SVIMS 2012 Mch UROLOGY

1. the fine longitudinal smooth muscle fibers of ureter extending from ureteric orifices to internal urethral meatus
a. mercier bar
b. bell muscle
c verumontanum
d. internal sphincter

2. deep layer of trigone is formed by
a. longitudinal muscle of ureter
b. waldeyer sheath
c. outer longitudinal muscle of bladder
d. inner circular muscle of bladder

3. the structures seen at renal hilum from anterior to posterior
a. renal artery, renal pelvis, renal vein
b. renal artery, renal vein , renal pelvis
c. renal pelvis, renal vein, renal artery
d. renal pelvis, renal artery, renal vein

4. somatic innervation to the testis is provided by
a. ilioinguinal nerve
b. genital branch of genitofemoral nerve
c. perineal branch of pudendal nerve
d. none of the above

5. obstruction of calculus most common location
a. UPJ
b. UVJ
c. crossing of gonadal artery
d. at the crossing of iliac vessels
6. Tyson glands location?
a. external urethral meatus
b. internal urethral meatus
c. frenulum
d. membranous urethra

7. largest glandular zone in prostate
a. peripheral
b. central
c. transition
d. periurethral
8. gustov simon performed nephrectomy through which incision?
a. posterior
b. lumbar
c. thoraco abdominal
d. midline

9. meaning of “like a fall of leaf from tree”
a. gonorrhea
b. apoptosis
c. necrosis
d. ischemia

10. ‘glitter cells’ are
a. old leucocytes
b. oval fat macrophages
c. deformed RBC`S
d. freash leucocytes

11. best investigation to measure for GFR
a. Tc 99 DMSA
b. Tc 99 DTPA
c. Sr Creatinine
d. IVP

12. best investigation for visualisation of renal cortical scar
a. Tc 99 DMSA
b. Tc 99 DTPA
c. IVP
d. USG

13. first line investigation for a patient presenting with renal colic
a. USG
b. IVP
c. CT scan abdomen
d. MR urogram

14. 1F (french) equals to
a. 0.33mm in circumference
b. 3.3mm in circumference
c. 0.33mm in diameter
d. 3.3mm in diameter

15. a 44y old patient presented with right loin pain, fever with chills, on USG dilated collecting system, next step in the management includes
a. retrograde stenting
b. PCN
c. broad spectrum antbiotics
d. observation


16. at what age men will have more UTI than girls
a. <1yr
b. <2yr
c. after 15yrs
d. after 50yrs

17. in dysuric females significant bacteruria is defined as when colony count is more than
a. 100/ml
b. 1000/ml
c. 10000/ml
d. 100000/ml

18. largest epithelial cell in the body is present in
a. kidney
b. bladder
c. prostate
d. urethra

19. false regarding emphysematous pyelonephritis
a. caused by clostridium welchii
b. not seen in type1 diabetics.
c. H2 ,Co2 gases are formed
d. Obstruction is present in 25% of cases

20. following is not a factor in the etiology of XGP
a. nephrolithiasis
b. obstruction
c. infection
d. immunodeficiency

21. false about TB epididymitis
a. usually aquired through spread from vas diference
b. presents with acute scrotum
c. diagnosis is by culture of sinus discharge
d. not a primary site of genitor urinary tract TB

22. after ilio ingunal node dissection the area covered by
a. Adductor longus
b. Sartorius
c. Posterior thigh flap
d. Gracilis

23. distal urethral ca in males best managed by
a. partial penectomy
b. urethroscopic resection
c. radiotherapy
d. resection by laser



24. most common endocrine abnormality in infertility evaluation of males
a. decreased testosterone
b. increased FSH
c. decreased FSH
d. decreased testosterone and decreased FSH

25. a 35yr old patient presented to infertility clinic, on genital examination testis is normal, semen analysis shows azoospermia, on hormonal evaluation FSH levels are normal. next step in the evaluation includes,
a. vasography
b. TRUS
c. Testis biopsy
d. CFTR testing

26. good prognostic factor for vasovasostomy
a. small soft testis
b. presence of sperm granuloma
c. abscent scrotal straight vas
d. on aspiration thick, white, toothpaste like vassal fluid

27. complete absence of semen in ejaculate is called as
a. azoospermia
b. asthenospermia
c. aspermia
d. teratospermia

28. a patient presented with acidic semen ,low volume ejaculate, absent fructose, diagnosis
a. obstruction of vas
b. testicular atrophy
c. epididymal obstruction
d. EJDO

29. abscent vas is commonly associated with
a. abscent testis
b. renal agenesis
c. cryptorchidism
d. horseshoe kidney

30. first sign of puberty growth in males
a. appearance of pubic hair
b. breast enlargement
c. lengthening of penis
d. enlargement of testis

31. absolute contraindication for the use of PDEI
a. h/o coronary artery disease
b. h/o hypertension
c. present congestive heart failure
d. present use of nitrates

