta-hydroxylase
(c) None of htem
(d) Both of them
13.50 Which of the following is pharmacologically active compound in biosynthesis of

catecholamines ?
(a) Tyrosine
(b) Dopa
(c) Dopamine
(d) None of them
13.51 How many percent of total content pf catecholamines is constituted by epinephrine ?
(a) 50
(b) 60
(c) 70
(d) 80
13.52 The catecholamines are converted in to which of the following ?
(a) Metanephrine
(b) Normetanephrine
(c) Vanillymandelic acid
13.53 In a patient of bilateral adrenalectomy, catecholamine products in urine will be :
(a) Absent
(b) Increased
(c) Decreased
(d) No change
13.54 Which are the tumours of the adrenal medulla ?
(a) Sympathogonioma
(b) Sympathoblastoma
(c) Ganglioneuroma
(d) Pheochromocytoma
13.55 Which of the following produce epinephrine. Norepinephrine or Dopamine ?
(a) Ganglioneuroma
(b) Neuroblastoma
13.56 How many percent of cases of pheochromocytoma may be inherited as a familial autosomal
fominant trait ?
(a) 5 percent
(b) 8 percent
(c) 10 percent
(d) 12 percent
13.57 From which of the following cells pheochromocytoma arise :
(a) Epitheloid cell

(b) Chromafin cell
(c) Sympathoblasts
(d) Ganglion cell
13.58 Where is the largest collection of the chromocyn tissue ?
(a) Para-aortic region

(b) Adrenal medulia
(c) Thorax
(d) Bifucation of carotid artery
13.59 Approximately, in how many percent of cases phenochromocytoma develops the adrenal
medula :
(a) 50 percent
(b) 60 percent
(c) 70 percent
(d) 80 percent
(e) 90 percent
13.60 Which is the most common site for ectopic pheochromocytoma ?
(a) Superior para-aortic region

(b) Inferior para-aortic region
(c) Organ of zuckerkandl
(d) Urinary bladder
13.61 What is the colour of pheochromocytoma on cut section ?
(a) Brown or gray

(b) Black
(c) Dark brown
(d) Yellow
13.62 The glomic tissue tumour (chemodectomas) secrete catecholamine. This statement is :
(a) True
(b) False
13.63 The glomic tissue tumours (chemodectoma) are found at :
(a) Carotid bifurcation

(b) Arch of aorta
(c) Bulb of jugular vein
(d) Along the femoral vessels
13.64 Glomic tissue tumours can be clinically distinquished from pheochromocytoma. This
statement is :
(a) True
(b) False
13.65 In how many percent of cases multiple pheochromocytoma are present :
(a) 5 percent
(b) 10 percent-
(c) 15 percent
(d) 20 percent
13.66 In which of the following sites, multiple pheochromocytoma can occur :
(a) In both adrenal glands

(b) In same adrenal gland
(c) In one adrenal site and other extra adrenal site
(d) Only extra adrenal
13.67 What is the incidence of malignancy in pheochromocytoma ?
(a) 5 percent
(b) 8 percent
(c) 10 percent
(d) 12 percent
13.68 What is the criteria for the diagnosis of malignancy in pheochromocytoma ?
(a) Histologic pattern

(b) Capsular invasion
(c) Vascular invasion
13.69 Which are the sites of metastasis from malignant pheochromocytoma ?
(a) Bones
(b) Lungs and liver
(c) Spleen
(e) Only A & B
13.70 The extraadrenal pheochromocytoma produce mainly :
(a) Epinephrine
(b) Nor-epinephrine
(c) Dopamine
13.71 Which are the symtons of pheochromocytoma ?
(a) Paroxysmal hypertension

(b) Sustained hypertension
(c) Symptoms of hypermetabolism
13.72 Which of the following is the test of choice for the diagnosis of pheochromocytoma ?
(a) Provocative test

(b) Suppresive test
(c) Chemical methods of diagnosis
13.73 Following drugs interfeces in the estimation of catecholamines EXCEPT :
(a) Nasal drops containing sympathomimetic amines

(b) Alpha methyl dopa
(c) Bronchodilators
(d) Thiazides
13.74 Use of which of the following results in low values of vanillymandelic acid :
(a) Reserpine
(b) Monoamine oxidase inhibitors
(c) Thiazides
(d) Methyl dopa
13.75 Use of which of the following results in high values of vanillymandelic acid (VMA) :
(a) Monoamine oxidase inhibitors

(b) Nalidixic acid
(c) Thiazides
(d) Ganglion blocking agents
13.76 What is the upper limit of normal 24 hrs. Urinary catecholamines ?
(a) 50 micrograms
(b) 100 micrograms-
(c) 150 micrograms
(d) 200 micrograms
13.77 What is the upper limit of normal 24 hrs, urinary vanillymandelic acid ?
(a) 4.5 mgs

(b) 5.5 mgs
(c) 6.5 mgs-
(d) 7.5 mgs
13.78 What is the upper limit of normal 24 hrs urinary excretion of normetanephrine ?
(a) 0.5 mg
(b) 0.7 mg
(c) 0.9 mg-
(d) 1.1 mg
13.79 Which of the following chemicals can be estimated for the diagnosis of pheochromacytoma ?
(a) Free catecholamines

(b) Vanillymadelic acid
(c) Normetanephrine
(d) Metaphrine
13.80 Which are the complications of pheochromocytoma ?
(a) Vascular accidents

(b) Cardiac amhythmias
(c) Hyperglycemia and glycosuria
(d) Abortion and premature delivery
13.81 Which is the treatment of choice for pheochromocytoma ?
(a) Continued observation

(b) Surgical excision
(c) Medical
(d) Radiotherapy
13.82 Which is the investigation of choice for the localization of pheochromocytoma ?

(b) Ultrasonography
(c) Selective angiography and venous sampling
(d) CT scan or MRI
13.83 The preoperative work up for pheochromocytoma should include the evaluation of thyroid
and parathyroid. This statement is :
(a) True
(b) False
13.84 Which of the following drugs are used in the preoperative management of
pheochromocytoma?
(a) Alpha blockers

(b) Beta blockers
(c) Both of them
(d) None of them
13.85 Which is the drug of choice for the control of hypertension is the preoperative management of
pheochromocytoma ?
(a) Methyl dopa

(b) Thiazides
(c) Alpha blockers
(d) Ganglion blocker
13.86 Which of the following monitoring required during pheochromocytoma surgery ?
(a) Electrocardiogram
(b) Arterial blood pressure
(c) Central venous pressure
(d) Urine output
13.87 Which is the drug of choice for intraoperative control of blood pressure ?
(a) Nitroprusside
(b) Phentolamine
(c) Diuretics
(d) Methyl dopa
13.88 Which is the likely possibility if reduction of blood pressure fails to occur immediately after the
excision of pheochromocytoma ?
(a) Improper control of blood pressure before surgery

(b) Improper control of blood pressure during surgery
(c) Additional undiscovered pheochromocytoma
13.89 The total plasma volume in a patient of pheochromocytoma is :
(a) Increased
(b) Decreased
(c) Remain same
13.90 Which is the drug of choice for the control of arrhythmias during pheochromocytoma surgery?
(a) Propranojol
(b) Lidocaine (Xylocaine)
(c) Nitroprusside
(d) Steroids
13.91 Which is the cell of origin for Neuroblastoma ?
(a) Chromaffin cells

(b) Neurones
(c) Neural crest cells
(d) Parafollicular
13.92 Which of the following tumour is benign ?
(a) Neuroblastoma
(b) Nephroblastoma
(c) Grawitz tumor
(d) Ganglioneuroma
13.93 Which is the most common site of Neuroblastoma ?
(a) Head
(b) Chest
(c) Adrenal
(d) Pelvis
13.94 Which of the following statement is WRONG about Neuroblastoma ?
(a) They occur predominatly in infacy and early childhood

(b) They are benign tumours
(c) They may arise in adrenal medulla
(d) Skull is the most common site for bone metastasis
13.95 In which age group neuroblastoma commonly occurs :
(a) 0-4 years

(b) 4-8 years
(c) 8-12 years
(d) 12-16 years
13.96 Which of the following investigation are usually NOT recquired in the evaluation of
Neuroblastoma ?
(a) Intravenouse urography

(b) Ultrasound
(c) CT scan
(d) Arteriography
(e) Venography
13.97 A left sided Neuroblastoma spreading upwards by lymphatics, giving rise to depostites in the
skull and proptosis due to orbital secondaries is known as :
(a) Peppers diesease

(b) Sipple syndrome
(c) Hutchison’s disease
(d) Werner syndrome
13.98 In differentiating between Wilm’s tumour and neuroblastoma, all of the following favour the
diagnosis of neuroblastoma EXCEPT :
(a) Absense of bony secondaries

(b) Raised urinary VMA
(c) Knobbly contour of abdominal mass
(d) Inferior displacement of the normal kidney on IVP
13.99 The following are true about neuroblastoma EXCEPT :
(a) Children less than 1 years old have better prognosis

(b) Primary tumour in the abdomen or adrenal has a better prognosis than tumour in the thorax
and cervical regions
(c) It is radiosensitive
(d) Spontaneus remission is kwown in children below 1 years of age
13.100 What is the treatment of neuroblastoma with secondary in bones ?
(a) Surgery
(b) Radiotherapy
(c) Chemotherapy
14
FEMALE UROLOGY
14.1 What is teh normal angle of urethral axis in females ?
(a) 100
(b) 200
(c) 350
(d) 600
14.2 Normal urethra-trigonal angle in females on a lateral cystogram is :
(a) 250
(b) 500
(c) 900
(d) 1300
14.3 In the lateral standing cystogram, if the bladder base is below the inferior rami of pubis, it is
known as :
(a) Normal
(b) Cystacele
(c) Urethrocele
(d) Vesico-vaginal fistula
14.4 If of cystogram, the angle of urethral axis is greater than 350, it is diagnostic of :
(a) Normal
(b) Cystocele
(c) Urethrocele
(d) Vesico-vaginal fistula
14.5 Proximal urethra and bladder neck have both alpha and beta receptors. The effect of
oestrogens on urethral pressure profile is :
(a) Increase urethral pressure

(b) No effect
(c) Decrease urethral pressure
14.6 Which is tbest method for diagnosing distal urethral stenosis ?
(a) Calibration with Bouge-a-Boule

(b) Calibration with urethral sounds
(c) Retrograde urethrogram
(d) Micturating cystourethrogram
14.7 All of the following are true about interstitial cystitis EXCEPT :
(a) Male : Female : 1 : 5

(b) Occurs mostly in elderly females
(c) Accompanied by urinary infection
(d) Symptoms are painful urge of micturition and frequency
14.8 Which is the best method for diagnosing interstitial cystitis ?
(a) Intravenous urogram

(b) Micturating cystourethrogram
(c) Urethral callbration
(d) Cystoscopy and biopsy of lesion
14.9 Which is the commonest of incontinence of urine in women ?
(a) Urge incontinence

(c) Mixed stress and urge incontinence
(d) Total incontinence
14.10 How many percnt of normal nulliparous women occasionally experience sress urinary
incontinence ?
(a) 0%
(b) 10%
(c) 25%
(d) 50%
14.11 In which of the following group of women, stress urinary incontinence is most common :
(a) Unmarried
(b) Nulliparous
(c) Multiparous premenopausal
(d) Multiparous postmenopausal
14.12 The following are true about stress urinary incontinerice EXCEPT :
(a) It is never caused by contraction of detrusor

(b) Residual urine is never present
(c) It is never accompanied by urge incontinence
(d) Multiparous postmenopausal
14.13 “Bonney’s test” is used for the diagnosis of :
(a) Uretero-vaginal fistula

(c) Distal urethral stenosis
(d) Ovarian vein syndrome
14.14 Green type I and II stress urinary incontinence is detected by :
(a) Patient’s symtoms and signs

(b) Boneney’s test
(c) Direct lateral cystogram
(d) Urodynamic evaluation’
14.15 Which of th followig test has the greatest value in diagnosing stress incontinence ?
(a) Bonney-Marshall test

(b) Measurement of urehtral length
(c) Bead-chain cystourethrogram
(d) Urodynamic evaluation
14.16 What is the mean urethral (maximal) resting pressure, with empty bladder, in normal women?

14.17 What is the mean urethral (maximal) resting pressure, with the bladder empty, in women with
mild stress urinary incontinence ?

14.18 What is the mean urethral (maximal) resting pressure, with empty baldder, in women with
severe stress urinary incontinence ?

