Urology — MCQs
On this page
BCG is used for the treatment of:
Most common cause of urinary obstruction in a male infant is -
A lady underwent vaginal hysterectomy for Carcinoma cervix. Following the surgery after her urethral catheter was removed, she complained of urinary incontinence. On examination she had normal voiding as well as continuous incontinence. Methylene blue dye was instilled in her bladder through her urethra and she was given oral Phenazopyridine dye. After some time her pads were checked and it showed yellow staining at the top most pad, while the middle or bottom pads were unstained. She is likely to have:
Posterior urethral valve is diagnosed on micturating cystourethrogram by-
A 70 year old patient with benign prostatic hyperplasia underwent transurethral resection of prostate under spinal anaesthesia. One hour later, he developed vomiting and altered sensorium. Which of the following is the most probable cause?
A man is brought to the emergency after he fell into a man hole and injured his perineum. He feels the urge to micturate but is unable to pass urine and there is blood at the tip of the meatus with extensive swelling of the penis and scrotum. What is the location of the injury?
A patient presents with a palpable mass in the right scrotum, separate from and above the testis. Ultrasound confirms a diagnosis of varicocele. Which structure is most likely involved?
A 45-year-old man presents with gross hematuria and a palpable abdominal mass. A CT scan reveals a renal mass with metastasis to the lungs. What is the most appropriate treatment strategy for this patient?
A 30-year-old male presents with an acute onset of severe scrotal pain. The scrotum is swollen and tender. What is the most likely diagnosis?
A 45-year-old man presents with a painless, enlarged scrotum. The transillumination test reveals a cystic mass. What is the most likely diagnosis?
Urology Indian Medical PG Practice Questions and MCQs
Question 991: BCG is used for the treatment of:
- A. Treatment of superficial bladder cancer (Correct Answer)
- B. Treatment of tuberculosis
- C. Treatment of anthrax
- D. All of the options
Explanation: ***Treatment of superficial bladder cancer*** - **BCG (Bacille Calmette-Guérin)** is a live attenuated strain of *Mycobacterium bovis* that is effective as an **immunotherapy** for superficial bladder cancer. - It is instilled directly into the bladder, triggering a localized immune response that targets and destroys cancer cells, preventing recurrence and progression. *Treatment of tuberculosis* - While BCG is derived from *Mycobacterium bovis*, it is primarily used as a **vaccine** to prevent severe forms of tuberculosis, especially in children, rather than a treatment for active disease. - Active tuberculosis is typically treated with a multi-drug regimen of **antibiotics**, not BCG. *Treatment of anthrax* - Anthrax is caused by **Bacillus anthracis** and is treated with specific **antibiotics** such as ciprofloxacin or doxycycline. - **BCG has no role** in the treatment of anthrax. *All of the options* - As BCG is not used for the treatment of tuberculosis or anthrax, this option is incorrect. - Its established therapeutic use is primarily in the management of superficial bladder cancer.
Question 992: Most common cause of urinary obstruction in a male infant is -
- A. Stone
- B. Anterior urethral valves
- C. Stricture
- D. Posterior urethral valves (Correct Answer)
Explanation: ***Posterior urethral valves*** - **Posterior urethral valves (PUV)** are the most common cause of significant **urinary tract obstruction** in male infants and are a congenital anomaly. - They are a membrane-like structure in the **posterior urethra** that obstructs urine outflow from the bladder. *Stone* - **Urinary stones** are a less common cause of obstruction in infants and are often associated with metabolic disorders or anatomical abnormalities. - While they can cause obstruction, they are not the most frequent cause in male infants. *Anterior urethral valves* - **Anterior urethral valves (AUV)** are a much rarer cause of urethral obstruction than PUV. - They occur more distally in the urethra and typically present with a **dilated anterior urethra**. *Stricture* - **Urethral strictures** in infants are usually acquired due to trauma, instrumentation, or infection, rather than being congenital. - They are less common than PUV as a primary cause of congenital urinary obstruction.