32. frontline investigation for vascular erectile dysfunction
a. duplex USG
b. combined intracavernous injection and stimulation
c. dynamic infusion cavernosography
d. pudendal artery angiography

33. high flow priapism is commonly caused by
a. trauma
b. sickle cell disease
c. antihypertensive drugs
d. idiopathic

34. egg plant deformity is seen in
a. pyronies disease
b. # penis
c. Rupture of urethra
d. Priapism

35. kidney size is decreased in all except
a. diabetes mellitus
b. renal artery stenosis
c. MCDK
d. Hypoplasia

36. how much % of normal GFR is regained after unilateral nephrectomy
a. 10 to 20%
b. 20 to 30%
c. 30 to 50%
d. 70 to 80%

37. a 7yr old child with stenosis at PUJ undergone open pyeloplasty . after 1yr he developed stricture at the same site. Now he is best managed by
a. endopyelotomy
b. laproscopic pyeloplasty
c. open pyeloplasty
d. nephrectomy

38. 1cm bulbar urethral stricture after truma best managed by
a. anastomotic urethroplasty
b. VIU
c. laser incision of the stricture
d. gradual dilatation

39. which of the following disease commonly recurres after renal transplantation
a. ADPKD
b. alport syndrome
c. primary oxaluria
d. renal dysplasia


40. RCC most commonly seen in
a. VHL syndrome
b. tuberous sclerosis
c. aquired renal cystic disease
d. birt hugh dube syndrome

41. Balkan nephropathy commonly causes
a. RCC
b. ureter tumors
c. bladder ca
d. prostate ca

42. nitric oxide precursor
a. arginine
b. citrulin
c. N2O
d. arachidonic acid

43. in pheochromocytoma ‘30% tumor’ applies to
a. adults.
b. children.
c. elderly
d. females

44. predominant muscurinic receptors mediating contraction of bladder
a. M1
b. M2
c. M3
d. M4


45. decreased compliance of the bladder seen in all except
a. neurogenic bladder
b. diabetes mellitus
c. BOO
d. PUV

46. a 36y old male came with recurrent voiding dysfunction.cystoscpy, clinical examination are normal ,no h/o fever, trauma, probable diagnosis is
a. bladder neck dysfunction
b. neurogenic bladder
c. ectopic ureter
d. fowler syndrome

47. Vincent curtsy sign is seen in
a. hypocontractile bladder
b. hyper contractile bladder.
c. hinman syndrome
d. prune belly syndrome

48. UMN/LMN lesions of bladder can be differentiated by
a. bethenichol test
b. ice water test
c. potassium sensitivity test
d. cystoscopy

49. normal voiding pressure in males
a. 10-20cm H20
b. 20-30cm H2O
c. 40-60cm H2O
d. 60-80cm H2O

50. CIC is first invented by
a. lapides
b. bradly
c. michell
d. demochowski

51. a female patient with h/o radiotherapy for carcinoma cervix is c/o incontinence with cough, the type of SUI she had
a. TYPE I
b. TYPE II
c TYPE III
d. TYPE IV

52. malignancy in bladder diverticulum doesn’t hav stage
a. T1
b. T2
c. T3
d. T4

53. intravesical BCG therapy is indicated in all exept
a. cis
b. multifocal ca
c. diffuse ca
d. invasive ca

54. most common cause of surgical ureteric injury
a. open abdominal hysterectomy
b. laproscopic hysterectomy
c. LSCS
d. vaginal hysterectomy

55. most common cause of VVF in developing countries
a. surgical injury
b. radiotherapy
c. malignancy
d. obstetric trauma

56. hyper parathyroidism causes which type of hypercalciuria
a. type1 absorptive
b. type2 absorptive
c. resorptive
d. renal leak

57. all of the following stones formed in acidic urine exept
a. ca oxalate
b. uric acid
c. cystine
d. phosphate

58. which of the following is not a indication of treatment of asymptomatic 4mm calyceal stone
a. pt with solitary kidney
b. women considering pregnancy
c. when the pt is a pilot
d. elderly pts

59. following stones difficult to fragment by ESWL except
a. uricacid
b. ca oxalate monohydrate
c. cystine
d. brushite

61. following lithotripsy has narrowest safety margin
a. EHL
b. LASER
c. Ballistic
d. Ultrasonic

62. infection stones commonly caused by all exept
a. Proteus
b. Serretia.
c. Klebsiella
d. Ecoli

63. after enterocystoplasty which of the following segment of bowel doesn’t cause metabolic acidosis
a. Stomach
b. Ileum
c. Jejunum
d. Sigmoid colon

64. best position for per rectal examination of prostate
a. supine
b. prone
c. left lateral
d. knee/elbow

65. 5-alpha reductase is not necessary for the development of
a. Acne
b. Hirsutism
c. BPH
d. Seminal vesicles