14.19 Which is the indisputable hallmark of a succesful operation for correction of stress urinary
incontinence ?
(a) Upward and forward displacement of urethrovesical juntion on lateral cystourethrogram

(b) Increased urethral pressure on urobodynamic evaluation
(c) Frequent and painful micturition associated with insignificant bacteriuria
14.20 Endoscopic suspension operation for stress incontinence is known as :
(a) Marshall-Marchetti-krantz operation

(b) Stamey operation
(c) Tanagho-smith operation
(d) Kaufman operation
14.21 In a cystocele, all of the following descends in to the vaginal cavity EXCEPT :
(a) Uterus
(b) Urinary bladder
(c) Trigone
(d) Urethra
14.22 Which of the following is the most important factor in preventing bacterial proliferation ?
(a) Adhesive nature of ceratin bacteria to the epithelial cells

(b) Failure of normal defence mechanism
(c) Alteration in pH of urine
(d) Altertion in osmolality of urine
(e) Diluting effect of urine accumulating in the bladder
14.23 Which is the commonest organism found in case of urethral syndrome ?
(a) Enterobacteria
(b) Gonococcus
(c) Trichomonos
(d) Pseudomonos
14.24 The following invade urethral defence mechanism EXCEPT :
(a) Onset of sexual activity

(b) Drinking lots of fluids
(c) Use of urethral catheter
(d) Atrophic changes due to oestrogen imbalance
(e) Urethral stenosis
14.25 The following are the clinical features of urethral syndrome EXCEPT :
(a) Recurrent attacks of frequent and painful micturition

(b) Incontinence of urine
(c) Nocturia, hesitency, poor stream
(d) Genaralised malaise, loin pain, backache
14.26 Haematuria associated with urethral syndrome should be fully investigated to EXCLUDE :
(a) Malignancy
(b) Interstitial cystitis
(c) Tuberculosis
14.27 In a case of urethral syndrome, intravenous urography is indicated in the following EXCEPT :
(a) As a routine in all cases

(b) Haematuria
(c) Positive urine culture of nonenterococcal organisms
(d) Generalised or upper urinary tract symptoms
14.28 Which of the following is NOT indicated in cases of uretrhal syndrome ?
(a) Urine culture

(b) Cystourethroscopy
(c) Retrograde pyelogram
(d) Urodynamic evaluation
14.29 Which of the following is the treatment of choice for urethral syndrome ?
(a) Cauterization of cervix

(b) Cauterization of submucosal glands of urethral
(c) Dilatation of urethra
(d) Transurethral surgery of the bladder neck
14.30 How many charrier gauge urethral dilalation should be done for the treatment of urethral
syndrome
(a) 20
(b) 25
(c) 30
(d) 35
14.31 Which is the treatment of choice for ‘Frequence dysuria syndrome’ :
(a) Urethral dilalation

(b) Urethrolysis
(c) Cauterization of submucosal glands of urethral
(d) Hormonal manipulation
14.32 Which is the commonest benign female urethral tumour ?
(a) Caruncle
(b) Cyst
(c) Polyp
(d) Condyloma acuminata
14.33 In which age group, urethral caruncle is most common :
(a) Children
(b) Yound age
(c) Childbearing age
(d) Postmenopausal
14.34 The following are symptoms of urethral caruncle EXCEPT :
(a) Dysuria, frequency

(b) Dyspareunia
(c) Incontinence of urine
(d) Pressure sensation in the periuneum
14.35 Histologically, urethral caruncle can be :
(a) Papillomatous
(b) Angiomatous
(c) Granulomatous
14.36 What is the treatment of choice for symptomatic urethral caruncle ?
(a) Urethral dilatation

(b) Complete excision and fulgration
(c) Transurethral resection
(d) Oestrogen
14.37 Congenital periurethral cyst can arise from the following EXCEPT :
(a) Vestigial remnants of the mullerian duct system

(b) Vestigial remnants of the mesonephric duct system
(c) Primitive urogenital sinus
(d) Mesoderm
14.38 In which decade there is peak incidence of carcinoma female urethra :
(a) 2nd-3rd decade

(b) 3rd-4th decade
(c) 5th-6th decade
(d) 7th-8th decade
14.39 The distal thrid of the female urehtral is lined by :
(a) Transitional epithelium

(b) Stratified squamous epithelium
(c) Columnar epithelium
14.40 The lymphatics of the distal third of the female urethra drains in to :
(a) Superficial and deep inquinal nodes

(b) External iliac nodes
(c) Internal iliac nodes
(d) Obturator nodes
14.41 Which of the following is the commonest female urethral cancer ?
(a) Squamous cell carcinoma

(b) Adenocarcinoma
(c) Transitional cell carcinoma
(d) Melanoma
14.42 Embryologic origin of congenital periurethral cyst can be recognised by :
(a) Gross appearance

(b) Cystopic appearance
(c) Histologic appearance
(d) Radiologic appearance
14.43 Which is the commonest prestation of carcinoma female urethra ?
(a) Frequency dysuria

(b) Urinary obstruction
(c) Urethral bleeding or spotting
(d) Perineal pain
14.44 Which is mandatory for the diagnosis of carcinoma female urethra ?
(a) Urine cystology

(b) Biopsy
(c) Retrograde urethrogram
(d) Urethroscopy
14.45 What is the treatment of choice for female urethral carcinoma arising from the distal third of
urethra and limited to mucosa only ?
(a) Excision of the tumour

(b) Urethrectomy
(c) Anterior exenteration
(d) Radiation therapy
14.46 What is the treatment of choice for female urethral carcinoma involving the entire urethra ?
(a) Excision of the tumour

(b) Urethrectomy
(c) Anterior exenteration
(d) Radiation therapy alone
14.47 What is the 5 year survival for patients with distal third female urethral tumour, appropriately
treated with good surgical therapy ?
(a) 40-50 %
(b) 50-60 %
(c) 60-70 %
(d) 90 %
14.48 What is the 5 year survival for patients with entire female urethral tumour treated
appropriately ?
(a) 10-15 percent

(b) 20-30 percent
(c) 40-50 percent
(d) 50-60 percent
14.49 Which is the commonest site for malignant melanoma in the genitourinary tract ?
(a) Kidney
(b) Ureter
(c) Bladder
(d) Female urethra
14.50 Which is the commonest mesenchymal tumour arising from the female urethra ?
(a) Leiomyoma
(b) Lipoma
(c) Lymphangioma
(d) Haemangioma
14.51 Which of the following suggests urethral obstruction at S1 level in pregnant or parous women
on excreatary or retrograde pyelogram ?
(a) Retrolliac ureter

(b) Ovarian vein syndrome
(c) Preureteral vanacava
(d) Vesico-ureteral reflux
(e) Congenital ureteral stenosis
14.52 All of the following characterise ovarian vein syndrome EXCEPT :
(a) Usually involves left ureter

(b) Obstruction occurs at L5- level
(c) Occurs in adult females
(d) Symptoms exaggerated by pregnancy
14.53 “Ovarian vein syndrome” in characterised by all of the following EXCEPT ?
(a) Occurs commonly on right side

(b) Accompanied by renal ptosis in 80% of cases
(c) Level of obstruction usually at S1 vertebra
(d) Nephropexy, alone is the operation of choice in most cases
(e) Symptoms are aggravated during pregnancy and menses
14.54 Which is the commonest cause of vesico-vaginal fistula in a developing country like India ?
(a) Tissue necrosis resulting from pressure between the head of the child and the pubis during
prolonged labour
(b) Due to gynaecological surgery
(c) Post-irradiation
(d) Malignancy
14.55 Which type of incontinence is present in vesico vaginal fistula ?
(a) Paradoxical
(b) Complete
(c) Urge
(d) Overflow
14.56 Which of the following investigations are advised in the diagnosis and management of vesico-
vaginal fistula ?
(a) Intravenous Urography

(b) Cystography
(c) Examination under anaethesia
(d) 3 swab test
(e) Cystopanendoscopy
(f) All of the above
14.57 How many percent of sexually active women of childbearing age are bacteriuric on screening
surveys ?

(b) 3-6 percent
(c) 6-9 percent
(d) 9-12 percent
14.58 The following anatomic and physiologic changes occur during pregnancy EXCEPT :
(a) Renal length increases approximately by 1 cm

(b) The collecting system especially the ureters undergoes decreased perislalsis
(c) Transient decrease in renal plasma flow
(d) Transient increase in giomerular filtration rate
14.59 Which normal physiological changes occur during pregnancy ?
(a) Decrease in glomerular filtration rate with decrease in blood flow

(b) Decrease in glomerular filtration rate with increase in blood flow
(c) Increase in glomerular filtration rate with increase in blood flow
(d) Increase in glomerular filtration with decrease in blood flow
14.60 As compared to normal, the urea and creatinine levels in pregnant women are :
(a) More
(b) Less
(c) Same
14.61 The presence of glycosuria in pregnant women is due to :
(a) Increase in filtered load of glucose which is not accomplished by an appropriate increase in
the maximum tubular capacity for reabsorption of glucose
(b) Increase in filtered load of glucose with decreased reabsorption by the tubules
(c) Decrease in filtered load of glucose with decreased reabsoprtion by the tubules
(d) Normal levels of filtered glucose with reabsorption by the tubules
14.62 During pregnancy, serum uric acid level is :
(a) Same
(b) Low
(c) High
14.63 During pregnancy, rise in serum uric acid level is a sensitive index of :
(a) Sodium depletion

(b) Rise in sodium
(c) Potassium depletion
(d) Rise in potasiium
14.64 During pregnancy, sodium sontent of the diet shoud be :
(a) Low
(b) High
(c) Normal
14.65 How much 24 hours urinary excretion of protiens is considered abnormal during pregnancy ?
(a) 150 mgs

(b) 200 mgs
(c) 250 mgs
(d) More than 300 mgs
14.66 Which of the following is assiciated with increased rate of bacteriuria ?
(a) Duration of pregnancy

(b) Lower socio economic class
(c) Multiparity
(d) Sickle cell trait
14.67 The high incidence of urinary tract infection during pregnancy is due to :
(a) Dilated ureters

(b) Diminished peristalsis
(c) Increased ureteric dead space
(d) Hypotonic ureters
14.68 Following are the consequences of untreated bacteriuria in pregnant women EXCEPT :
(a) Pyelonephritis
(b) Miscarriage
(c) Low birth weight babies
(d) High incidence of congenital nomalies
14.69 Which of the following decrease serum drug concentrations during pregnancy ?
(a) Maternal expanded fluid volume

(b) Distribution of drug in the fetus
(c) Increased renal blood flow
(d) Increased glomerular filtration
14.70 Exposure to X-rays during pregnancy is most harmful to the fetus in :
(a) First trimester

(b) Second trimester
(c) Third trimester
(d) At term
14.71 The following have been proposed as theories in the aetiology of “pyeloureterectasis in
pregnancy” EXCEPT :
(a) Due to fetal movements

(b) Hormonal effect
(c) Vesicoureric reflux
(d) Obstruction by enlarging uterus at pelvic brim
(e) Obstruction due to pelvic veins
14.72 All of the following true about pyeloureterectasis of pregnancy EXCEPT :
(a) Some degree of dilation occurs during every pregnancy which subsides within two months
(b) Left ureter more ofter involved that right ureter
(c) In 10% the hydronephrosis presists following delivery
(d) The pyeloureterctasis is most marked during last trimester
14.73 All of the following are true about pyeloureterectasis of pregnancy EXCEPT :
(a) More common in the right kidney

(b) Occurs in 1-2% of all pregnancies
(c) Intravenous urogram should never be done in pregnancy
(d) A single episode of pyelonephritis with local signs should be treated with a course of
antibiotics followed by low dose suppressive therapy for the rest of the pregnancy
(e) The nest pregnancy should be delayed till the patient has been abacteriuric for at least one
year
14.74 In what percentage of cases, cateriuria is likely to recur in the next pregnancy, if bacteriuria is
present in one pregnancy :
(a) 10%
(b) 20%
(c) 30%
(d) 40%
(e) 50%
14.75 How long after pregnancy, should urine examination be continued in a patient with bacteriuria
during pregnancy ?
(a) One months

(b) Two motns
(c) Three monts
(d) Six monts
14.76 What is the incidence of acute pyelonephritis during pregnancy ?
(a) 1-4 percent

(b) 5-8 percent
(c) 8-12 percent
(d) 12-16 percent
14.77 What is the average incidence of pyelonephritis in pregnant women who have bacteriuria at
the time of first antenatal check up ?
(a) 20
(b) 24
(c) 28
(d) 32
14.78 For prevention of pyelonphritis, bacteriuria should be treated preferably for :
(a) 2 weeks
(b) 6 weeks
(c) Several short courses
(d) Thoughout pregnancy
Match the Following antibiotics with their Effects of the fetus :
14.79 Tetracycline (a) Staining of teeth
14.80 Chkiraohenicol (b) Adverse effect on cartilage formation
14.81 Trimethoprim (c) Faetal malformation
14.82 Flouroquinolones (d) Ototoxicity and nephrotoxicity
14.83 Aminoglycosides (e) Gray syndrome
14.84 The following are save and effective drugs during any phase of pregnancy EXCEPT :
(a) Penicillins
(b) Ampicillins
(c) Trimethoprim
(d) Cephalosporins
14.85 Which of the following drug should be avoided during the trimester of pregnancy ?
(a) Penicillins
(b) Long acting sulfa preprations
(c) Cephlosporins
(d) Trimethoprim
14.86 Which of the following drug should be avoided during the first trimester of pregnancy ?
(a) Trimethoprim
(b) Short acting sulphonamides
(c) Penicillins
(d) Cephalosporins
14.87 At which preconception serum creatinine level, normal pregnancy is rare :
(a) 1.5 mg/dl

(b) 2.0 mg/dl
(c) 2.5 mg/dl
(d) More than 3 mg/dl
14. 88 At which serum creatinine level, pregnancy is ill advised ;
(a) 1 mg/dl
(b) 1.3 mg/dl
(c) 1.5 mg/dl
(d) 1.7 mg/dl
14.89 How many percent of amniotic fluid contributed by hte urine by 3rd timester of prenancy ?
(a) 60
(b) 70
(c) 80
(d) 90
14.90 Which is the major souce of amniotic fluid during the 3rd trimester of pregnancy ?
(a) Skin
(b) Gastrointestinal tract
(c) Central nervous system
(d) Urine
15
OPERATIVE UROLOGY
15.1 The following are indications of simple nephrectomy EXCEPT :
(a) Pyonephrosis
(b) Chronic pyelonephritis with severe parenchymal destruction
(c) Xanthogranulomatous pyelonephritis
(d) Symptomatic hydronephrosis in children
15.2 The dorso-vertical lumbotomy incision is indicated in the surgery of following conditions
EXCEPT :
(a) Multiple pelvic stones

