JIPMER 2012 Mch urology

1.which of the following is false about molecular biology ?
a. splicing: the removal of introns(spliced out) and the connection of
exons(spliced together) in mRNA
b. telomere: an essentiall structural molecule of chromosome consisting
of repitative noncoding DNA and associated telomere specific
binding proteins that cap and stabilise the chromosome
c. transcription: synthesis of RNA on DNA template
d. transfection: synthesis of proteins from mRNA template

2. the charecteristics of synthetic biomaterials used in the reconstruction
of genitourinary tract include
a. rapidly biodegradable
b. greater surface area to volume ratio
c. not affected by pore size
d. inhibiting tissue fibrous ingrowth


3. which of the following is false about bladder pain syndrome(BPS) or
Interstitial cystitis?
a.female to male ratio 5:1
b.fluctuating course of disease without longterm sequele
c. no effect on pregnancy outcome
d.the disease seen at younger age in males and hunners ulcer seen more
commonly in males


4. gerota’s fascia opens
a.superiorly
b.inferiorly
c.medially
d.laterally

5. seminal vesicles contributes -----% of semen volume?
a. 40%
b. 30%
c. 70%
d. 80%

6. sex steroids are secreted by which layer of adrenal cotex?
a. zona glomerulosa
b. zona fasciculate
c. zona reticularis
d. zona vasculosa
7. in prostate glandular volume contributes what % of total volume?
a. 30%
b.40%
c. 60%
d. 70%

8. renal arteries arises at the level of?
a. T12
b. L1
c. L2
d. L3

9.what % of bladder wall is composed of collagen ?
a. 50%
b. 60%
c. 30%
d. 20%


10. latent pacemaker cells are present in?
a. upper ureter
b. middle ureter
c. lower ureter
d. all of the above

11. retroperitoneal fibrosis is idiopathic in ?
a. 30%
b. 50%
c. 70%
d. 90%

12.anti proliferative factor (APF) is a marker of ?
a. acute prostatitis
b. neurogenic bladder
c. interstitial cystitis
d. bladder cancer

13. the segment of kidney most variable in origin of its blood supply?
a. apical
b. middle
c. lower
d. posterior

14.intra operatively ureter can be identifided as it enters the pelvis
a. at the superior border of sacrum
b.at the crossing of uterine artery
c. over the common iliac artery where internal iliac artery arises
d. at the aortic bifurcation


15. following drugs are contraindicated during pregnency except?
a.floroquinolones
b.cefaclor
c. chloramphenicol
d. tetracyclins

16. a man who is evaluated for sexually transmitted disease
(STD) is unlikely to have chlamyda infection if exposure to sexual
partener is more than
a. 15days
b. 30days
c. 45days
d. 60days

17. Reiter’s syndrome includes all except
a. prostatitis
b. urethritis
c. Conjunctivitis
d.arthritis

18. hematospermia commonly due to
a. trauma
b. malignancy of seminal vesicles
c.tuberculosis of prostate,seminal vesicles
d. non specific inflammation of prostate, seminal vesicles

19. normal levels of daily protein excretion in adults
a. 50 – 80 mg
b. 80 –150mg
c. 100—200mg
d. <50 mg

20. which of the following best describes the function of thin descending
loop of nephron
a. impermeable to water, slightly permeable to Na, Cl
b. permeable to water, impermeable to Na, Cl
c. impermeable to water, highly permeable to Na, Cl
d. impermeable to water and Na , Cl

21. which of the following procedure has highest failure rate in the
treatment of UPJ obstruction?
a. ballon dilatation
b. antegrade incision of UPJ
c. retrograde laser ureterotomy
d. retrograde ureteroscopic incision of UPJ

22.true about retrocaval ureter
a. it is due to persistence of anterior cardinal vein in the
retroperitonium
b. “S” shape deformity on retrograde pyelography is diagnostic
c. definitive diagnosis can be made by IVU
d. surgery is not indicated in all the cases

23. false about angiotensinogen
a. it is a 452 aminoacid protein
b. functions as serine protease inhibitor similar to alfa-1 antitrypsin
c. liver is the primary site of storage where it is synthesised
d. estrogen and glucocortcoids increases the angiotensinogen levels in
the blood

24.following reagent is used for the detection of protein on urinary
dipstick test?
a. peroxidise
b. red azo dye
c. indoxyl
d. tetrabromophenol blue

25. stage of CKD when GFR is 26ml/1.73m/min
a. stage 2
b. stage 3
c. stage 4
d. stage 5

26. leucocyte esterase test depends on
a. double oxidative reaction
b.oxidation of diazonium salt by indoxyl
c. diazotisation to form red azo dye
d. calorimetric reaction with sodium nitroprusside