66. hormone neccessary for the development of external genitalia
a. DHT
b. Testosterone
c. LH
d. GnRH

67. which of the following is not a wolfian duct derivative
a. vas diference
b. epoopheron
c. prostatic utricle
d. gartner`s duct

68. which of the following not a indication of BPH surgery
a. PVR >150ml
b. Recurrent UTI
c. Bladder stones
d. Recurrent hematuria

69. during prostatectomy cavernosal nerves most likely to be damaged at
a. base
b. sides
c. apex
d. bladder neck

70. 5 bacteria / HPF equals to
a. 100/ml
b. 1000/ml
c. 10000/ml
d. 100000/ ml

71. how much % of early ca prostate patients have PSA values < 4ng/ml
a. 0
b. 15
c. 30
d. 60

72. after microsurgical inguinal dissection for varicocele the veins remained are
a. Pampiniform
b. Cremateric
c. Vasal
d. Testicular


73. a patient presented with LUTS, on examination there is 120g prostate and a 4cm bladder calculus. management of choice includes
a. open supra pubic prostatectomy
b. open retropubic prostatectomy
c. TURP
d. Perineal prostatectomy

74. false regarding ARPKD
a. due to mutation in chromosome 6
b. autosomal recessive mode of inheretence
c. presence of hepatic fibrosis
d. multiple cysts visualized on USG

75. most common malignancy arising from bladder diverticula
a. TCC
b. SCC
c. Adeno carcinoma
d. Sarcoma

76. a patient taking finasteride since 12months . now the PSA value is 7, what could be the PSA levels before starting this drug
a. 3.5
b. 14
c. 21
d. 49

77. horse shoe kidney most commonly associated with
a. Trisomy 18
b. Turner`s syndrome
c. MRHK syndrome
d. Tuberous sclerosis

78. most common histology of posterior urethral ca in females
a. SCC
b. TCC
c. Adeno ca
d. Verrucous ca

79. management of inguinal region in a patient with ca penis, T1G1 tumor and clinically negative nodes
a. ilioinguinal node dissection
b. modified inguinal node dissection
c. SLNB
d. Observation

80. verrucous ca of penis caused by which HPV types
a. 6, 11
b. 16, 18
c. 31, 33
d. 40, 45

81. FLOWER OF BOUQUET appearance on IVP is seen in
a. medullary cystic disease
b. multicystic dysplastic kidney
c. medullary sponge kidney
d. multilocular cyst

82. subcapsular hemorrhage with associated hypertension seen in
a. ASK-UPMARK kidney
b. LUMP kidney
c. `S` shape kidney
d. PAGE kidney

83. retrograde ejaculation commonly seen with
a. tamsulosin
b. terazocine
c. doxazocine
d. prazocine

84. on antenatal USG there is unilateral dilated system, management include
a. vesico-amniotic shunt
b. abortion
c. early CS
d. serial followup

85. false about PUV
a. type 1 is most common
b. type 2 most commonly causes obstruction
c. type 3 is due to incomplete dissolusion of urogenital membrane
d. type 4 is seen only in PB syndrome

86. false about VURD association
a. posterior urethral valves
b. vesico ureteral reflux
c. dysplastic kidney.
d. renal aplasia

87. all are components of PBS except
a. defective abdominal muscle
b. bilateral hydrouretero nephrosis
c. dilatation of bladder
d. presence of valves in posterior urethra

88. which of the following physical examination finding is important in patients with ambiguous genitalia
a. presence of hypospidias
b. length of penis
c. palpability of gonad
d. sacral dimple

89. hypospidiasis is rare in
a. male hermaphroditism.
b. CAH
c. pure gonadal dysgenisis
d. bilateral cryptorchidism

90. following suspected when there is transverse testicular ectopia
a. complete androgen insensitivity syndrome
b. peno scrotal disproportion
c. persistant mullarian ducts
d. 21 hydroxylase deficiency

91. chronic pyelonephitis is best diagnosed by
a. USG
b. IVP
c. CT scan abdomen
d. Tc 99 DMSA

92. androgen receptor gene located on
a. long arm of chromosome X
b. long arm of chromosomeY
c. short arm of chromosome X
d. short arm of chromosomeY

93. bulbo cavernous reflex can be elicited by all except
a. finger in the rectum
b. squeezing of glance
c. squeezing of clitoris
d. squeezing of scrotum

94. diagnosis of UTI is best made by
a. qualitative urine culture
b. quantitative urine culture
c. microscopic examination of urine for bacteria
d. clinical examination

95. bilateral renal agenesis, all are true except
a. incidence is more in males than females
b. complete ureteral atresia seen in 50% patients
c. abscent or hypoplastic bladder
d. abscent adrenal glands

96. most common type of megaureter
a. primary non obstructed
b. primary obstructed
c. secondary non obstructed
d. secondary obstructed