(b) Pelviureteric juntion obstruction
(c) Upper ureteral stone
(d) Hypernephroma
15.3 In which of the following condition radical nephrectomy is indicated in hte management of
renal cell carcinoma :
(a) Bilateral localised tumour

(b) Unilateral localised tumour with normal contralateral kidney
(c) Unilateral localised tumour with nonfuntioning contralateral kidney
(d) Unilateral tumour with widespread metastasis with normal contralateral kideny
15.4 Radical nephrectomy involves removal of all of the following EXCEPT :
(a) Kidney along with suprarenal gland

(b) Perirenal fat along with Gerota’s fascia
(c) Ispilateral sympathetic chain
(d) Enlarged hilar lymph nodes
15.5 While doing radical nephrectomy which one of the following approaches is ideal ?
(a) Ligation of renal artery before ligation of renal vein

(b) Ligation of renal vein before ligation of renal artery
(c) Ligation of both renal artery and vein together
(d) Ligation of ureter before ligation of renal artery and vein
15.6 What should be done if tumour embolus is found in the renal vein during radical nephrectomy ?
(a) Tumour embolus should be left

(b) Tumour embolus should be removed
(c) Radical nephrectomy operation should be postponed
(d) Inferior venacava should be ligated
15.7 Following are the indication of partial nephrectomy EXCEPT :
(a) Calculous disease with obstruction of the lower pole calyx with impaired drainage
(b) Tumour in a solitary kidney
(c) Polar tumour with normal contralateral kideney
(d) Segmental parenchymal scarring secondary to vascular injury causing hypertension
15.8 Following are indications of surgery in bilateral adult polycystic disease of the kidney EXCEPT :
(a) Calculous disease with infection

(b) Severe pain due to bleeding or obstruction
(c) Hypertension
(d) Development of tumour
15.9 Indications of surgery in renal calculous disease are all of the following EXCEPT ?
(a) Asymptomatic non-obstructive small calyceal stone

(b) Significant or increasing obstruction
(c) Sytemic infection in presence of obstruction
(d) Deterioration of renal funtion
15.10 Which is the surgery of choice for removal of an average sized pelvic stone ?
(a) Nephrolithotomy
(b) Pyelolithotomy
(d) Anatrophin nephrolithotomy
15.11 Which is the surgery of choice for statement of large inferior calyceal calculus with narrow
infundibulum and scarring and atrophy of the overlying parenchyma ?
(a) Pyelolithotomy
(b) Nephrolithotomy
(c) Partial neprectomy
(d) Anatrophic nephrolithotomy
15.12 Which is the surgery of choice for removal of branched calculus with small intrarenal pelvis ?
(a) Extend pyelolithotomy

(b) Nephrolithotomy
(d) Anatrophie nephrolithotomy
15.13 The following are the auxillary aids available for localisation and removal of residual stones
during surgery EXCEPT :
(a) Fibreoptic nephroscopy

(b) Intraoperative radiography
(c) Intravenouse urography
(d) Ultrasonography
15.14 For coagulum pyelolithotomy, coagulum is prepared from the following EXCEPT :
(a) Croprecipitated plasma

(b) Bovline thrombin
(c) Calcium carbonate
(d) Calcium chloride
15.15 Which of the following approach is preferable ofr exploration of the horse-shoe kidney ?
(a) Dorsovertical lumbotomy

(b) Anterior subcostal extraperitoneal
(c) Midline or paramedian transperitoneal
(d) Thoraco-abdominal
15.16 Which of the following is NOT desirable during pyeloplasty ?
(a) Dependent ureteropelvic segement

(b) Progressive funneling of the ureteropolvic segement
(c) Kinks and obstruction at the suture line
(d) Straight ureter of adequate calibre
15.17 Which of the following are of vital importance for the surgery of ureteropelvic juntion
obstruction ?
(a) Pre operative evaluation

(b) Surgical technique
(c) Post operative care
15.18 Which type of pyeloplasty is preferable in a case of coexiting vesicoureteral reflux and
ureteropelvic juntion obstruction ?
(a) Dismembering
(b) Non dismembering
(c) Any of the above
15.19 In the assessment of severe ureteropelvic juntion obstruction, intravenous pyelogram

delineates the following EXCEPT :
(a) Proximal limit of the stricture

(b) Status of the ureter distal to stricture
(c) Differential renal funtion
(d) Presence of radioopaque stones
15.20 The following statements are correct regarding intravenous urography in the assessemnt of
ureteropelvic juntion obstruction EXCEPT :
(a) Patient should be well hydrated

(b) High dose intravenous urogram should be done
(c) Abdominal (ureteral) compression should be used
(d) Oblique and lateral views should be taken
15.21 The following statements are correct for the mobolization ureter during pyeloplasty EXCEPT :
(a) Keep the periureteral investing sheath intact

(b) Use diathermy on the ureter
(c) Point clamp and tie any persistant bleeders
(d) Do not crusn the ureter with forceps
15.22 Which type of structures are preferable for the pyeloplasty repair ?
(a) Continuous
(b) Blanket type
(c) Interrupted
(d) Double layer
15.23 What is the internal caliber of the lumbar ureter in adults ?
(a) 4-6 Fr
(b) 6-10 Fr
(c) 10-14 Fr
(d) 14-16 Fr
15.24 What is the internal caliber of intramural ureter in adults ?
(a) 3-5 Fr
(b) 5-7 Fr
(c) 7-10 Fr
(d) 10-12 Fr
15.25 Which is the nephrostomy cather of choice following pyeloplasty ?
(a) 2-way Foley’s catheter

(b) 3-way Foley’s catheter
(c) Malecot’s catheter
(d) Red rubber catheter
15.26 The following statements are correct in the management of bilateral hyronephrosis EXCEPT ?
(a) In unifected hydronephrosis of equal degree either side can be repaired first
(b) In unequal and unifected but moderately advanced hydronephrosis with salvageable
kidneys, the more involved side should be repaired first
(c) In the better of the two kidneys is infected, it should be repaired first, after the infection is
controlled
(d) In salvageable, uninfected, bilateral hydronephrosis with calculi in one kidney, the other
kidney should be repaired first
15.27 Which of the following is a contraindication for use of stent and nephrostomy following
pyeloplasty ?
(a) Previous surgical failure

(b) Intrarenal bifid pelvis
(c) Chronic infection
(d) Renal stones
15.28 Which is the pyeloplasty of choice for correction of an obstructive high insertion of ureter in to
the pelvis ?
(a) Nondismembering classic Foley Y-V plasty

(b) Nondismembering Culp-Deweerd pyeloplasty
(c) Dismembered Foley-Y pyeloplasty
(d) Dismembered Anderson-Hynes pyeloplasty
15.29 In nondismembered Foley Y-V pyeloplasty, suturing of the flap should start :
(a) From the tip upwards

(b) From the pelvis downwards
(c) From midway to upwards and downwards
(d) From anywhere
15.30 Which of the following is a contraindication for culp-deweerd spiral flap pyeloplasty ?
(a) Dependent ureteropelvic

(b) Extrarenal pelvis
(c) Intrarenal pelvis
15.31 Which is the opertion of choice for correcting stricture of the lumbar ureter ?
(a) Culp-deweerd spiral flap

(b) Scandino prince vertical flap
(c) Davis intubated ureterotomy
(d) Ureterocalyceal anastomosis
15.32 After pyeloplastic when there is no urinary leak, drain should be left in place for a minimum of:
(a) 2 days
(b) 5 days
(c) 7 days
(d) 10 days
15.33 After Davis-intubated ureterotomy, the stent should be in place for about :
(a) 1-2 weeks

(b) 2-4 weks
(c) 4-6 weeks
(d) 6-8 weeks
15.34 Which is the treatement of choice for a 3 cms size, spiky calculous in upper 1/3 of the ureter ?

(b) Endoscopic manipulation
(c) Ureterolithotomy
(d) Ureterolithostomy
(e) Ureteroneocystostomy
15.35 Which is the treatment of choice for a 4 mm size calculus in lower 1/3 of ureter causing pain
and hydronephrosis ?

(b) Retrograde ureteroscopy and stone removal
(c) Antegrade ureteroscopy and stone removal
(d) Ureterolithotomy
15.36 The following statement are correct regarding transuretero ureterotomy EXCEPT ?
(a) The recipient ureter including its ureterovesical must be normal

(b) The bladder and bladder outlet must be normal
(c) The procedur is applicable for proximal ureteral defect
(d) The ureter is transported anterior to the great vessels
15.37 Following are relative contraindications for transureteroureterotomy EXCEPT ?
(a) Dilated upper urinary tract

(b) Widefield large dose radiation
(c) Tuberculosis
(d) Urolithiasis
15.38 How mach lenght of ureter can be gained by “Psoas bladder hitch operation” ?
(a) 1-3 cms

(b) 3-5 cms
(c) 5-7 cms
(d) 7-9 cms
15.39 In “ Psoas bladder hitch operations “ bladder is stiched to :
(a) Psoas minor

(b) Psoas major
(c) Both of them
(d) None of them
15.40 Usually how much lenght can be gained is “ Boari flap procedure “ ?
(a) 1-5 cms

(b) 5-10 cms
(c) 10-15 cms
(d) 15-20 cms
15.41 Fluid and electrolyte imbalance in ureterosigmaidostomy is characterised by :
(a) Hyperkalemia with hyperchloremia

(b) Hyperkalemia with hypochloremia
(c) Hyperkalemia with hypochloremia
(d) Hyperkalemia with hyperchloremia
15.42 Following are the relative contraindications for ureterosigmoidostomy EXCEPT ?
(a) Dilated upper tracts with evidence of pyelonephritis

(b) Normal renal function
(c) Poor rectal sphincter tone
(d) Previous radiation to the pelvis
15.43 Which of the following is a rare complication of ureterosigmoidostomy ?
(a) Pyelonephritis
(b) Ureteral obstruction
(c) Neoplasm at the site of anastomosis
(d) Fluid and electrolity imbalance
15.44 Which type of urinary diversion is contraindicated in a patient af neurogenic with poor rectal
sphinster control ?
(a) Cutaneous ureterostomy

(c) Ureterosigmoidostomy
(d) Ileal condult diversion
15.45 Which is a preferable long term supravesical urinary diversion in a child with normal upper
tracts ?
(a) Cutaneous ureterostomy

(b) Continent urinary diversion
(c) Ileal condult diversion
(d) Ureterosigmoidostomy
15.46 Which of the following statements is WRONG about diverticula of the urinary bladder ?
(a) Usually develop in patients who have outlet obstruction

(b) Treatment of the cause of obstruction should accompany civerticulectomy
(c) The presence of diverticulum is an indication for its removal
(d) Presistent infection is usually associated with failure of the diverticulum to empty
15.47 Which of the following statement regarding ileal conduit diversion is WRONG ?
(a) The loop should be brought out through the rectus muscle
(b) The optimum placement of stoma should be determined before surgery, with the patient
placed in supine standing and sitting positions
(c) The stoma should be close to the umblicus
(d) The stoma should not be too close to a bony protuberence
(e) The stoma should not be close to a skin fold
15.48 What should be the preferable skin incision if ileal conduit diversion is planned along with
cystectomy ?
(a) Right paramedian

(b) Middine
(c) Left paramedian converted to lower midline
(d) Transverse
15.49 Which of the following statement is WRONG fot the prepration of ileal conduit stoma ?
(a) A button of skin and subcutaneous tissue approximately the size of a quarter is excised
(b) The skin edges should not be undermined
(c) The diameter of the excised subcutaneous tissue should be more than the diameter of the
excised skin
(d) The ileal segment should be brought through the rectus muscle
(e) The ileal segment should protrude 2 inches above the skin
15.50 Which of the following statement is WRONG regarding radical cystectomy ?
(a) It includes removal of enblock of peritoneum atached and adjacent to the baldder
(b) Lymphatics from the bifurcation of the common iliacartery on either side to the inquinal
ligament distally are removed
(c) The prostate and seminal vesicles are removed
(d) The urethra is removed in all cases
(e) The dissection is bounded laterally by the spermatic vessels
15.51 Which of the following is a contraindication for partial cystectomy in the management of
carcinoma urinary bladder ?
(a) Localised tumour in the dome with a 3 cm wide normal mucosa

(b) Elderiy parient
(c) Multiple tumours in the bladder
(d) Absence of carcinoma in situ or atypia in other parts of the bladder
15.52 Approximately how many kilo cycles per second is wave frequency for the cutting current in
transurethral surgery :
(a) 500
(b) 1000
(c) 1500
(d) 2000
(e) 2500
15.53 Approximately how many kilo cycles per second is wave frequency for the coagulation in
transurethral surgery :
(a) 500
(b) 1000
(c) 1500
(d) 2000
(e) 2500
15.54 Which of the following should be the quality of the irrigating fluid for transurethral resection
of prostate ?
(a) Optically clear

(b) Non-electrolytic
(c) Isotonic
15.55 Which is the prefeable irrigating fluid for transurethral resection of bladder tumour ?
(a) Distill water

(b) Saline
(c) Dextrose
(d) Glycine
15.56 Which of the following statement is WRONG regarding continuous suction irrigation
resectoscope ?
(a) A constant level of bladder filling and intravesical pressure is maintained