27. SI unit of absorbed dose of radiation?
a. gray
b. roentgen
c. sieverts
d. rads

28. false about acute interstitial nephritis (AIN)
a. clinical picture although variable usually involves abnormal urinary
sediment
b.renal biopsy is not usually required for the confirmation of diagnosis
c.most common cause of granuloma formation is sarcoidosis
d. nephrotic range proteinuria is frequently seen in AIN due to
NSAID`S

29. most commonly used transducer in TRUS
a. 2Mhz
b. 3Mhz
c. 5Mhz
d. 7Mhz

30.in the treatment of hyperkelemia which of the following doesn`t alter
the serum K+ levels
a.insulin + glucose
b.sodium bicarbonate
c.calcium gluconate
d.nebulised albuterol

31.adult effective dose of radiation who exposed to CT KUB without and
with contrast
a. < 0.1 msv
b. 0.1 to 1 msv
c. 1 to 10 msv
d. 10 to 100 msv

32. following is not a mechanism of action of idiosyncratic anaphylactoid
reactions due to intravascular iodinated contrast media
a. release of vasoactive substances including histamine
b. activation of physiologic cascades including complement, kinin,
coagulation, and fibrinolytic systems
c. activation of cholinesterase
d. patient`s anxiety

33. treatment regimen for uncomplicated cystitis in asymptamatic adult
women
a. 3 days
b. 5 days
c. 7 days
d. 10 days

34. which of the following is false when Tc 99-DMSA is used to
differentiate hydronephrosis(HDN) from multi cystic kidneys
(MCDK)
a. MCDK rarely reveals concentration of isotope in the cortex
b. HDN rarely excrete the isotope in the collecting system
c. MCDK more medial enhancement than periphery
d. HDN more peripheral enhancement than medial

35. true about JJ stents
a. increases ureter peristalisis
b. decreases the intra renal pressure
c. increases the intra renal pressure
d. it provides better drainage than nephrostomy


36. Michaelis Gutmann bodies charestrically found in
a. xantho granulomatous pyelonephritis
b. chlamyda infection
c. interstitial cystitis
d. renal malakoplakia

37. false about spermatocytic seminoma
a. contributes < 1 % of testicular tumors
b. arises from germcell intra epithelial neoplasia
c. commonly seen in the 6th decade
d. usually benign, orchiectomy is the treatment of choice

38. urethral injuries seen in
a. 5% of pelvic# in males
b. 10% of pelvic# in males
c. 30% of pelvic# in males
d. 40% of pelvic# in males

39. half life of HCG and AFP respectively
a. 24 to 36 hrs, 3 to 7 days
b. 24 to 36 hrs , 2 to 3 days
c. 5 to 6 hrs, 3 to 5 days
d. 2 to 3 hrs , 3 to 7 days

40. when compared to silicon, catheters made up of latex are
a. less cost
b. less tissue reactivity
c. less bacterial adherence
d. less incidence of UTI

41. following is not a relative contraindication of retroperitoneal
approach
a. previous per cutaneous renal surgery
b. previous open renal surgery
c. h/o radio therapy
d. h/o xantho granulomatous pyelonephritis

42. advantages of rigid endoscopes A/E
a. larger working channel
b. larger lumen allows for improved irrigant flow
c. improved image quality due to presence of rod lens system
d. ability to deflect the endoscope tip

43. following catheter is used during difficult catheterisation in males
a. Robison
b. Council
c. Coude
d. Whistle tip


44. false about phenylephrine used in the treatment of priapism
a. drug of choice for intra corporeal injection
b. it is a non selective alfa agonist which acts on alfa receptors
c. doesn`t have beta mediated chronotropic, ionotropic effects
d. is diluted to 200 micro grams per ml and given as 0.5ml to 1ml

45. following is not used for the treatment of pyronies disease
a. carnitin
b. intralesional verapamil
c. extra corporial shockwave therapy
d. radiation therapy

46. other name for “sertolicell only syndrome”
a. hypospermatogenesis
b. maturation arrest
c. germinal cell aplasia
d. endstage testis

47. which of the following disease doesn`t recurr after renal
transplantation
a. FSGS
b. HUS
c. ADPKD
d. Primary oxaluria

48. not a absolute indication of renal exploration after trauma
a. hemodynamic instability with shock
b. expanding, pulsatile renal hematoma
c. suspected renal pedicle avulsion
d. non viable tissue

49. false about medial fibroplasia
a. most common fibroplasia constituting 30 to 40% of fibrous
lesions
b. occurs in women between 35 to 50y of age
c. often involves both renal arteries
d. none of the above