97. most common complication of TRUS biopsy
a. infection
b. bleeding per rectum
c. recto urethral fistula
d. hematospermia

[snip]. enterobacteraciae are
a. aerobic gram +ve
b. aerobic gram -ve
c. anaerobic gram +ve
d. anaerobic gram –ve

99. richest source of prostaglandins in the body
a. kidney
b. skeletal muscle
c. liver
d. seminal vesicles

100.following branch of renal artery is most variable in its origin
a. apical
b. middle
c. lower
d. posterior

NIMS 2011 mch urology paper

---

NIZAM’S INSTITUTE OF MEDICAL SCIENCES
Punjagutta, Hyderabad - 500 082, A.P., India.
Set: A

Question Booklet

Entrance Examination for Admission to MCh Urology

Subject MCh Urology


26 June 2011 Marks 90 Time: 01 hr : 30 min

• Please verify whether the number printed on this question booklet
corresponds to your hall-ticket number
• Please read the instructions on the OMR-Answer sheet carefully
• Each question in this booklet is followed by four alternative answers
Select the one that is most appropriate and darken the corresponding
Oval in the OMR-Answer sheet
• Please return this question booklet along with your OMR-Answer sheet
• Answer sheets not accompanied with the question booklets will not be
corrected
• Please identify the Set mentioned above in the appropriate place in the
OMR-Answer sheet.







1 of 22










Q1. A 65-year-old male is being worked up for invasive bladder cancer (T3, N1, and
M0). Regarding the optimum management of this case, which of the following statements
is true?

A) radical cystectomy with adjuvant chemotherapy
B) radical cystectomy with extended lymph node dissection (ELND)
C) Neoadjuvant chemotherapy with radical cystectomy
D) Neoadjuvant/adjuvant chemotherapy with radical cystectomy and ELND

Q2. All of the following statements are correct regarding uroflowmetry except
A) in men Qmax decreases with age where as in women it is not influenced by age
B) the voided volume should be at least less than 150ml
C) multiple flow rates be recorded to improve accurancy of the test
D) uroflowmetry alone is insufficient to diagnose bladder out flow obstruction
Q3. A woman aged 50 years who underwent renal transplantation 2 years earlier
presented with pain in the left hip joint. She was receiving prednisolone, azathioprine, and cyclosporin. Shown below is the radiograph of the hip joint.














The most appropriate line of management is

A) replacement of prednisolone with deflazacort
B) parathyroidectomy
C) treatment with calcitriol
D) hip replacement




2 of 22






Q4. All of the following drugs can cause urinary retention except
A) tricyclic antidepressants
B) anticholinergics
C) alpha - adrenergic receptor blockers
D) antihistamines

Q5. A patient with complete lesion of the spinal cord between spinal cord level T6 and S2 generally exhibits the following involuntary features
1. involuntary bladder contractions.
2. detrusor areflexia.
3. detrusor sphincter dyssynergia.
4. autonomic hyperreflexia
A) Only 1,2 and 3 are correct.
B) Only 1 and 3 are correct.
C) Only 2 and 4 are correct.
D) Only 4 is correct.
Q6. The most common renal vascular anomaly

A) supernumerary left renal artery
B) supernumerary right renal artery
C) supernumerary left renal vein
D) supernumerary right renal vein

Q7. Which one of the following procedures is recommended before resection of a large right-sided hepatocellular carcinoma?
A) left transarterial chemoembolization and left portal-vein embolization
B) left transarterial chemoembolization and right portal-vein embolization
C) right transarterial chemoembolization and left portal-vein embolization
D) right transarterial chemoembolization and right portal-vein embolization

Q8. According to the Center for Disease Control and Prevention (CDC) definition for surgical site infection in a surgery with an implant, the maximum time considered to define infection in a surgical implant is
A) 15 days
B) 30 days
C) six months
D) twelve months




3 of 22






Q9. Histologically renal ischemia is most damaging to

A) proximal tubular cells
B) distal tubular cells
C) glomeruli
D) blood vessels

Q10. The most common cause of fetal hydronephrosis is
A) vesicoureteric reflux
B) posterior urethral valve
C) megaureter
D) PUJ obstruction

Q11. In a male patient with a pelvic fracture due to blunt trauma, retrograde
urethrography demonstrates disruption of membranous urethra. Which one of the following constitutes the appropriate initial treatment
A) passage of transurethral catheter
B) suprapubic cystostomy
C) perineal urethrostomy
D) bilateral percutaneous nephrostomy

Q12. The shock wave during extracorporeal shock wave lithotripsy is timed to coincide with a particular point in the electrocardiogram (ECG) and occurs
A) at the peak of the P wave
B) 20 msec after the peak of the R wave
C) 200 msec after the peak of the R wave
D) at the peak of the T wave

Q13. Most common cause of acquired renal arterio-venous fistula

A) needle biopsy of kidney
B) renal trauma
C) renal surgery
D) renal cell carcinoma