(b) Constant flow ensure clear vision
(c) Constant flow obviates the need to stop and empty the bladder
(d) It shortens operation time
(e) The sheath allows large working element and large electrode
15.57 What should be the preoperative diet before transurethral surgery of the prostate ?
(a) Normal diet

(b) Liquid diet
(c) Restricted fluid intake
(d) Plain water
15.58 What is the preoperative sedation of choice immediately before transurethral surgery ?
(a) Narcotics
(b) Diazepam
(c) Barbiturates
(d) Phenargan
15.59 Which of the following are the prerequisites for the transurethral surgery of the prostate ?
(a) Panendoscopy for evaluation of stricture urethral bladder calculi, tumour etc.
(b) Calibration of urethra
(c) Lubrication of urethra
15.60 Resection of the prostate down to the capsule can result in :
(a) Less problems of postoperative infection

(b) Less problems of secondary haemorrhage from necrotic tissue
(c) Less problems of regrowth of adenoma
15.61 Overresection of prostate can result in to the following EXCEPT ?
(a) Increased fibrosis at the bladder neck

(b) Incontinence of urine
(c) Venous bleeding and fluid absroption
(d) Increased risk of carcinoma prostate
15.62 During transurethral resection of prostate verumontanum should be :
(a) Partly resected

(b) Completely resected
(c) Preserved
Match Surgical Landmarks for Transurethral Prostatectomy
15.63 Adenoma (a) Coarse striations
15.64 Prostatic capsule (b) Snowlike appearance
15.65 Venous sinus (c) Cloud like appearance
15.66 Fluid absorption during transurethral prostatectomy will result in the following EXCEPT :
(a) Hyponatremia
(b) Increase in central venous pressure
(c) Increase in blood pressure
(d) Increase in pulse rate
(e) Mental confusion
15.67 Control of venous bleeding during TURP can be achieved by :
(a) Coagulation
(b) Foley’s balloon traction
(c) Haemostatic drugs
(d) Hypotension
15.68 Which of the following substance is released at the time of transurehtral resection of
carcinoma prostate ?
(a) Streptokinase
(b) Urokinase
(c) Alkaline phosphatase
(d) Lactic dehydrogenase
15.69 The action of urokinase is blocked by :
(a) Vit.K
(b) Epsilon aminocaproic acid
(c) Glycine
(d) Glucagon
15.70 Which of the following should be done repeatedly fot the diagnosis of disseminated
intravascular coagulation ?
(a) Partial thromboplastin time

(b) Prothrombin time
(c) Platelet count
(d) Fibrin split products
15.71 Which of the following drugs are used for the treatment of disseminated intravascular
coagulopathy ?
(a) Heparin
(b) Fresh whole blood
(c) Fibrinogen
15.72 During TURP, irrigant fluid can enter the sytemic circulation by the following routes EXCEPT :
(a) Through the prostatic plexus of veinns

(b) Through the bladder wall
(c) Via the periphrostatic space
(d) Via the retroperitoneal space if there is extravasation
15.73 Which is the most popular method of investigating the incidence of fluid absorption after
TURP ?
(a) Estimation of serum sodium

(b) Estimation of respective solute in the irrigating fluid
(c) Esimation of total blood volume
(d) Estimation of serum potassium
15.74 Which of the following statement is FALSE regarding measurement of serum sodium
estimation as a method of investigation for fluid absorption ?
(a) It is easy to measure

(b) There is a good corelation between a fall in sodium and a rise in the serum levels of
respective solute used in irrigation fluid
(c) It can measure the amount of fluid absorped
(d) The levels can improve quite rapidly after cessation of resection
15.75 What is the half life of glycine ?
(a) 55 mnts
(b) 85 mnts
(c) 105 mnts
(d) 125 mnts
15.76 The following factors influence the extent of absorption of fluid following TURP EXCEPT :
(a) Surgical technique

(b) Age of the patient
(c) Pressure in the bladder & prostatic fossa
(d) Duration of resection
15.77 Haemolysis occur due to absroption of which of the following :
(a) Glycine 1.5 percent

(b) Mannitol
(c) Distil water
(d) Sorbitol 5 percent
15.78 What is the concentration of glycine used for TURP ?
(a) 0.5 percent

(b) 1.0 percent
(c) 1.5 percent
(d) 2.0 percent
15.79 What percentage of glycine is near isotonic ?
(a) 0.5 percent

(b) 1.0 percent
(c) 1.5 percent
(d) 2.0 percent
15.80 Isotonic solution results in to the following complications EXCEPT :
(a) Haemolysis
(b) Water intoxication
(c) Due to absroption of products of the solute
(d) Hyponatraemia
15.81 Absorption of the isotonic irrigant results in reduction in the plasma levels of the following
EXCEPT :
(a) Sodium
(b) Chloride
(c) Potasium
(d) Bicarbonate
(e) Calcium
(f) Magnesium
15.82 Which electrocardiographic changes are produced by hyponatremia ?
(a) Tall and peak T waves

(b) Narrowing of QRS complex and ST depression
(c) Widening of QRS complex and ST
(d) Inverted Q waves depression
15.83 What are the classical features of dilutional hyponatraemia ?
(a) Bradycardia
(b) Hypotension
(c) Mental confusion
15.84 Which fluid is recomended for bladder irrigation after TURP ?
(a) Distill Water

(b) 5 percent Dextrose
(c) 1.5 Percent glycine
(d) Normal saline
15.85 Which of the following statement is FALSE regarding glycine ?
(a) It is an essential amino acid

(b) It is converted in the liver to glyoxalate
(c) It is further metabolised in to oxalate which is excreted in urine
(d) It’s absroption induce hyperxaluria
15.86 The following are the diagnostic features of fluid absoption EXCEPT :
(a) Low plasma sodium level

(b) Low serum osmolality
(c) Increase in serum levels of solutes
(d) Decrease in serum bicarbonates levels
15.87 In what situation, serum osmolality may remain normal following fluid absroption :
(a) Due to hyponatraemia

(b) Due to presence of large quantities of solutes in the circulation
(c) Due to haemolysis
15.88 The management of fluid absroption consist of the following EXCEPT :
(a) Continue operation

(b) Induce diuresis
(c) Correct serum sodium levels
(d) Correct blood loss
15.89 Which of the following is preferable to induce forced diuresis, where 5% mannitol is used as
irrigating fluid ?
(a) 10-20 percent mannitol

(b) Frusemide
(c) Hypertonic saline
(d) Hypotonic saline
15.90 Which of the following is recomended for the correction of hyponatraemia following fluid
absorption ?
(a) Hypertonic saline

(b) Sodium bicarbonate
(c) Frusemide
15.91 Fluid absorption can be prevented by :
(a) Low intravesical pressure

(b) By avoiding opening venous channels
(c) By avoiding breach in the capsule
(d) By limiting resection time
15.92 During percutaneous and endoureteric stone surgery, systemic absroption of irrigating fluid
may occur due to :
(a) Extravasation of fluid caused by rupture of the renal pelvis or ureter

(b) Via the veins which may open up during track dilatation
(c) Leakage of fluid in to the retroperitoneal space
15.93 During endourologic procedures, fluid absorption can be prevented by the following EXCEPT :
(a) The height of the bag should be kept above 80 cms

(b) Amplatz open darinage sheath should be used to keep the intrapelvic pressure low
(c) Oreall endoscopy time should be limited to 2 hours
(d) Stone manipulation is to be abndoned if damage to the renal pelvis or ureter is suspected
15.94 How long before surgery, medical treatment for Peyronie’s disease should be tried ?
(a) 3 month
(b) 6 month
(c) 9 month
(d) 12 month
15.95 Medical treatment of peyronie’s disease consists of the following EXCEPT :
(a) Vit. E
(b) Potaba
(c) Inj. Steroid
(d) Radiation
(e) DMSO
15.96 Which of the following statement is FALSE about peyronie’s disease ?
(a) There is an inflammatory process in association with fibrotic changes in the elastic
connective tissue of the tunica albuginea of the corpora cavernosa
(b) About 10% of patient’s have Dupuytren’s contracture
(c) The disease usually occurs in middle age but can also occur in young men
(d) It commonly also involves the urethra
15.97 Which of the following is an indication for circumcision ?
(a) Balanitis
(b) Herpetic infection
(c) Phimosis
(d) Redundant prepuce
15.98 Which is the treatment of choice in a suspected case of torsion testis ?
(a) Immediate exploration

(b) Conservative treatment
(c) Elevation of scrotum
(d) Orchidectomy
15.99 In patient of stricture urethra with periurethral abcess and phlegmon, which is the first line of
treatment aling with drainage of the abseass :
(a) Urethral dilatation

(c) Internal urethrotomy
(d) Urethroplasty
15.100 Which is the ideal donor site of skin for one stage graft urethroplasty ?
(a) Scrotum
(b) Penis
(c) Abdomen
(d) Thigh
15.101 In which part of urethra, inflammatory stricture associated with urethritis are generally
located :
(a) Pendulous
(b) Bulbous
(c) Meatus
(d) Prostatic
15.102 In which part of urethra, iatrogenic stricture following TUR or instrumentation are located :
(a) Meatus
(b) Fossa navicularis
(c) Bladder neck
(d) Penoscrotal juntion
15.103 The selection of treatment for a patient with urethral stricture is depend upon :
(a) Site of the stricture

(b) Length of the stricture
(c) Density of the stricture
(d) General condition of the patient
15.104 In which position urethral artery and artery to the bulb of the urethra run in the corpus
spongiosum :
(a) Lateral
(b) Anterior
(c) Medial
(d) Posterior
15.105 To define the full extent of the stricture urethra, which is the investigation of choice :
(a) Intravenous urography with micturating cystourehrography

(b) Retrograde and voiding urethrograms
(c) Uroflowmentry
(d) Cystourethroscopy
15.106 Stricture urethra in males shoud be dilated up to :
(a) 24 Fr
(b) 26 Fr
(c) 28 Fr
(d) 30 Fr
15.107 Id dilatation is to be the treatment of choice for the stricture urethra, eventually what shoid
be the frequency of dilatation :
(a) Every month

(b) 3 month
(c) 6 month
(d) 6-12 month
15.108 Which is the preferable site of incision in internal urethrotomy ?
(a) 3 O’clock
(b) 6 O’clock
(c) 9 O’clock
(d) 12 O’clock
15.109 Which is the treatment of choice for 2 cm, long impassable bulbomembranous traumatic
stricture urethra in a 25 years old male ?
(a) Perineal urethrostomy

(c) Internal urethrotomy
(d) End to end anstomosis
15.110 Whose name is associated with visual internal urethrotomy ?
(a) Waterhouse
(b) Sachse
(c) Blady
(d) Turner warwick
15.111 Which lense gives forooblique view ?
(a) 0o
(b) 30o
(c) 70o
(d) 120o
15.112 In urology catheters are used for the following EXCEPT :
(a) To diagnose problems

(b) To drain urine or blood
(c) To drain blod clots
(d) To maintain anatomoc continuity
15.113 Ballon catheters are commonly known as :
(a) Robinson catheter

(b) Foley catheter
(c) Malecot catheter
(d) Pezzer catheter
15.114 Which portion of small bowel may lie wihtin the confines of the pelvis and as such may be
exposed to pelvic irradiation and or pelvic disease ?
(a) The middle 2 ft of the ileum

(b) The last 2 inches of the terminal ileum
(c) The proxmial 1/3 of the ileum
(d) The 5 feet of the small bowel begining approximately 6 feet from the ligament of trietz
(e) B and C
15.115 Which of the following statement is FALSE regarding advantages of stomach over other
intestinal segments for urinary intestinal diversion ?
(a) It is less permeable to urinary solutes

(b) It acidifies the urine
(c) It has a net excretion of chloride rather than net absroption
(d) It produces more mucus
(e) Urodynamically, it behaves as other intestinal segments
15.116 Which segment of the bowel has highest bacterial concentration per gram of fecal content ?
(a) Jejunum
(b) Distal ileum
(c) Ascending colon
(d) Descending colon
15.117 Which of the following a cause of stricture at the ureterointestinal anasomosis ?
(a) Ischaemia
(b) Urinary leak
(c) Radiation
(d) Infection
15.118 Which of the following electrolyte abnormalities will occur when stomach is used in
continent urinary diversion ?
(a) Hypochloremic metabolic alkalosis

(b) Hyponatremia hyperkalemia and metabolic acidosis
(c) Hyperchloremic metabolic acidosis
15.119 Loss of significant portions of the ileum results in to the following EXCEPT :
(a) Malabsorption of Vit B12

(b) Malabsorption of bile salts
(c) Loss of lipids (fatty diarrhoea)
(d) Malabsorption of folic acid
15.120 Loss of significant portion of the jejunum relults in to malabsoprtion of the following EXCEPT :
(a) Vit B 12
(b) Fat
(c) Folic acid
(d) Calcium
15.121 What is reported mean incidence of cancer following ureterosigmoidostomy ?
(a) 6 percent
(b) 11 percent
(c) 16 percent
(d) 22 percent
15.122 Which is the most common histopathologic type of tumour develop following
ureterosigmoidostomy ?
(a) Adenocarcinoma
(b) Undifferentiated
(c) Carcinoma
(d) Sarcoma transitional cell carcinoma
15.123 Cancer can develop following which type of ureterointestinal anastomosis :
(a) Ureterosigmoldostomy
(b) Ileal condults
(c) Colonic condults
(d) Bladder augmentation
15.124 The following are advised to detect occurence of cancer after ureterosigmoidostomy EXCEPT:
(a) Colonoscopy
(b) Barium enemia
(c) Monitoring of blood in the school
(d) Cystologic examination of the mixed urine and faeces specime
15.125 The following statements are TRUE for continent urinary diversion in comparison to ileal
condult diversion EXCEPT :
(a) Longer hospital stay