50. following immunosuppressant causes diabetes
a. mycophenolate mofetil
b. cyclosporine
c. sirolimus
d. azathiopine

51. grade of injury when ureter transection is <50% following truma
a. grade 1
b. grade 2
c. grade 3
d. grade 4

52. postoperative IV fluid of choice after renal transplantation
a. 0.25% NaCl
b. 0.45% NaCl
c. 0.9% NaCl
d. 3% NaCl

53. after transplantation the minimum duration after which couple is advised to plan for pregnancy
a. 3m
b. 6m
c. 12m
d. 24m

54. drug which decreases the levels of cyclosporine in the blood
a. refampicine
b. phenobarbitone
c. ketoconazole
d. phenytoin

55. regarding fertility after transplantation all of the following true except
a. after successful kidney transplantation, levels of FSH, LH,
testosterone usually becomes normal and spermatogenesis
improves
b. among male recipients who have fathered children, there has
been increase in congenital abnormalities in the offspring
c. impregnation be delayed atleast 1y after transplantation
d. successful renal transplantation usually restores fertility in
premenopausal women

56. false about renal artery stenosis after renal transplantation
a. it can be due to atheroma or faulty suture technique
b. can present with impaired renal function
c. finding of bruit over the kidney graft is a reliable
sign of diagnosis
d. percutaneous transluminal angioplasty is the intial treatment
of choice

57. one French (1F) equals to
a. 0.33mm in circumference
b. 3.3mm in circumference
c. 0.33mm in diameter
d. 3.3mm in diameter

58. most common cause of gross hematuria in >50y male
a. RCC
b. Ca bladder
c. Ca prostate
d. Hypercalciuria

59. hypomagnesuric urolithiasis caused by A/E
a. laxative abuse
b. inflammatory bowel disease
c. chronic thiazide therapy
d. chronic citrate therapy

60. false about cystinuria
a. is caused by autosomal recessive error of transepithelial transport involving intestine and kidneys
b. crystallization occurs when excreted concentration is above
250mg / L
c. relatively more radio opaque and diagnosed on plane xray
d. staghorn calculi or multiple, filled calyces are common

61. false about pregnancy associated hydronephrosis
a. commonly starts from 2nd trimester
b. usually resolves within one month following delivery
c. left side is more common than right side
d. ureter dialatation doesn`t extend below pelvic brim

62. the wavelength of Ho-YAG laser
a. 1060nm
b. 2100nm
c. 520nm
d. 10600nm

63. incidence of primary bladder calculi is highest during
a. 1st decade
b. 2nd decade
c. 3rd decade
d. 4th decade

64. mineralogical name for calcium oxalate monohydrate
a. whewellite
b. weddellite
c. brushite
d. whitlockite

65. microscopic appearance of cystine calculi
a. hexagonal
b. envelope shaped
c. hourglass
d. rectangular

66. not a cause of aquired renal tubular acidosis
a. obstructive uropathy
b. idiopathic hyper calciuria
c. cystinuria
d. recurrent pyelonephritis

67. which of the following is not a poor prognostic factor for metastatic RCC
a. karnofsky performance score <80%
b. elevated lactate dehydrogenase(>1.5 times upper limit of normal)
c. elevated corrected calcium (>10mg/dL)
d. prior nephrectomy status

68. true about recurrence after partial nephrectomy for RCC
a. incidence is 30 to 50%
b. most commonly seen in tumor bed
c. commonly due to persistence of the tumor
d. thermal ablation is a treatment option

69. most common cyst from which adrenocortical carcinoma arises?
a. endothelial
b. epithelial
c. pseudocyst
d. parasitic

70. most common primary urethral calculi?
a. ca oxalate
b. ca phosphate
c. uricacid
d. magnesium ammonium phosphate

71. halflife of dapoxetene?
a. 45mins
b. 1.5hrs
c. 2hrs
d. 4hrs

72. infection calculi most commonly caused by?
a. E coli
b. Pseudomonas
c. Proteus
d. Staphylococcus

73. following is not a feature of Hinman Syndome
a. incontinence
b. recurrent UTI
c. incomplete emptying
d. hematuria

74. according to AMID classification type 1 synthetic mesh
a. poresize 30 to 50 mm
b. poresize 50 to 75mm
c. submicronic pore size
d. poresize > 75 mm



75. for following reasons vaginal approach is preffered over
abdominal for bladder neck closure except
a. prior pelvic surgery
b. prior pelvic radiotherapy
c. when martius flap is used
d. greater flexibility of lower limbs

76. false about Fowler Syndrome
a. abdominal distention
b. no sensation
c. increased bladder capacity >1 L
d. feeling of urgency