Q14. The growth of which one of the following renal calculi is not affected by
manipulation of urinary pH
A) cystine
B) uric acid
C) calcium oxalate
D) ammonium magnesium phosphate



4 of 22






Q15. The number of ureteric constrictions along its course include
A) one
B) two
C) three
D) four
Q16. A 28-year old man presented with bilateral saddle anesthesia, prominent bowel and bladder dysfunction with relative preservation of muscle strength in the lower extremities. The most likely site of lesion is
A) cauda equina
B) peripheral neuropathy
C) lumbar segments (L3-L4) of the spinal cord
D) conus medullaris
Q17. In which of the following situations following a blunt trauma to abdomen will a CT imaging with contrast pick up significant renal injury

1. microscopic hematuria
2. microscopic hematuria with shock
3. urinary obstruction
4. gross hematuria

A) only 1, 2 and 3 are correct
B) only 1 and 3 are correct
C) only 2 and 4 are correct
D) only 4 is correct
Q18. What is the single most important preventive measure to control cross- infection
in hospitals.
A) use of gloves by health care workers
B) fumigation
C) prophylactic antibiotics
D) hand hygiene

Q19. All of the following are the indications for nephrectomy in a patient symptomatic
with genitourinary tuberculosis except
A) nonfunctioning kidney with calcification
B) nonfunctioning kidney without calcification
C) hydronephrosis due to PUJ stricture
D) extensive disease with hypertension





5 of 22






Q20. Shown below is the distribution of the laboratory test results in normal and two different disease states (disease 1 and disease 2).

Assertion: The laboratory test is more reliable to diagnose disease 1 than the disease 2 Reason : Test reliability decreases if test result values in diseased population overlap with those of the normal population













A) Assertion and Reason are correct and Reason is the correct explanation of the Assertion
B) Assertion and Reason are correct and Reason is not the correct explanation of the Assertion
C) Assertion is true and Reason is false
D) Assertion is false and Reason is true

Q21. A 3-day old infant presented with gross hematuria. The child was born at 31 weeks of gestation by Cesarean section with meconium contamination. Examination revealed dehydrated child with unilateral palpable flank mass. The most probable
clinical diagnosis is

A) Wilm's tumor
B) infantile polycystic kidney disease
C) neuroblastoma
D) renal vein thrombosis

Q22. Which one of the following anatomical zones most commonly gives rise to benign prostatic hyperplasia
A) central zone
B) peripheral zone
C) transition zone
D) anterior fibromuscular stroma





6 of 22






Q23. Which one of the following is the treatment of choice in children with normal renal function, mild bilateral hydronephrosis, and posterior urethral valves

A) primary endoscopic valve fulguration
B) percutaneous nephrostomy
C) vesicostomy
D) bilateral ureterostomy

Q24. A new serum marker that increases in a particular disease state is being evaluated. The graph below depicts the relationship between sensitivity and false positive rate for different cut-off values for the marker concentration in the serum.




















Assuming that both correct diagnosis and ruling out the disease are equally important clinically, which one of the values represents the appropriate cut-off value
A) 200
B) 5
C) 75
D) 50

Q25. The principal mechanism for moving spermatozoa through the epididymis is

A) contraction of the cells around the epididymal duct
B) inherent spermatozoal mobility
C) movement of rete testis fluid
D) movement of cilia



7 of 22






Q26. Lumbodorsal fascia connects anteriorly with

A) transversalis fascia
B) transversus abdominis muscle
C) internal oblique muscle
D) external oblique muscle

Q27. During developmental process of nephron, the ability to concentrate the urine reaches an adult value at the age of about
A) 8 months
B) 18 months
C) 48 months
D) 60 months
Q28. Which one of the following regimens is correct for basiliximab administration in renal transplantation










A) regimen 1
B) regimen 2
C) regimen 3
D) regimen 4

Q29. Which is safe and effective energy available today to fragment renal stones?

A) Pnuematic lithotripsy
B) Ultrasound lithotripsy
C) Laser lithotripsy
D) Electrohydraulic lithotripsy.










8 of 22






Q30. The cell of origin of renal cell carcinoma is

A) proximal convoluted tubule
B) loop of Henle
C) distal convoluted tubule
D) collecting duct

Q31. Which of the following is commonly associated with the syndrome shown in the following clinical photograph























A) ureterocele
B) tethered cord syndrome
C) undescended testes
D) hypospadiasis












9 of 22






Q32. Which one of the following types of exstrophy of the urinary bladder depicted in the diagrams below is most suitable for functional closure































A) diagram 1
B) diagram 2
C) diagram 3
D) diagram 4
Q33. To suspect ejaculatory duct obstruction, in a azoospermic man, all the following
findings are necessary except
A) both vas should necessarily be palpable
B) low semen volume
C) acidic semen pH
D) low semen fructose