(b) Higher complication rate
(c) Greater potential for reoperative surgery
(d) Poorer psychosocial adjustment
15.126 Which of the following urinary diversion is useful following total pelvic exentezation ?
(a) Jejunal condult

(b) Ileal condult
(c) Colonic condult
(d) Ileocaecal condult
15.127 Which of the following statement is FALSE regarding orthotopic voiding operations for the
statement of bladder cancer ?
(a) Mostly. They are not adoptable to the female patient

(b) Continence is dependent on the preservation of the external sphicter in the male
(c) Day time continence rate may be well in excess of 95 percent
(d) Noctural enueresis is rare
(e) There is a higher risk of urethral cancer recurrence
15.128 Which location of the catheterizing portal of continent catheterizing pouch is preferred for
the individual confired to a wheel chair ?
(a) Umblicus
(b) Lower quadrant of the abdomen
(c) Upper quadran of the abdomen
(d) Below the bikini line
16
RENAL TRANSPLANTATION
16.1 All of the following are contraindications for cadaver kidney donors, EXCEPT :
(a) Intestinal perforation

(b) Generalised infection
(c) Primary renal disease
(d) Renal disease secondary to hypertension
(e) Patients treated with intravenous dimently sulfoxide for cerebral edema
16.2 All of the following are generally acceptable criteria for cadavar kidney donors EXCEPT :
(a) 1-55 years of age

(b) Evidnece of primary oxalosis
(c) Normal renal function
(d) No malignant disease outside the central nervous system
16.3 Prenephrectomy management of a cadavar donor begins after declaration of death involves all
of the following EXCEPT :
(a) Maintaining blood pressure at 90 mm Hg

(b) Maintaining urine output at 30 ml/hr
(c) Weaning from vasopressors
(d) If vasopressors can not be discontinued a noradrenaline infusion is preferred
(e) Frusemide 10-80 mg or mannitol 12.5-50 gm may be infused to inilate diuresis if dopanine
infusion is unsuccesful
16.4 The surgical goals of cadaver kidney retrieval are all of the following EXCEPT :
(a) Intact ureteral blood supply

(b) Preservation of inferior vena cava with the right kidney
(c) Warm ischemia time in cadaver kidney is not of paramount importance
(d) Preservation of multiple or anomalous renal vessels
16.5 At the time of performing cadavar donor nephrectomy, the surgeon must also remove the
following , EXCEPT :
(a) At least 6 lymph nodes

(b) 100 ml heparinised blood
(c) Portion of spleen
(d) Portion of liver
16.6 Renal preservation by pulsatile hypothermic perfusion with cryprecipitate plasma can be
successfully done for upto :
(a) 12 hrs
(b) 36 hrs
(c) 72 hrs
(d) 100 hrs
16.7 The intital objectives of flusing after removal of kidneys with cold solutions are the following
EXCEPT :
(a) Achieve rapid cooling

(b) Reduce cellular metabolic requirement
(c) Check out anomalous blood vessels
(d) To wash out blood along with its coagualtion factors
16.8 Which of the following is an extracellilar solution ?
(a) Holland’s solution

(b) Euro collins solution
(c) Collins solutions
16.9 Which of the following statement regarding recipients are FALSE ?
(a) Age of the recipient byond 45 years increases mortally significantly

(b) Chronic carries of hepatitis B antigen are at a higher risk
(c) Patients with active tuberculosis must receive appropriate drug therapy for two years prior
to transplantation
16.10 Which of the following statement regarding recipients is FALSE ?
(a) Underlying malignant disease is an absolute contraindication

(b) The patients who once had malignant but is now 3 years tumour free is also a
contrandication
(c) Tumours with very low metastatic disk (e.g. Squamous or basal cell carcinoma) can be
considered for transplantatation immediately after successful treatment
(d) Immunosuppressive drugs may exacerbate cancer
16.11 The commonest cause for renal failure necessitating renal transplantation is :
(a) Chronic pyelonephritis

(b) Diabetic nephropathy
(c) Chronic glomerulonephritis
(d) Nephrosclerosis
16.12 Glomerular disease, causing renal failure, has been shown to recur after transplatation in a
small percentage of cases. Which type of glomerular disease recurs most commonly
(a) Membranous nephropathy

(b) Membrano proliferative glomemlonephritis
(c) Focal segmental glomerulosclerosis
(d) IGA nephropathy
16.13 Pretransplant nephrectomy in the recipient is undertaken judiciously in all of the following
conditions EXCEPT :
(a) Polycystic kidneys

(b) Persistent pyelonephritis
(c) Primary oxalosis
(d) Uncontrolled hypertension
(e) Progressive glomerulonephritis
16.14 The human lymphocyte antigen (HLA)system is composed of 5 series of antigens controlled by
gentic loci on which chromosome :
(a) 4th
(b) 5th
(c) 6th
(d) 7th
16.15 When classified according to their function and biochemistry, the class I antigens comprise the
following EXCEPT :
(a) A
(b) B
(c) C
(d) D & DR
16.16 Class II antigens are distributed on the following cells EXCEPT :
(a) T-lymphocytes
(b) Stimulated T lymphecyte
(c) B-lymphocytes
(d) Monocytes
16.17 In the kidney, class I antigens are found of the following EXCEPT :
(a) Glomeruli
(b) Tubules
(c) Vasculature
(d) Interstitial dendritic cells
16.18 By matching which antigns, the best results are obtained in cadavar transplant :
(a) A
(b) B
(c) C
(d) D
(e) DR
16.19 HLA stands for :
(a) Human leucocyte antigen

(b) Human lymphocyte antigen
(c) Human lympoblast antigen
(d) Human lysozyme antigen
16.20 Which one of the following antigens is detected by mixed lymphocyte cluture ?
(a) A
(b) B
(c) C
(d) D
(e) DR
16.21 In general, which cross match is more crucial for a succesful transplant :
(a) T-lymphocyte
(b) B-lymphocyte
16.22 Which of the following is the commontest cuase for hyperacute rejection ?
(a) Tranmitted streptococcal infection

(b) Streptococcal alpha toxin
(c) Positive T-lymphocyte cross match
(d) Pulsatile perfusion with cryoprecipitated plasma
16.23 HLA-adentical sibling allografts defined as those that are identical genotypically for HLA-A,B,C
and DR antigens as well as being stimulatory in mixed lymphocyte culture (HAL-D) :
(a) True
(b) FALSE. It should be non stimulatory in mixed lyphocyte culture (HLA-D)
(c) FALSE. It should ne “non-identical genotypically for HLA-A,B,C and DR”
16.24 Which antigen is least important in renal allografting ?
(a) A
(b) B
(c) C
(d) DR
(e) D
16.25 The presense of a malignancy in the recipient is a contraindication for renal transplantation.
Which of the following is an EXCEPTION to this rule :
(a) Multiple myeloma

(b) Cancer stomach
(c) Cancer lung
(d) Hodgkin’s lymphoma
(e) Osteosarcoma
16.26 Which is the single most important factor influecing ultimate cadaver allograft survival :
(a) Degree of HLA matching

(b) Blood transfusions
(c) Methods of renal preservation
(d) Race of the individual
16.27 Which gruop of prospective candidates for renal transplantation should be given pretransplant
donor specific blood transfusiaon ?
(a) HLA- identical siblings

(b) Serologically identical HLA with high responders on mixed lymphocyte culture
(c) Serologically nonidentical HLA living related pair with high stimulation on mixed lymphocyte
culture
16.28 What is the optimal number of pre-tranplan blood transfusion
(a) 1
(b) 3
(c) 6
(d) 9
16.29 At wht intervais pretransplant blood transfusion involve transfusion of 200 ml of fresh blood
(a) Alternate days

(b) Weekly
(c) Fortnighly (2 wks)
(d) Montly
16.30 Cyslosporine cause immunosuppression by its potent, revarcible and profomtial action on :
(a) T-lymphocytes
(b) Myelosuppression
(c) B-lymphocytes
16.31 What is the optimal initial dose of cyclosporine ?
(a) 5-10 mg/kg/day

(b) 14-17 mg/kg/day
(c) 20-25 mg/kg/day
(d) 30-35 mg/kg/day
16.32 Which is the ideal therapeutic plasma concentration of cyclosporine ?
(a) Less than 100 ng/ml at peak

(b) 100-200 ng/ml at peak
(c) 200-300 ng/ml at peak
16.33 Which is the most common side effct of cyclosporine :
(a) Hepatotoxicity
(b) Gingival hyperplasia
(c) Oncogenicity
(d) Gastrolintestinal bloating
(e) Nephrotoxicity
16.34 Which is the usual route of adminitration of cylosporine ?
(a) Oral
(b) Intramuscular
(c) Intravenous
(d) Intrathecal
16.35 Which is the best method of distinguishing a rejection episode from a cyclosporine
nephrotoxicity :
(a) Renal biopsy

(b) Ultrasound
(c) Renal angiography
(d) IVP
16.36 In which order, the normal transplant arteriogram comprises of three phases :
(a) Arterial phase, nephrogram, venous phase

(b) Arterial phase, venous phase ,nephrogram
(c) Nephrogram , arterial phase, venous phase
(d) nephrogram Arterial phase, nephrogram, venous phase
16.37 How many seconds after completionof the arterial injection, maximum opacification of venous
phase occurs :
(a) 1 sec
(b) 5 sec
(c) 10 sec
(d) 15 sec
16.38 An arteriogram picture of acute rejection usually shows attenuation, constriction or occlusion
of the intra renal vessels and this appearance is called :
(a) Christmas tree appearance

(b) Pruned tree appearance
(c) Clothes line appearance
16.39 DYPA scan done in an anuric patient immedicately following transpalntation reveals a faint but
definite uptake of isotope by the graft. The most probable diagnosis is :
(a) Acute tubular necrosis

(b) Arterial thrombosis
(c) Hyperacute rejection
(d) Fish hook appearance
16.40 How much time after transplantation the findings of acute tubular neorosic are maximal ?
(a) 6 hours
(b) 24 hours
(c) 3 days
(d) 1 week
Match the most appropriate answers
16.41 Best anatomic (a) Hippuran
16.42 Best evaluation of allogant (b) DMSA

Perfusion and function
16.43 It filteres from the glomerulus (c) DTPA and Hippuran
16.44 Is both filtered and secreted (d) DTPA
16.45 Where as the cadaver allograft survival is approximately 55% at one year, the allograft survival
rate in living related transplant patient at one year is approximately ?
(a) 40%
(b) 60%
(c) 80%
(d) 100%
16.46 Which of the following is FALSE ?
(a) When used along with azathioprine and prednisone, antilymphocyte globulin (ALG)
sidnificantly decreases the number of early rejection episodes
(b) ALG can be used as the sole treatment for acute allograit rejection
(c) ALG is ineffective in patients having acute allograft rejection which is resistant to steroids
(d) The use of ALG has led to reduced cumulative dosages of steroids
16.47 The following areas are irradiated in “Total lymphoid irradation” EXCEPT :
(a) Midabdomen
(b) Lateral abdomen
(c) Lungs
(d) Pelvis
(e) Neck
16.48 Which of the following statement is FALSE :
(a) Franstionated total lymphoid irradiation is better than single dose therapy
(b) The effect of total lymphoid irradiation is permanent and does not dissipate with time
(c) Both mantle and inverted Y fields can be irradiated simultaneously
(d) Total lymphoid irradiation should be combined with pharmacologic immunos uppression for
long term maintenance
16.49 The variable influecing the results of a retransplantation in patients treated with total
lymphoid irradiation include :
(a) Dosage of irradiation

(b) Timing of irradiation
(c) Interval from irradiation to transplantation
(d) Adjuvant pharmacologic immunosuppression used
(e) A,B, and D
(f) All of the a bove
16.50 In the post transplant patient, rising titres of blood urea can accur dur to all of the following
causes EXCEPT :
(a) Urinary tract infection

(c) Rejection
(d) Bleeding gastric ulcer
(e) Steroids in high doses
16.51 Foolowing renal transplantation, a rising titre of blood urea without a concomittant rise in
creatinine values can be caused by the following conditons EXCEPT ?
(a) Steroids (high dose)

(b) Rejection
(c) Acute tubular necrosis
(d) Liver failure
16.52 All of the following can cause hypertension in a posttransplant patient EXCEPT :
(a) Hyperacute rejection

(b) Chronic rejection
(c) Scar tissue encasement of artrial anastomasis
(d) Salt and water retention
(e) Prednisone overdosage
16.53 Which of the following statement is FALSE regarding renal transplant ?
(a) Second transplants are less successful han first transplants

(b) Prior to attempting the second transplant the first transplanted kidney should always be
removed
(c) Rejection of a transplant recipient becomes pregnant the pregnancy should be terminated
(d) If pregnancy is not terminated, caesarean section is the method of choice at the time of
delivery
16.54 Approximately how many times greater is the incidence of cancer in renal transplant patients
on immunosuppressive therapy than in general population :
(a) 10 times
(b) 25 times
(c) 50 times
(d) 100 times
16.55 Which is the most common gynaecologic malignancy in renal transplant patients ?
(a) Ovaries
(b) Cervix
(c) Vagina
(d) Fallopian tubes
16.56 The following statment are TRUE EXCEPT :
(a) Oral contraceptives constitude more risk to transplant patients than pregnancy
(b) For achieving permanent sterization tuballigation by laparoscope is the method of choice in
females
(c) In a pregnant transplant recipient. Azathioprime is not the preferred immunosuppressive
agent
(d) There is an increased incidence of rejection during pregnancy
Match the Following
16.57 Early disruption of vascular suture line (a) Sepsis
16.58 Left renal vein (b) Technical error
16.59 Delayed disruption of arterial suture vein (c) Shorter
16.60 Right renal vein (d) Longer

