Showing posts with label MCh URO. Show all posts
Showing posts with label MCh URO. Show all posts

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

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




13 of 22






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




14 of 22






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.




15 of 22






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


16 of 22






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


17 of 22






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









18 of 22






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







19 of 22






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








20 of 22






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