10 of 22







Q34. Regarding diagnosis of inflammatory carcinoma of breast

Assertion: It is best done by biopsy of breast lump
Reason: There is extensive involvement of dermal lymphatics
A) Both Assertion and Reason are true, and Reason is the correct explanation for Assertion
B) Both Assertion and Reason are true, and Reason is not the correct explanation for Assertion
C) Assertion is true, but Reason is false
D) Assertion is false, but Reason is true


Q35. 25 year old male presents with primary infertility. On examination secondary
sexual characters are well developed, bilateral vasa are present and testis are normal.
Semen analysis reveals azoospermia. Which investigation is required next for further
evaluation.
A) vasography
B) serum FSH
C) testicular biopsy
D) serum testosterone

Q36. In a carcinoma rectum, the contraindication to anterior resection of rectum is
A) age >60 years
B) poorly differentiated histology
C) sigmoid lymphnodes
D) single hepatic metastasis
Q37. A 26 year old man is investigated for infertility associated with a low sperm count. Plasma FSH and LH are elevated with low testosterone level.Which of the following statements is/are correct?

1. A history of mumps may be relevant to his problem.
2.Testosterone concentration will increase on administration of clomiphene.
3. Data are consistent with primary testicular failure.
4. The presence of a pituitary tumour secreting gonadotrophins explains the data.
A) only 1,2 and 3 are correct
B) only 1 and 3 are correct
C) only 2 and 4 are correct
D) only 4 is correct





11 of 22






Q38. Predictor/predictors of urosepsis following percutaneous nephrolithotomy

1.midstream clean catch
2. renal pelvic urine culture
3. bladder urine culture
4. stone culture

A) only 1,2 and 3 are correct
B) only 1 and 3 are correct
C) only 2 and 4 are correct
D) only 4 is correct

Q39. In the analysis of evidence for efficacy of therapy, highest weightage is given to

A) randomised controlled clinical trials
B) systematic reviews
C) cohort studies
D) meta-analysis
Q40. The ureter gets its blood supply from which of the following artery/ateries

1. common iliac artery
2. internal iliac artery
3. middle rectal artery
4. inferior vesical artery
A) only 1, 2 and 3 are correct
B) only 1 and 3 are correct
C) only 2 and 4 are correct
D) only 4 is correct

Q41. Management of renal abscess less than 3cms

A) observation
B) intravenous antibiotics and observation
C) USG / CT guided percutaneous drainage
D) open surgical drainage

Q42. Most effective long term treatment for post-prostatectomy incontinence secondary to sphincter dysfunction is

A) artificial urinary sphincter
B) urethral bulking agents
C) pharmacotherapy
D) bio feedback and pelvic floor exercises



12 of 22






Q43. Radionuclide used for the treatment of bone metastasis is
A) technetium - 99
B) yittrium - 90
C) strontium - 89
D) Indium-111
Q44. A patient with bronchial asthma on bronchodilator therapy is scheduled for
laparotomy. The most suitable pulmonary function test to assess improvement in lung function is
A) forced vital capacity
B) total lung capacity
C) peak exporatory flow rate
D) maximum breathing capacity

Q45. The following drugs are used in Renal cell carcinoma

1. Sorafenib
2. Sunitinib
3. Temsirolimus
4. Dasatinib

A) Only 1,2 and 3 are correct
B) Only 1, and 3 are correct
C) Only 2 and 4 are correct
D) Only 4 is correct

Q46. The interlobular artery in the kidney arises from
A) segmental artery
B) lobular artery
C) interlobar artery
D) arcuate artery
Q47. A 10-month old girl was admitted with high grade fever associated with recurrent urinary tract infection. On the right side, ultrasound scanning revealed a duplex moiety with hydroureteronephrosis and ureterocele of the upper moiety with internal echos. Left kidney was normal. Immediate treatment of choice
A) percutaneous nephrostomy of the upper moiety
B) cutaneous ureterostomy
C) heminephroureterectomy of the upper moiety
D) endoscopic decompression of ureterocele




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Q48. Muscles (1,2 and 3) related to the posterior surface of right kidney in the diagram shown below represent which one of the following respectively

























A) psoas major, quadratus lumborum, transversus abdominis
B) transversus abdominis, psoas major, quadratus lumborum
C) psoas major, transversus abdominis, quadratus lumborum
D) transversus abdominis, quadratus lumborum, psoas major

Q49. A 17-yr old boy is admitted to the hospital after an automobile accident. Except for a quiet abdomen, he has no localizing physical findings. After receiving 2000 mL of lactated Ringer's solution intravenously, his pulse rate is 90 beats per minute and blood pressure 110/70 mmHg. Abdominal CT scan reveals a laceration of the left lobe of the liver extending from the dome more than halfway through the parenchyma. Appropriate mangement at this time would be