16.61 Sudden swelling and pain in the transplanted kidneys can be caused by all of the following
EXCEPT :
(a) Arterial thrombosis

(b) Renal vein thrombosis
(c) Acute rejection
(d) Total ureteral obstruction causing backpressure
Match the Following
16.62 Propranolol (a) Promotes sodium diuresis
16.63 Guanethidine (b) Beta blocker
16.64 Hydralazine (c) Smooth muscle relazant
16.65 Alpha methyl dopa (d) Ganglion blocker dopa
16.66 Frusemide (e) Produces a false neural transmitter
16.67 Which of the following qualities a urinary bladder must fulfill before it is adjudged to be
suitable for renal transplantation
(a) Adquate capacity

(b) Adequate detrusor contractility
(c) No outlet obstruction
(d) No residual urine
(f) A and C
16.68 Hyperacute rejection is caused by :
(a) Cellurlar rejection

(b) Humoral antibodies
(c) Both
(d) None
16.69 Patients undergoing pretransplant nephrectomy usually required more number of blood
transfuntions than patients who have not had their kidneys removed : this statement is
(a) False
(b) True
16.70 Which one of the following statement regarding tranplantation in diabetic patients is FALSE ?
(a) Chances to success are lower

(b) Mortality rates are higher
(c) Insulin requirment is doubed following tranplantation
(d) Patients mortality is higher following tranplantation as compaired to chronic hacmodialysis
16.71 Which of the following is a leading cause of death in tranplant recipients ?
(a) Urinary fitsula

(b) Anastomotic blow-cut
(c) Anaemia
(d) infection
(e) Cerebral stroke
16.72 Which of the following statement is FALSE ?
(a) A patient of angina pectoris is at a higher risk during chronic dialysis than after a successful
transplant
(b) Coronary artery bypass shouia antedate renal transplantation if the angina deteriorates
(c) A patient having myocardial infation during a dialysis programme can be taken up for renal
trasplantation
(d) Double tranplantation i.e. heart and renal transplant in a single individual cannot be done
16.73 In the post transplant patient, steroid therapy should never be instituted until sprecise
diagnosis of rejection has been made by either renal scan or renal biopsy : this statement is :
(a) True
(b) False
16.74 Acute rejection is characterised by all of the following signs and symptoms EXCEPT :
(a) Rising serum creatinine

(b) Falling urinary output
(c) Rising urinary sodium
(d) Fever and malaise
16.75 A successfully treated acute rejection episode is judged by all of the following parameters
EXCEPT :
(a) Decrease in size and tenderness of graft

(b) Increase in urinary output and urinary sodium
(c) Absence of jaundice
(d) Fall in serum creatinine
(e) Patient become afebrile
16.76 The ideal tranplant recipient is the patient who has received :
(a) Multiple blood transfusions and remains negative in his reaction towards a random panel of
lymphocystes
(b) Multiple blood transfusions and becomes moderately positive in his reaction towards donor
lymphocytes
(c) No blood transfusions at all
(d) Only third party blood transfusion
16.77 During blood transfusion, on the surface of which cells the foreign antigen which tend to
‘sensitize’ a individual are present :
(a) Red blood cells

(b) Lymhocytes
(c) Plasma
(d) Bone marrow
16.78 The ideal type of blood transfusion that could be given to a recipient prior to tranplantation
is :
(a) Reconstituted frozen red blood cells

(b) Whole blood
(c) Platelet concentrates
(d) Crystalloid colloid solutions
16.79 Which “full house” donor recipient combinations stands the best chance of success ?
(a) Parent sibling

(b) Sibling sibling
(c) Cadaver
(d) Unrelated living
(e) No difference as long as it is “fullhouse”
16.80 In chronic dialysis patients the risk of depression and suicide as compared to the general
population is :
(a) Same
(b) Less
(c) Slightly increased
(d) Very much increased
16.81 The commonest cause of proteinuria in a patient who is one year post-transplant is :
(a) Recurrent glomerulonephritis

(b) Chronic rejection
(c) Renal artery stenosis
(d) Partial ureteral obstruction causing hydronephrosis
16.82 Which of the following statement is FALSE regarding renal tranplant ?
(a) Pretranplant arteriogram in the recipient is a must

(b) In a live related donor having two renal arteries arising close together from the aorta, patch
of the aorta can be taken as it facitilies the recipient anastomosis
(c) The renal iliac artery cannot be used for the arterial anastomosis in the recipient
(d) Transplanted renal artery thrombosis gives rises to a tender and swollen kidney
(f) Only C and D
16.83 Cystomegalovirus lafection is common in the transplant recipient. All of the following
statements are true EXCEPT :
(a) It can occur because of reactivation of talent virus from blood transfusion
(b) Can occur from the renal graft from an infected donor
(c) Can lead to diminished graft funtion
(d) Reactivation of a previous infection is more harmfull than a primary cytomegalovirus
infection
16.84 Which among the following statements about cytomegalovirus infection in the transplant
patient are true ?
(a) It involves multiple organs

(b) During the acute phase the complement fixation titre is negative and becomes positive 3-4
week later
(c) Most likely souce is the reactivation of a latent endogenous virus
(d) Discontinuation of immunosuppressive agents is the most effective treatment
(f) A and D
16.85 In which of the following conditions, rejection episodes should NOT be treated :
(a) Major infection

(b) Juvenile diabetic
(c) Atherosclerotics with angina
(d) Periureteric leak
16.86 In which clinical conditions, immunosuppressive drugs should be immediately discontinued
and steroiuds reduced :
(a) Acute rejection

(b) Nocardia asteroides
(c) Cytomegalovirus
(d) Simultaneous occurence of B and C
16.87 Which of the following organism can cause opportunistic infection in the transplanted
recipient ?
(a) Pneumocystis carinii

(b) Nocardia asteroides
(c) Cytomegalovirus
(d) Simultaneous occurrence of B and C
16.88 A second of thrid rejection episode closely following the firsshould not be treated with drugs,
if the renal funtion has not be treated with drugs, if the renal funtion has not recovered
following the first course of therapy. This statement is :
(a) False
(b) True
16.89 Azathioprine and predisone therapy can be discontinued, if a siblingsibling, nonstimulating

mixed lymphocyte culture, HLA identical transplant recipient has not had any episode of
rejection, whatshoever till 1 year following transplantation : This statement is :
(a) False
(b) True
Match the Following
16.90 Transplanting organ from one site (a) Xenografts

to another in the same individual
16.91 Transplanting organs in identical twins (b) Allograft
16.92 Transplanting organs amoinngst members of (c) Autograft

the same species
16.93 Transplanting organs amongst members of (d) Isograft

different species
16.94 Azathioprine has been the mainstay of immunosuppression is renal transplantation. Which
one of the following statement is FALSE :
(a) It inhibitis the generation of cytotoxic T-cells

(b) Its dosage has to be reduced according to the severity of renal failure
(c) Dosage 3mg/kg/day
(d) It inhibits proliferation of immunocompetent cells as well as cause suppression of antigen
recognition
(e) Side-effects include infections, hepatitis, bonemarrow depression and malignancies
16.95 Amongst the following, which is the most active agent in inducing transplantation immunity :
(a) Prednisone
(b) Anti-lympcyte serum
(c) Azathioprine
(d) Cyclosporine
16.96 Total body irradiation, total lymphoid irradiation, local irradiation of graft, thymectomy etc,
are various methods of :
(a) Immunopotentiation
(b) Non-specific immunosuppression
(c) Specific immunosuppression
(d) Treunent of acute rejection
16.97 Antilymphocyte serum (ALS) contains antibodies against :
(a) Platelets
(b) Kidney
(c) Lymphocytes
(e) A and C only
16.98 Which is the single most common cause for loss of an allograft ?
(a) Rejection
(c) Anastomotic blow-out
16.99 What is the preferred method of lowering BUN prior to renal transplatation ?
(a) Temporary percutaneous nephrostomy

(b) Peritoneal dialysis
(c) Haemodialysis
(d) Ureteral catheterisation and drainage
17
UROTRAUMATOLOGY
17.1 Which of the following statement is FALSE regarding penetrating injuries of the kidney ?
(a) They can result from gun shot and stab wounds
(b) Injury due to high velocity missile is limited to the kidney only
(c) They are associated with high incidence of injury to other intraperitoneal viscera
(d) Exploratory laparotomy is indicated in most cases
17.2 Non-penetrating renal injuries can occur due to :
(a) Automobile accidents

(b) Blow to abdomen or flank
(c) Accidental falls
(d) Sudden violent twisting of the trunk
17.3 The following disease make the kidney more susceptible to injury EXCEPT :
(a) Hydronephrosis
(b) Renal tumors
(c) Renalcystic disease
(d) Congenital ingle kidney
17.4 The following physical findings suggest renal injury EXCEPT :
(a) Tendemess in the flank or upper quadrant

(b) Welling
(c) Contusion of the flank
(d) Pneumothorax
17.5 Which of the following statement is FALSE regarding haematuria along with renal injuries ?
(a) The presence of gross or microscopic blood in urine requires exclusion of renal injury
(b) The absence of haematuria excludes renal injury
(c) The degree of haematuria does not correlate with the extent of renal injury
(d) Contusion or minor cortical lacerations may produce gross haematuria
17.6 The following are postive findings on excretory urography in a case of acute renal injury
EXCEPT :
(a) Decreased excretion of contrast medium

(b) Obliteration of renal or psoas shadows
(c) Scoliosis of lubar spine
(d) Extravasation of contrast medium
(e) Contralateral compensatory hypertrophy
17.7 Which type of pyelogram is indicated in cases of renal injuries ?
(a) Lowdose pyelogram

(b) Rapid sequence pyelogram
(c) Highdose pyelogram
(d) High dose pyelogram with nephrotomography
17.8 The following indicates renal injury EXCEPT :
(a) Nonvisualised kideny on pyelogram

(b) Failure to delineate location and extent of injury
(c) Suspicion of pedicle injury
(d) Normal funtioning kidneys with normal pelvicalyceal system
17.9 Which of the following investigation is rarely indicated in evaluation of renal injury ?
(a) Intravenous pyelogram

(b) Retrograde pyelogram
(c) Radioisotope renal scan
(d) Renal angiogram
(e) CT scan
17.10 The treatment of contusion or swallow laceration of the kidney includes the following
EXCEPT :
(a) Bedrest
(b) Analgesics
(c) Broadspectrum antibiotics
(d) Nephrostomy
17.11 After how many weeks of contusion or swallow laceration of kidney, the patient may be
allowed to return to active work :
(a) 2
(b) 4
(c) 6
(d) 8
17.12 In how many percent of cases of non penetrating injuries of the kidney have contusion or
shallow cortical laceration ?
(a) 65%
(b) 75%
(c) 85%
(d) 95%
17.13 The following are the long term sequelae of conservative treatment of major renal cortical
laceration EXCEPT :
(a) Secondary haemorrhage

(b) Abscess formation
(c) Renal atrophy
(d) Hypertension
(e) Renal vein thrombosis
17.14 In which of the following operative procedure ureteric injury is most frequent :
(a) Wertheim’s hysterectomy

(b) Total hysterectomy
(c) Salpingo-oophrectomy
(d) Caesarean section
17.15 The presence of ureteral injury in the postoperality period is suggested by :
(a) Inordinate and unexplained abdominal pain

(b) Abdominal tenderness and mass
(c) Unexplained fever
(d) Leakage of urine per vagina or wound
17.16 Which of the following is unreliable in excluding surgical injury to the ureter ?
(a) Leakage of urine through vagina wound
(b) Abdominal tenderness and mass
(c) Absence of haematuria
(d) Inordinate and inexplained pain
17.17 The following are radiographic findings on exretory urography in ureteral injuries EXCEPT :
(a) Extravasation
(b) Hydronephrosis
(c) Nonvisualisation of kidney
(d) Delayed exeretion of dye
(e) Dilatation of ureter below injury
17.18 Which of the following is a contraindication for transureteroureterostomy ?
(a) Pesistent infection

(b) Existing calculus disease
(c) Urothelial malignancy
(e) A and C only
17.19 The technique of primary reanastmosis of the ureter includes the following EXCEPT ?
(a) Mobilisation of the ureteral ends

(b) Debridement of all damaged tissue
(c) Spatulation of the opposing ureteral ends
(d) Meticulous water tight reanastomosis
(e) Cauterization of cut ends of ureter
17.20 In which of the following situations, primary closure of ureteral injury is contraindicated :
(a) Active infection

(b) Tension on anastomosis
(c) Fibrosis
(d) Ischemia
17.21 Ureteral injury can be managed by the following EXCEPT :

(a) Ureteral stent
(b) Ureteral reimplantation
(c) Transuretero-ureterotomy
(d) Autotranplantation
(e) Partial nephectomy
17.22 Bladder injuries, secondary to blunt trauma, can result in :
(a) Contusion
(b) Extraperitoneal rupture
(c) Intraperitoneal ruptue
(e) B and C
17.23 In extraperitoneal rupture of bladder, extravasation will occur :
(a) Into the perivesical space

(b) Below the urogenital diaphragm
(c) Into the peritoneal cavity
(d) A and B
17.24 What percentage of cause of extraperitoneal rupture bladder are associated with fracture
pelvic ?
(a) 65%
(b) 75%
(c) 85%
(d) 95%
17.25 What percentage of cases of fracture pelvis will have extraperitoneal rupture of bladder ?
(a) 5%
(b) 15%
(c) 25%
(d) 35%
17.26 In intraperitoneal rupture of bladder, bladder usually ruptures at the :
(a) Dome
(b) Lateral wall
(c) Anterior wall
(d) Posterior wall
17.27 ‘Tear-drop’ deformity on cystogram is suggestive of :

(a) Compressio by pelvic haematoma
(b) Extraperitoneal rupture of bladder
(c) Intraperitoneal rupture of bladder
(e) B and C
17.28 Which of the following are principles in the management of rupture bladder ?
(a) Adequate urinary diversion

(b) Prompt adequate drainage of perivesical area
(c) Closure of defect if possible
17.29 Urethral rupture can occur due to all of the following EXCEPT :
(a) Blunt force

(b) Penetrating wounds
(c) Iatrogenic factors like instrumentation
(d) Spontaneous
17.30 What percentage of cases of intrapelvic rupture of urethra are associated with fracture
pelvis ?
(a) 60%
(b) 70%
(c) 80%
(d) 90%
17.31 Pendulous or bulbous urethral rupture permit extravasation within the confines of :
(a) Buck’s fascia

(b) Colle’s fascia
(c) Scarpa’s fascia
(d) Camper’s fascia
17.32 Bulbomembranous rupture of urethra results in urinary extravasation in the following EXCEPT:
(a) Within confines of colle’s fascla

(b) Within confines of dartos and scarpa’s fascia
(c) Anterior abdominal wall
(d) In to the pelvis
17.33 Which is the investigation of choice in a suspected case of urethral injury ?

