Urinary Stone (931/1700)

A pt had passed a 4mm stone in his urine. He has a 3mm stone in the renal pelvis found on US.
What is the management?
a. ESWL
b. None
c. Dormier basket
d. Surgery
e. PCNL

Small kidneys (1318/1700)

An elder man who has anorexia, prostate symptoms and HTN. There are small kidneys on US.
What is the dx?
a. Hypertensive renal disease
b. Prostate ca
c. BPH

Scrotal swelling (701/1700)

A 17yo boy while playing football got a kick and now he is complaining of severe pain and
swelling of the left side of his scrotum. What inv is the most appropriate to dx?
a. Needle aspiration of scrotum
b. US scrotum
c. MSU
d. Surgical exploration of scrotum
e. Urine test for hematuria

Painless hematuria (1614/1700)

 A 24yo man presents with painless hematuria. No other complaint and no abnormality is found on physical exam. What is the most appropriate initial inv which is helpful to get a dx?

a. Coag screening
b. MSU
c. Cystoscopy
d. MRI spine
e. Abdominal US

Renal Stone (1703/1700)

A 34yo man had a 4mm ureteric stone which he passed in urine. This time he presents withh
3cm stone in the right kidney. Single most appropriate treatment?

a. No treatment
b. ESWL
c. Laparotomy
d. Observe
e. Operative stone removal

Complication of TURP (556/1700)

A pt after transurethral prostatic biopsy. What electrolyte imbalance can he develop?
a. Hyperkalemia
b. Hyponatremia
c. Hypocalcemia
d. Hypernatremia
e. Hypercalcemia

Cause of fracture (554/1700)

A 72yo man brought to the ED with onset of paraplegia following a trivial fall. He was treated for
prostatic malignancy in the past. What is the single most probable dx?

a. Paget’s disease
b. Osteoporotic fx of vertebre
c. Secondary
d. Multiple myeloma
e. Spondylosis

Urinary Symptoms (482/1700)

A 25yo woman presents with urinary freq, dysuria and fever. Urine microscopy shows 20-50 RBC
and 10-20 WBC in each field. What is the most probable dx?
a. Schistosmiasis
b. Kidney trauma
c. Ureteric calculus
d. Bladder calculi
e. Cystitis

Recurrent UTI, Now Loin pain (528/1700)

A 29yo lady admitted with hx of repeated UTI now developed hematuria with loin pain. What is the most probable dx?
a. Acute pyelonephritis
b. Chronic pyelonephritis
c. UTI
d. Bladder stone

Frequency, dysuria, fever, loin pain (466/1700)

A 32yo woman of 38wks gestation complains of feeling unwell with fever, rigors and abdominal
pains. The pain was initially located in the abdomen and was a/w urinary freq and dysuria. The
pain has now become more generalized specifically radiating to the right loin. She says that she
has felt occasional uterine tightening. CTG is reassuring. Select the most likely dx?
a. Acute fatty liver of pregnancy
b. Acute pyelonephritis
c. Roung ligament stretching
d. Cholecystitis
e. UTI

Testicular pain (399/1700)

A child was woken up from sleep with severe pain in the testis. Exam: tenderness on palpation
and only one testis was normal in size and position. What would be your next step?

a. Analgesia
b. Antibiotics
c. Refer urgently to a surgeon
d. Reassurance
e. Discharge with analgesics

Risk factors for bladder cancer (368/1700)

A 39yo coal miner who smokes, drinks and has a fam hx of bladder cancer is suffering from BPH. The most important risk factor for his bladder carcinoma is?
a. Fam hx
b. Smoking
c. Exposure to coal mine
d. BPH

Acute abdominal pain (367/1700)

A 32yo woman has severe right sided abdominal pain radiating into the groin which has lasted for 3h. She is writhering in pain. She has no abdominal signs. What is the most likely cause of her abdominal pain?
a. Appendicitis
b. Ruptured ectopic pregnancy
c. Salpingitis
d. Ureteric colic
e. Strangulated hernia

Scrotal swelling (364/1700)

A 22yo sexually active male came with 2d hx of fever with pain in scrotal area. Exam: scrotal skin
is red and tender. What is the most appropriate dx?
a. Torsion of testis
b. Orchitis
c. Inguinal hernia
d. Epididymo-orchitis

Small sized kidneys, HTN, proteinuria (329/1700)

A man has a BP of 160/90mmHg, proteinuria++. KUB US are equally reduced in size with smooth
borders and normal pelvic calyceal system. What is the cause of HTN in the pt?

a. Chronic glomerulonephritis
b. Chronic pyelonephritis
c. Bilateral renal artery stenosis
d. Essential HTN
e. Polycystic kidney

Bag of worms swelling and flank pain (323/1700)

A 47yo man comes to the GP with a swelling in his left groin which disappears on lying down.
The swelling was bluish in color and felt like a bag of worms. He also complains of a mass in the
left loin along with hematuria occasionally. What could be the possible dx?
a. Left sided RCC
b. Varicosity 2nd to liver disease
c. Testicular tumor
d. UTI
e. IVC obstruction

Urinary incontinence (312/1700)

 A 58yo lady presented with urinary incontinence. She looks anxious for her condition. Urine
culture is sterile. Her urodynamic study is normal. What is the next step?
a. Antibiotics
b. Topical estrogen
c. Systemic estrogen
d. Duloxetine
e. Pelvic floor exercise

Testicular pain (311/1700)

A 15yo boy presents with testicular pain for 2days. There is no hx of trauma. Exam: temp=38.5C,
right hemi-scrotum tenderness. What is the single most appropriate management?

a. Give antibiotics
b. Give analgesia
c. Reassure
d. US scrotum
e. Exploratory surgery

Recurrent UTI's (308/1700)

What advice would you give for the parents of a child with repeated UTI?
a. Surgery
b. Prophylactic antibiotics
c. Increase fluids
d. Toilet training
e. Laxatives

Sarcoidosis and renal stones (303/1700)

 A 34yo African-caribbean man with a hx of sarcoidosis has presented with bilateral kidney
stones. What is the most likely cause for this pt’s stones?
a. Hypercalcemia
b. Hyperuricemia
c. Diet
d. Recurrent UTIs
e. Hyperparathyroidism