A) bed rest and observation
B) abdominal exploration and ligature of intrahepatic blood vessels
C) abdominal exploration and packing of the hepatic wound
D) abdominal exploration and left hepatic artery ligation




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Q50. A kidney transplant recipient on multiple immunosuppressive drugs develops leukopenia. Which of the following is least likely to be the culprit drug
A) sirolimus
B) mycophenolate mofetil
C) azathioprine
D) tacrolimus

Q51. The findings of increased FSH level, normal LH and normal testestorone are suggestive of
A) isolated spermatogenic failure
B) post vasectomy
C) testicular failure
D) hypoganodotropic hypogonadism
Q52. Which one of the following drugs used in the management of prostatic cancer is an androgen receptor antagonist

A) goserelin
B) flutamide
C) finasteride
D) leuprolide

Q53. In endopyelotomy for PUJ obstruction, the recommended site of incision is
A) medial
B) anterior
C) lateral
D) posterior
Q54. Regarding flaccid state of the penis
1. smooth muscles are relaxed
2. smooth muscles are tonically contracted
3. arterial flow is significant
4. arterial flow is minimal
A) only 1, 2 and 3 are correct
B) only 1 and 3 are correct
C) only 2 and 4 are correct
D) only 4 is correct
Q55. Urine sample is not a midstream collection if there is presence of
A) Pus cells of 3 per high power field
B) Presence of corynebacteria
C) Presence of squamous epithelium
D) Presence of lactobacilli specially in females.




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Q56. Essential clinical evidence of brain death

1.unresponsiveness to all forms of stimuli
2.absent pupillary reaction
3.positive apnea test
4.absent deep tendon reflexes

A) only 1, 2 and 3 are correct
B) only 1 and 3 are correct
C) only 2 and 4 are correct
D) only 4 is correct

Q57. Anal incontinence will result from division of

A) the first sacral nerve roots bilaterally
B) the second sacral nerve roots bilaterally
C) the third sacral nerve roots bilaterally
D) the fourth sacral nerve roots bilaterally

Q58. The role of microbial biofilm in pathogenesis of infections

1. provides protection against epithelial adherence by microbes
2. conisists of many cells and polysaccharides
3. is important in microbial shedding from host
4. contributes to drug resistance of microbes

A) only 1, 2, and 3 are correct
B) only 1 and 3 are correct
C) only 2 and 4 are correct
D) only 4 is correct

Q59. BRCA-1associated breast cancer is most often associated with which of the following characteristics
A) infiltrative lobular cell type
B) her2/neu overexpression
C) well differentiated histology
D) hormone receptor negative
Q60. The avascular plane in the kidney runs

A) anterior to the anterior calyces
B) posterior to the anterior calyces
C) anterior to the posterior calyces
D) posterior to the posterior calyces


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Q61. Regarding renal cell carcinoma,

Assertion: There is little evidence of immune response to tumor cells
Reason: Tumor cells do not express specific tumor associated antigens on cell surface
A) Both Assertion and Reason are true, and Reason is the correct explanation for Assertion
B) Both Assertion and Reason are true, and Reason is not the correct explanation for Assertion
C) Assertion is true, but Reason is false
D) Assertion is false, but Reason is true


Q62. The anterior urethra receives dual blood supply from
A) circumflex and cavernosal arteries
B) bulbar and dorsal artery of the penis
C) bulbar and circumflex arteries
D) cavernosal and bulbar arteries

Q63. Ability of sperm to fertilize the ova in humans is acheived maximally in
A) testes
B) proximal corpus of epiddidymis
C) distal corpus of epididymis
D) ductus deferens

Q64. Which of the following is the most essential interaction molecule for T cell activation?

A) CD4/CD8 molecule
B) CTLA 4 (CD52)/B7
C) CD28/B7
D) CD19/CD20

Q65. Which of the following malignancies has a high risk of recurrence after renal transplantation?
A) basal cell cancer
B) testicular cancer
C) thyroid cancer
D) myeloma
Q66. All types of primary neoplasms metastasize to the liver except those arising from

A) Lung
B) Brain
C) Gastrointestinal tract
D) Melanomas


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Q67. Keyhole sign in the fetus during antenatal ultrasonography is diagnostic of

A) hydronephrosis
B) hydroureteronephrosis
C) medullary pyramids
D) posterior urethral valves

Q68. A 12 year old boy presented with fresh bleeding per rectum. Colonoscopy
revealed a pedunculated single rectal polyp-1cm in diameter with a smooth and glistening surface. This type of rectal polyp would be

A) tubulovillous adenoma
B) inflammatory pseudopolyp
C) lymphomatous polyp
D) juvenile polyp
Q69. All of the following statements regarding postvoid residual (PVR) urine volume
associated with BPH are true except
A) residual (PVR) urine volume measurement has significant intraindividual variability
B) PVR does not correlate well with other signs or symptoms of prostatism
C) PVR can be measured with sufficient accuracy by ultrasound scanning
D) increased PVR indicates impending damage to bladder and kidneys
Q70. Most of the women who develop pyelonephritis in pregnancy, acquire it during