(a) Retrograde urethrogram
(b) Intravenous urogram with micturating cystourethrogram
(c) Micturating cystourethrogram
(d) Cystopanendoscopy
17.34 Which of the following statement is WRONG about colle’s fascia ?
(a) It is deep to Buck’s fasica

(b) It attaches posteriorly at the triagular ligment
(c) It attaches laterally with the fascia lata at the inquinal ligament
(d) It continues anteriorly as scarpa’s fascua to the level of coracoclavicular fasica
17.35 Penile trauma can occur due to :
(a) Bullet wound

(b) Stab wound
(c) Avulsion power take of injuries
(d) Strangulation
17.36 Which of the following statement is FALSE regarding penile trauma ?
(a) Trauma usually affects one of its structural components

(b) The extent of extravasation of blood and urine is determined by the integrity of buck’s fasica
(c) If buck’s fasica has been violated the extravasation will extent to colle’s fascial attachement
(d) The portion of penis that is injured determines the type of repair required
18
ENDOUROLOGIC
SURGERY AND ESWL
18.1 Opposite which vertebra, the right renal pelvis lies on radio logical examination :
(a) D12
(b) L1
(c) L2
(d) L3
18.2 At which embryo stage, does the renal pelvis lie opposite 2nd lumbar vertebra :
(a) 5 mm
(b) 10 mm
(c) 13 mm
(d) 16 mm
18.3 All of the following factors hold the kidney in its position EXCEPT :
(a) Envelopong renal fascia

(b) Cascular connections
(c) Intra-abdominal pressure
(d) Adrenals
18.4 The normal amplitude of movement of kidney along with respiration is in order of :
(a) 1 cm
(b) 2 cm
(c) 3 cm
(d) 4 cm
18.5 Which of the following statement is FALSE regarding movement of kidney along with
respiration ?
(a) The amplitude of movement is variable

(b) The right kidney is more mobile than left
(c) The movement is more pronounced in men than in women
(d) A kidney transfixed by a percutaneous needle will convey this movement to the needle
which will clearly oscilate
18.6 Which of the following statement is WRONG about surgical the anatomy of the kidney ?
(a) The lower border 2 or less above the highest point of the iliac crest
(b) The projection of the right kidney is on the whole ½ lower
(c) The male kidney is lightly larger than the female kidney
(d) The right kidney is slightly larger than the left kidney
18.7 Which of the following statement is FALSE regarding anatomy of the minor calyces ?
(a) There are 7-13 minor calyces in the adult kidney

(b) The polar calyces are directed in one of the three planes : anterior, posterior or vertical
(c) The angle of the anterior calyces to the coronal plane of the kidney is more acute than
posterior calyces
(d) The anterior calyces are more haphazardly arranged than the posterior calyces
18.8 All of the following can cause pain during percutaneous renal surgery EXCEPT :
(a) Puncture of the capsule

(b) Dilatation of the track
(c) Distension of the pelvis
(d) Angling of the nephroscope
(e) Puncture of Gerota’s fascia
18.9 Following are the ideal characteristics of a percutaneous tract EXCEPT ?
(a) Direct
(b) Long
(c) Straight
(d) Of sufficient calibre
18.10 The following are the diagnostic and therapeutic applications of operative nephroscopy
EXCEPT :
(a) Residual stones

(b) Renal pelvis tumours
(c) Inflammatory space occupying lesions
(d) Vascular abnormalities
(e) Renal trauma
18.11 All of following are mechanical methods of stone disruption EXCEPT ?

(a) Ultrasound
(b) Electrohydraulic shock-waves
(c) Extracorporeal shock waves
(d) Laser
(e) Chemolysis
(f) Lithoclast
18.12 Ultrasound frequencies in clinical practice are measured in :
(a) Tens
(b) Hundreds
(c) Thousands
(d) Millions
18.13 The world LASER is an acronym for :
(a) Light amplication by stimulated emission of radiation

(b) Light amplitude by simulated emission of radiation
(c) Light amplication by simultaneous emission of radiation
(d) Light amplication by single emission of radiation
18.14 Which of the following LASERS are most commonly used in management of carcinoma
Bladder ?
(a) Ruby
(b) Co2
(c) Neon
(d) Nd-Yag
18.15 The Nd-Yag (Yittorium Aluminium Gamet) is which type of laser :
(a) Solid state crystal

(b) Liquid
(c) Gaseous
18.16 Which of the following statement is FALSE about Nd-Yag laser ?
(a) It has significant penetrating power

(b) It has significant coagulating power
(c) It is poor for cutting
(d) It is visible
18.17 Which of the following is CORRECT regarding management of staghorn calculus via
percutaneous route ?
(a) Longer operation time

(b) Multiple operative sessions
(c) Singnificant failure rate
(d) Greater chance of producing fluid absorption into the circulation
18.18 Which is the anaethesia of choice for one-stage percutaneous stone removal ?
(a) Local anaesthetic and sedation

(b) Epidural
(c) Spinal
(d) General
18.19 Which is the position of choice for percutaneous stone removal ?
(a) Prone-oblique
(b) Lateral
(c) Anterior-oblique
(d) Supine
18.20 Which is the irrigating fluid of choice for percutaneous stone removal ?
(a) Distil water

(b) Normal saline
(c) 5% dextrose
(d) Boiled water
18.21 Which of the following statement is FALSE regarding irrigating fluid for percutaneous stone
removal ?
(a) There is no need for urethral catheter

(b) Room temperature should be adjusted
(c) Large volume of cold irrigating fluid may cause significant cooling
(d) Intake-output chart should be maintained
18.22 Which is irrigating fluid of choice if diathermy is required during percutaneous renal surgery ?
(a) Distilled water

(b) Normal Saline
(c) Glycine
(d) 5% dextrose
18.23 Technique of stone manipulation during percutaneous renal surgery depends upon :
(a) Size and shape
(b) Position
(c) Number
(d) Chemical composition
18.24 The chance of mechanical extraction without fragmentation are good in in its largest diameter
the size of the stone is less than :
(a) 1.5 cm
(b) 2.0 cm
(c) 2.5 cm
(d) 3.0
18.25 Stone in upper 1/3rd of the ureter can be removed by :
(a) Open surgery

(b) Parcutaneous nephrostomy and antegrade removal
(c) Extra-corporeal shock wave lithotripsy
(e) A and B only
18.26 Which of the following is currently not recommended is the management of a calculous in the
middle 1/3rd ureter ?
(a) Open surgery

(b) Ureterorenoscopy and retro grade removal
(c) Percutaneous nephrostomy and antegrade removal
(d) Extra-corporeal shock were lithotripsy
18.27 Stone in lower 1/3rd of the ureter can be managed by :
(a) Open surgery

(b) Ureterorenoscopy and retro-grade removal
(c) Zeiss loop
(d) Extracorporeal shock wave lithotripsy
18.28 Which of the following is contraindicated in management of radiolucent ureteric calculi ?

(a) Open surgery
(b) Percutaneous nephrostomy and angegrade removal
(c) Ureterorenoscopy and retro grade removal
(d) Extracorporeal shock wave lithotripsy
18.29 Who was first to recognise the segmental distribution of the renal artery ?
(a) Brodel
(b) Graves
(c) Boyce
(d) Gilvermet
18.30 Which of the following is a problematic stone for management by extracorporeal shock wave
lithotripsy ?
(a) Calcium oxalate

(b) Calcium phosphate
(c) Calcium magnesium ammonium phosphate
(d) Cystine
18.31 Which of the following organ is most susceptible for injury due to shock waves ?
(a) Kidney
(b) Lung
(c) Liver
(d) Spleen
18.32 Which of the following is the treatment of choice for a 1.0 cm size radicopaque pelvic
calculous without distal obstruction ?
(a) Open surgery

(b) Percutaneous stone removal + ESWL
(c) Extracorporeal shock wave lithotripsy monotherapy
(d) Ureterorenoscopy and retro grade removal
18.33 The following are relative contraindications for management of calculous disease by
extracorporeal shock wave lithotripsy EXCEPT ?
(a) Children less than 100 cms tall

(b) Untreated bleeding disorders
(c) Gross obesity (weight more than 130 kgms)
(d) Solitary kideny
18.34 Which of the following anaethesia is desirable for second generation extracorporeal shock
wave lithotriptors ?
(a) Epidural
(b) General
(c) Local cutaneous and paravertebal
(d) High frequency jet ventilation
18.35 The following are complications of extracorporeal shock wave lithotripsy EXCEPT ?
(a) Colic
(b) Fever
(c) Residual fragincats
(d) Urinary fistula
18.36 Percutaneous nephrostomy is not indicated as a diagnostic manoeuver in the following

EXCEPT :
(a) Transitional cell carcinoma of the upper urinary tract

(b) Whitaker test
(c) Active renal tuberculosis
(d) Renal trauma
18.37 Which of the following is the most serious contraindication for percutaneous nephrostomy ?
(a) Uncorrected or uncontrolled bleeding disorder

(b) Kyphoscoliasis
(c) Obesity
(d) Allergy to contrast medium
(e) Terminal cancer
18.38 The structures within the retroperitoneum includes the following EXCEPT :
(a) The adrenal glands, kidney and ureter

(b) The descending transverse and ascending portions of duodenum and pancreas
(c) The gail bladder and common bile duct
(d) The great vessels and braches
(e) The ascending and descending colon
18.39 The perirenal space contains the following EXCEPT :

(a) Adrenal gland
(b) Kidney
(c) Lymphnodes
(d) Proximal ureter
18.40 The anterior calyces are now many degrees anterior to the frontal plane of the kidney
(a) 30
(b) 50
(c) 70
(d) 90
18.41 The posterior calysces are how many degrees posterior to the frontal plane of the kideny :
(a) 20
(b) 40
(c) 60
(d) 80
18.42 Which of the following renal segment is NOT supplied by the anterior division of renal artery ?
(a) Apical
(b) Upper
(c) Middle
(d) Lower
(e) Posterior
18.43 Opacification of collecting system for perutaneous nephrostomy can be obtained by delivery
of contrast material by :
(a) Retrograde ureteral catheter

(b) Intravenously
(c) Direct fine needle puncture of the renal pelvis
(d) Reflux from a urinary condult
18.44 What is the route of choice for contrast introduction into collecting system prior to puncture
for percutaneous removal of kideny stones ?
(a) Retrograde ureteral catheterization

(b) Intravenous
(c) Direct fine needle puncture of renal pelvis
(d) Rellux from a urinary conduit
18.45 In the presence of high grade upper urinary tract obstruction what is the route for
opacification for percutaneous puncture :

(b) Intravenous
(c) Direct fine needle puncture of renal pelvis
(d) Rellux from a urinary conduit
18.46 Which of the following route is NOT indicated for opacification for percutaneous puncture in
presence of impaired renal function ?

(b) Intravenous
(c) Direct fine needle puncture under ultrasound or flouroscopic guidence
(d) Reflux from a urinary condult
18.47 The following are the advantages of ultrasound guide fine needle puncture EXCEPT :
(a) The fluid dilated collecting system can be directly visualized without the need of contrast
agents
(b) The depth of the required tract to the kindney can be accurately meansured
(c) A safe route avoiding other abdominal organs can be ensured
(d) There is no radiation exposure to operators hand
(e) Nondilated ‘spidery’ collecting system can be easily pucnture
18.48 Which is the preferred calyx for a nephrostomy puncture ?
(a) Anterior
(b) Posterior
18.49 Which of the following is the reason for approach through a posterior calyx for a nephrostomy
puncture
(a) Acces through an anterior calyx results in to a more difficult angle between the nephrostomy
tract and the calyceal infundibulum
(b) The length of the tract tract through the renal parenchyma is minimized
(c) Posterior calyces are usually more medial then anterior calyces, this reduces the chance of
violation of organs in lateral relationshio to the kidney
18.50 Which of the following needle is preferred for percutaneous puncture ?