77. false regarding the outcome following revascularisation of
atherosclerotic renal artery disease
a. outcome is similar irrespective of pre op serum cr leveles
b. outcome is good when there is deterioration in the renal function where angiotensin receptor blockers are used to
controle HTN
c. preop kidney size >9cm good outcome
d. B/L renal artery stenosis good outcome


78. false about primary hyperoxluria
a. type 1 is most common and due to deficiency of alanin/glyoxalate aminotransferase enzyme
b. type 2 is due to deficiency of glyoxalate reductase/hydroxypyruvate reductase
c. urinary oxalate levels increased without increase in serum levels
d. without treatment death is common before 20y of age

79. most important pathogenitic mechanism of uricacid stones
a.dcreased urinary pH
b.low urine volume
c. hyper uricosuria
d. hyper calciuria

80. most common cause of ureterocolic fistula
a. extensive local colonic malignancy
b. diverticulitis
c. chrons disease
d. radiotherapy

81. following is not a feature of Gouverneur Syndrome
a. frequency
b. dysuria
c. hesitancy
d. tenismus

82. incidence of unilateral renal agenisis
a. 1/1100
b. 1/2200
c. 1/1600
d. 1/450

83. true among the following
a. most of the urinary oxalate derived from dietary sources
b. severe calcium restriction leads to enteric hyperoxaluria
c. oral oxalate restriction is the treatment of primay hyperoxaluria
d. [snip]% of oxalate is ultrafilterable and reabsorption is negligible

84. false regarding stones during pregnancy
a. age adjusted incidence of stones is similar in multiparous and primapara women
b. incidence is similar in pregnancy and non pregnancy states
c. incidence is more on Lt side than Rt side
d. ureteric stones twice common than renal stones

85. prostate volume highly correlates with
a. PSA
b. Urine flow rate
c. Post void residual volume
d. histological grade

86. in a postmenopausal women with T2 bladder ca planned for
surgery. Which of the following structure is not removed
a. ovaries
b. uterus
c. vagina
d. all of the above

87. true physical restriction of ureter is seen at
a. UPJ
b. UVJ
c. at the crossing of gonadal vessels
d. where ureter crosses iliac vessels

88.reflux of urine into non dilated ureter, pelvis corresponds to VUR
a. grade 2
b. grade 3
c. grade 4
d. grade 5


89. cremasteric artery is a branch of
a. internal pudendal
b. obturator
c. inferior epigastric
d. external iliac
90. true about triangulation technique used during percutaneous
access to upper collecting system
a. ability to maintain both the medio-lateral, cephalo-caudal planes as
in the `eye-of-the needle` technique
b. ability to moniter the depth of the needle continuously
c. typically 21-gauge needle is used to maintain the angle of entry
d. can be used to place the needle at any location and angle

91. false about klinefelter syndrome
a. enuchoidism
b. gynecoomastia
c. azoospermia
d. decreased gonadotrophin levels

92. inner most covering of testis
a. tunica albugenia
b. tunica vasculosa
c. tunica vaginalis
c. cremasteric fascia

93. mechanism of absorption of Hco3- in PCT
a. active diffusion
b. action of carbonic anhydrase
c. passive diffusion
d. no absorption in PCT

94. transverse plication of redundant ureter
a. kalisinki plication
b. starr plication
c. polatino – lead better method
d. hendren plication

95 medullary sponge kidney true
a. common in male stone formers than female
b. is a rare cause of hypercalciuria
c. is a rare cause of hypertension
d. is heritable

96. persistence of hydronephrosis in immediate postop period after surgical correction of VUR is commonly due to
a. UPJO
b. UVJO
c. non obstructive hydronephrosis
d. infravesical obstruction






97. most common crossed renal ectopia
a. crossed renal ectopia without fusion
b. crossed renal ectopia with superior fusion
c. crossed renal ectopia with inferior fusion
d. solitary crossed renal ectopia

98. true about thoracic kidney
a. most commonly associated with diaphragmatic hernia
b. renal arteries commonly derived from thoracic aorta
c. renal rotation is usually complete
d. frequently associated with ascent of other intra abdominal structures

99.following is true regarding the prenatal ultrasonography of
renal cysts
a. multiple microcysts usually visualised as diffuse hypoechogenic
kidney
b. multiple renal cysts are usually communicating
c. a cyst in the upper pole of kidney is usually a dilated upper pole of duplex kidney
d. presence of central large cyst is charecterestic of MCDK


100. after ureteroneocystostomy for correction of VUR
a. early refux is common
b. contralateral reflux is more common than ipsilateral
c. early reflux spontaneously resolves by 1yr
d. persistence of reflux at 1yr doesn`t correlates with preop grade of reflux