A) first month of pregnancy
B) first trimester of pregnancy
C) second trimester of pregnancy
D) third trimester of pregnancy

Q71. A 30 year male presented to emergency with acute right loin pain radiating to
groin of 2 hrs duration. What is your choice of investigation to manage this case
A) plain X-ray KUB
B) ultrasonography of the abdomen
C) unenhanced CT
D) MRI









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Q72. In the treatment of lower calyceal stones by extracorporial shock wave lithotripsy (ESWL), all of the following factors are important except

A) infundibulopelvic angle
B) position of the patient
C) lower calyceal pattern
D) infundibular diameter

Q73. An obese woman aged 50 years presenting with grade III stress urinary
incontinence, of the surgical procedures listed below, the preferred method is

A) tension free vaginal tape (TVT)procedure
B) tension free vaginal trans obturatory tape (TOT)
C) Gittes Bladder neck suspension
D) anterior colporrhaphy
Q74. Components of seminal vesicle secretion includes all of the following except

A) D-fructose
B) prostaglandin-A
C) Ig A antibodies
D) prostaglandin-E

Q75. The mechanism of action of sildenafil citrate is through
A) inhibition of type II alpha reductase
B) nitric oxide /cyclic GMP pathway
C) local release of endothelins
D) inhibition of cytochrome P-450 enzyme
Q76. The normal volume of renal pelvis and calyces is not more than
A) 0.8 mL
B) 8.0 mL
C) 80 ml
D) 800 mL
Q77. Urine production in the fetus of human kidney is known to begin at about
A) 10-12 weeks
B) 14-16 weeks
C) 20-22 weeks
D) 24-26 weeks







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Q78. Spastic bladder can be treated with

A) tizanidine
B) oxybutynin
C) bethanechol
D) baclofen

Q79. In a patient with chronic renal failure, renal ultrasound showed the presence of a
more than one cm difference in kidney size.The etiology of the renal disease could be
1. diabetes
2. ureteric reflux
3. amyloidosis
4. fibromuscular dysplasia
A) only 1, 2 and 3 are correct
B) only 1 and 3 are correct
C) only 2 and 4 are correct
D) only 4 is correct

Q80. The cuff of an endotracheal tube should be inflated to what pressure to prevent aspiration while not causing ischemia to underlying laryngeal mucosa

A) 5 mm Hg
B) 20 mm Hg
C) 40 mm Hg
D) 60 mm Hg
Q81. The concept of urethral plate 'relaxing incision' as an adjunct to hypospadias repair is used in
A) Snodgrass's TIP urethroplasty
B) MAGPI
C) Duckett's preputial island flap
D) Mathieu's perimeatal based flap

Q82. On T1 weighted MRI images, fluid appears
A) bright
B) dark
C) not seen
D) variable








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Q83. The parotid salivary gland receives its parasympathetic innervation from which one of the following nerves

A) Vagus
B) Facial
C) glossopharyngeal
D) oculomotor

Q84. All of the following are the requirements for fluids suitable for irrigation during transurethral resection of the prostate except

A) clear to vision
B) capability of conducting electricity
C) isotonic
D) nonhemolytic
Q85. End-stage testes are seen in

A) bilateral cryptorchidism
B) maturation arrest
C) Young's syndrome
D) Klinefelter's syndrome

Q86. Which one of the following drugs used in the treatment of human immunodeficiency virus infection is known to cause urolithiasis
A) zidovudine
B) lamivudine
C) indinavir
D) stavudine

Q87. The following are true in development of human kidney

1. the kidney derives from the intermediate endoderm
2. the ureteric bud developes as an outgrowth of the Wolffian duct
3. cells of the pre-tubular aggregates undergo epithelial-to-mesenchymal conversion to become renal vesicle
4. the renal vesicle forms the glomerulus and tubule from the proximal convoluted tubule to the distal convoluted tubule
A) only 1,2 and 3 are correct
B) only 1 and 3 are correct
C) only 2 and 4 are correct
D) only 4 is correct




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Q88. A 45-year old man presented with raised renal parameters six weeks after renal transplantation. Ultrasound examination revealed a large lymphocele compressing the graft ureter with hydroureteronephrosis. The next line of management

A) percutaneous catheter drainage
B) double "J" stenting of the graft ureter
C) percutaneous nephrostomy
D) laparoscopic deroofing of the lymphocele
Q89. Which one of the following diagrams depicted below represents the correct nephrotomy incision (dashed line)





















A) diagram 1
B) diagram 2
C) diagram 3
D) diagram 4
Q90. In male infertility, indication for endocrinal evaluation includes

A) absent ejaculation
B) asthenospermia
C) sperm density between 5-10 million per ml
D) maturation arrest