(a) Diamond tip
(b) Bevelled
18.51 The following are the advantages of dilating a percutaneous tract with balloon catheters
EXCEPT :
(a) Speed
(b) Reduced trauma to the tissues
(c) Less bleeding
(d) Reduced pain
(e) Inexpensive
18.52 Which are the dilators of choice for dilating scarred of fibrotic tissue ?
(a) Baloon catheter

(b) Semi rigid coaxial oilator
(c) Metal coaxial dilator
(d) Fole’s catheter
18.53 Which of the following is a safe intercostal puncture zone ?
(a) Lower half of the intercostal space

(b) Upper half of the intercostal space
18.54 What are the complications of intercostal puncture ?
(a) Accumulation of pleural fluid

(b) Pneumothoax
(c) Laceration of liver and spleen
18.55 The following may be indications for double puncture EXCEPT :
(a) Staghorn calculi

(b) Multiple calculi
(c) Duplex collecting sytem with stone in each division
(d) Single pelvic stone
(e) When initial nephrostomy was inappropriately placed
18.56 In which of the following double puncture is mandatory ?

(a) Staghorm calculi
(b) Multiple calculi
(c) Duplex collecting system with stone in each division
(d) Calyceal calculi
18.57 The double puncture technique presumably carries with it twice the risk for complications as
does a single nephrostomy puncture :
(a) True
(b) False
18.58 Following are the advantages of stone removal through teflon sheath EXCEPT :
(a) Intact stone of any size can be removed

(b) It provides repeated access to the collecting system
(c) Effects temponade of the tract
(d) Pevent loss of irrigating fluid in retroperitoneum
(e) Prevents build up of intrarenal pressure from irrigating fluid
18.59 Which is the irrigating fluid of choice for electrohydraulic lithotripsy ?
(a) Distilled wated

(b) Normal saline
(c) 1/7 Normal Saline
(d) Dextrose
18.60 What should be the minimum distance between the tip of the probe and the tip of the lense
during electrohydraulic disintegration ?
(a) 1 mm
(b) 2 mm
(c) 3 mm
(d) 5 mm
18.61 What should be the minimum distance between the tip of the probe and the stone during
electrohydraulic disintegraion ?
(a) 1 mm
(b) 2 mm
(c) 3 mm
(d) 5 mm
18.62 Following are the drawbacks of electrohydrolic lithotripsy for kidney stones EXCEPT :
(a) If the probe is accidenly discharged on the renal pelvic mucosa perforation or bleeding may
ensure
(b) Due to use of hypotonic solution, absorption of the fluid may lead to hyponatraemia and
haemolysis
(c) The system dose not allow for simulatenous distintegration and removal of stone
fragements
(d) Larger calculi can be distintegrated
18.63 Which is the funtion of nephrostomy catheter aftet percutaneous stone removal ?
(a) To drain collecting system

(b) To provide temponade of the tract
(c) To presserve assess to the kidney in case either further procedures are necessary or any
complications arise
18.64 Which type of catheter can be used after percutaneous stone removal ?
(a) Red rubber catheter

(b) Malecot’s catheter
(c) Ballon catheter
18.65 The following are the advantages of balloon catheter after percutaneous stone removal
EXCEPT :
(a) It is easy to introduce the catheter through the tract

(b) It can be used to temponade the bleeding site
(c) In obese patients it can be used to prevent catheter dislodgement
(d) In patients with intercostal puncture it can be used to prevent catheter dislodgement
secondary to rib motion with respiration
18.66 Which is the disadvantage of balloon catheter after percutaneous stone removal ?
(a) The balloon adds to the catheter profile and can make it difficult to introduce the catheter
through the tract
(b) The balloon may deflate and then dislodge
(c) There is risk of over distention and even reputuring a portion of the collecting system
18.67 Which catheter is commonly removed at the end of percutaneous stone removal ?
(a) Foley’s catheter
(b) Ureteric catheter
(c) Nephrostomy catheter
(d) Safety catheter
18.68 Post operative care after percutaneous stone removal invollowing EXCEPT ?
(a) Accurate monitoring of patients vital signs and urine volumes

(b) Monitoring of bleeding and clotting time every 6 hourly
(c) Observing the tubing for kinks or twisting
(d) Urine culture to check for urinary tract infection
18.69 Which of the following investigation is usually not necessary in the evaluation of essential
haematuria ?
(a) Urine analysis for RBC morphology and urine cytology

(b) Intravenous urography/ultrasound/CT scan
(c) Ureteronephroscopy
(d) Antegrade percunaneous nephroscopy
18.70 Which of the following statement is WRONG regarding ureterorenoscopy for the evaluation of
essential haematuria ?
(a) Avoid causing any latrogenic injury to the collecting system

(b) Prior placement of an indewelling ureteral stent
(c) Maintain a loow inflow pressure of irrigant
(d) Use of non ionic contrast material to outline collecting system
18.71 In case of essential haematuria, after basic radiographic and other diagnostic studies, which is
the most common lesion found during ureterorenoscopic exmination :
(a) Glomerulonephritis
(b) Papillary necrosis
(c) Pyelonephritis
(d) Vascular abnormalities like hemangioma or AV malformations
18.72 What is the appearance of the fungal mass on ureterorenoscopy ?
(a) Dull gray

(b) White gelatinous
(c) Bright red
(d) Dark red
18.73 Which is the most common cause of retroperitoneal urinoma ?

(a) Following renal trauma
(b) Secondary to ureteral obstruction
(c) Complication of an endosurgical procedure
(d) Calculus disease
In Relation to Endoicision for Management of Ureteric Stricture
Match the Following
18.74 Above the iliac vessel (a) Anterior
18.75 Directly overlying iliac vessel (b) Medially
18.76 Below the iliac vessel (c) posterolateral
18.77 Ureteral stones of which location can be treated by ESWL :
(a) Above the iliac crest

(b) Over the iliac crest
(c) Below the iliac crest
18.78 Successful disintegration of ureteral stones by ESWL in dependent upon the presence of an
expansion chamber. This statement is :
(a) True
(b) False
18.79 In comparision to native stones in the kidney the amount of necessary energery required for
disintegration of a ureteral stone pushed back into the kidney is :
(a) Same
(b) More
(c) Less
18.80 For successful ESWL disintegration of ureteral stones the aim is to create an expansion
chamber of at least :
(a) 3 Fr
(b) 4 Fr
(c) 5 Fr
(d) 6 Fr
18.81 In comparision to kidney stones for successful disintegration of ureter stones in presence of
adequate expansion chamber the amount of energy requir is :
(a) Same
(b) More
(c) Less
18.82 Success rate of ESWL disintegration of ureteral stones drops due to the following EXCEPT :
(a) Completely obstruting stones

(b) History of stone more than 6 weeks
(c) Stones containing calcium oxalate
(d) Stones treated in situ in the ureter
18.83 Which of the following group is considered a low risk to experience post-treatment
pyelonephritis following ESWL :
(a) Patients without history of infection a negative urinalysis and negative urine culture
(b) Patients without history of infection a postive urinalysis and negative culture
(c) Parients with history of infection a positive urinalysis and negative culture
(d) Parient without history of infection a positive urinalysis and positive culture
18.84 Which of the following statment is FALSE regarding treatment of infected stones by ESWL ?
(a) Treatment of infected stones is no longer a contraindication for ESWL

(b) They can be safely treated once approiate antibiotic treatment is initiated at least 24 hours
prior to ESWL treatment
(c) Incidence of post-treatment pyelonephritis is more if infection is present
(d) A patient presenting with obstruction ureteral stones assoctiated with infection can be
safely treated by ESWL alone
18.85 Treatment of coice for a patient presenting with obstruction ureteral stones associated with
infection is :
(a) ESWL monotherapy

(b) Appropriate antibiotic treatment for 24 hours followed by ESWL
(c) Ureteric catheterization followed by ESWL
(d) Percutaneous nephrostomy followed by antibiotic treatment and than ESWL
18.86 Which of the following statement is FALSE regarding treatment or radiolucent and semi opque
stones by ESWL under X-ray localization ?
(a) Uric acid stones cystine stones and fainly visible struvite stones are not primary indications
for ESWL
(b) They can not be readily localized with X-ray system
(c) X ray visualization is only possible after administration of contrast medium
(d) Fragmentation of these stones can be easily obtained
18.87 Which of the following statement is FALSE regarding management of Bilateral renal stones by
ESWL ?
(a) Symptomatic stone should be treated first

(b) Contralateral stone should be larger than symptomatic stone
(c) The contralateral stone should be less than 8mm in size
(d) The necessary number shock waves anticipated for successful disintegration be less than
1.000
18.88 Which of the following statement is FALSE regarding management of bilateral ureteral stones
by ESWL ?
(a) Bilateral ureteral stones can be treated in same session

(b) Only symptomatic stone can be treated in the 1st session
(c) After complete eradication of stone material contralateral should be treated in the 2nd
session
(d) Stones in presence of urinary tract infection should not be treated
18.89 Which of the following statement is FALSE regarding management of renal calculi in children
by ESWL ?
(a) The treatment is performed under general anaesthesia

(b) Because of close proximity of the pediatric kidney to the longs special measures are tkane to
protect lungs
(c) The energy used to disintegrate the stone is same as for adults
(d) Children eliminates the disintegrated material faster and with less problems
18.90 Which of the following is not a contraindication for ESWL monotherapy for renal stones
assoctiated with ?
(a) Untreatable bleeding disored

(b) Decompensated heart insufficiency
(c) Single functioning kidney
(d) Severe narrowing at any level of the urinary tract
(e) Pregnancy
18.91 In a pregnant lady with renal calculi disease following treatment option available EXCEPT :
(a) Conservervative treatment with analgesis and antibiotics
(b) Percutaneous nephrostomy under local anaesthesia if there is unmanageable pain or
imminent urosepsis
(c) Extra corporeal shock wave lithortipsy
18.92 Following recquired for evaluation of the ESWL patient EXCEPT :
(a) History and physical examination

(b) Family History of calculous disease
(c) Intravenous pyelogram not older than 3 months
(d) Urinalysis and urine culture
18.93 Following is required for preparation of the ESWL EXCEPT ?
(a) I.V. fluids infusion

(b) Plain X ray and ultrasound
(c) Carminatives
(d) CT scan
18.94 ECG triggering of the shock wave is linked to :
(a) Q wave
(b) R wave
(c) S wave
(d) T wave
18.95 Following are recquired for after care of ESWL patient EXCEPT :
(a) Immediate moblization

(b) Oral fluid intake
(c) Plain X ray and ultrasound
(d) Retrograde pyelogram
18.96 The following auxillary aids are used along with ESWL EXCEPT ?
(a) Percutaneous nephrostomy

(b) Double J stent
(c) Urethroscopy
(d) Ureteroscopy
18.97 Which of the following statement is correct regarding the management of staghorn calculi
with ESWL ?
(a) Initial PCN followed by ESWL

(b) ESWL followed by PCN
(c) Double J stent followed by ESWL

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1

1.2 A typical collecting duct drains about how many nephrons :

(a) 10-14 mm stage

1.5 Which is the level of origin of the renal blastema:

(a) Lower sacral segmen

1.8 By which week of gestation, trantitional epithelium is present in the ureter :

1.10 In which week of gestation, the glanural uretra appears :

1.11 By which week of gestation cowper glands are present :

(a) 20-22 weeks

(a) Leydig cell

1.14 After of the weeks of development, mullerian inhibiding substates (MIS) ?

1.15 Which of the following statement is false regarding mullerian duct?

1.16 Which is the deepest layer in the anterolateral abdominal wall ?

(a) Latissimus dorsi

(a) Serratus posterior inferior

1.18 The kidney a are :

(a) The are paired, reddish brown, solid organs

1.29 What is the usual length of the adult kidney ?

(a) 8-10 cms

1.30 What is the usual width of the adult kidney ?

(a) 3-5 cms

1.31 What is the average thickness of the adult kidney ?

(a) 140 gms

1.35 In case of congenital absennce of kidney. Gerota’s fascia is :

1.37 Which of the following statement regarding gerota’s fascia is incorrect :

(a) There is a separate compartment between renal and adrenal gland

(a) This is lemon yellow in colour

(a) Midlateral countour

(a) 1st lumbar vertebral body

1.41 Which is the first segment branch of the renal artery ?

(a) Left renal vein

(a) Superior border

1.47 Which segmental arteri has the most variable origin ?

1.48 The afferent arteriosles to the glomeruli are the branches of :

(a) Lobar arteries

1.50 The vasa recta are derived from :

(a) Afferent arteriole

(a) It leave aorta at slightly lower level-

(a) They ussually arise from aorta

1.53 As per scale. 1 F (freach) is equal to :

(a) The segmental artery was anatomosis with another artery

1.57 Approximately how many glomeruli are usually present within :

(a) 0,5 – 1 million

1.59 How many renal papillae are usually present in a kidney ?

1.60 Which of the following statement is FALSE ?

1.62 On an average, how many minor calyces are present :

1.63 In adults, the lenght of the ureter varies between :

(a) 10-24 cms

1.67 Which is the narrows part the ureter ?

(a) Uretero pelvic junction

1.68 Approximately, what is the normal diameter of the perviuretereric junction ?

1.69 Which is the intermost layer of muscle in the ureters ?

(a) Renal artery

1.72 The lymphatics of the ureter drain in to :

(a) Hypogastric lymhinodes

1.74 The reffered pain to ureteric colic is occasioned by the :

(a) lliotypogastric nerve (L1 or T12 and L1)