Question 993: A lady underwent vaginal hysterectomy for Carcinoma cervix. Following the surgery after her urethral catheter was removed, she complained of urinary incontinence. On examination she had normal voiding as well as continuous incontinence. Methylene blue dye was instilled in her bladder through her urethra and she was given oral Phenazopyridine dye. After some time her pads were checked and it showed yellow staining at the top most pad, while the middle or bottom pads were unstained. She is likely to have:
- A. Vesicouterine fistula
- B. Vesicovaginal fistula
- C. Ureterovaginal fistula (Correct Answer)
- D. Urethrovaginal fistula
Explanation: ***Ureterovaginal fistula*** - The **yellow staining** on the topmost pad, resulting from oral **Phenazopyridine** excreted by the kidneys, indicates that the urine is bypassing the bladder and leaking into the vagina directly from a ureter. - The **negative methylene blue test** (no blue staining) rules out bladder involvement, confirming that the leak is from a higher part of the urinary tract (ureter). *Vesicouterine fistula* - This type of fistula involves a communication between the **bladder and the uterus**, which is not relevant in a patient who has undergone a hysterectomy. - The presence of continuous incontinence with a normal voiding pattern would not typically be seen with this type of fistula, especially after hysterectomy. *Vesicovaginal fistula* - If a vesicovaginal fistula were present, the patient's pads would show **blue staining** from the methylene blue instilled into the bladder, indicating a direct leak from the bladder into the vagina. - The absence of blue staining in the pads rules out this diagnosis. *Urethrovaginal fistula* - A urethrovaginal fistula would involve a connection between the **urethra and the vagina**, typically leading to leakage of urine from the urethra. - While it causes incontinence, the specific finding of **yellow staining from oral Phenazopyridine** without blue staining from bladder instillation points away from a urethral source.
Question 994: Posterior urethral valve is diagnosed on micturating cystourethrogram by-
- A. Dilatation of posterior urethra (Correct Answer)
- B. Bladder wall hypertrophy
- C. Bladder neck contracture
- D. Vesico-Ureteric reflux
Explanation: ***Dilatation of posterior urethra*** - **Posterior urethral valves (PUV)** create an obstruction in the **posterior urethra**, leading to its characteristic dilatation during micturition due to increased pressure. - This **dilatation** is a direct radiographic sign of the anatomical obstruction caused by the valves. *Bladder wall hypertrophy* - **Bladder wall hypertrophy** is a secondary change that occurs over time due to the bladder working harder against the obstruction caused by PUV, but it is not the primary diagnostic feature on a micturating cystourethrogram (MCU). - While present in many cases of PUV, it indicates chronic obstruction rather than directly imaging the valves themselves. *Bladder neck contracture* - **Bladder neck contracture** is a narrowing at the exit of the bladder, which is a different anatomical obstruction than PUV. - The primary pathology in PUV is within the **posterior urethra**, distal to the bladder neck. *Vesico-Ureteric reflux* - **Vesico-ureteric reflux (VUR)** is the retrograde flow of urine from the bladder into the ureters and kidneys, which is a common associated finding with PUV due to the high bladder pressures. - While often seen in PUV, VUR is a complication or associated condition, not the direct diagnostic indicator of the valves themselves.
Question 995: A 70 year old patient with benign prostatic hyperplasia underwent transurethral resection of prostate under spinal anaesthesia. One hour later, he developed vomiting and altered sensorium. Which of the following is the most probable cause?
- A. Water intoxication (TURP syndrome) (Correct Answer)
- B. Hyperkalemia
- C. Overdose of spinal anaesthetic agent
- D. Rupture of bladder
Explanation: ***Water intoxication (TURP syndrome)*** - **Transurethral resection of the prostate (TURP)** uses a hypotonic irrigation solution, which can be absorbed through venous sinuses opened during resection. - This absorption leads to **dilutional hyponatremia** and **fluid overload**, causing symptoms such as vomiting, altered sensorium, and even seizures or coma, collectively known as **TURP syndrome**. *Hyperkalemia* - **Hyperkalemia** is not a common complication of TURP. While irrigation solutions can cause electrolyte imbalances, they usually lead to dilutional hyponatremia, not elevated potassium. - Symptoms of hyperkalemia typically include **cardiac arrhythmias** and muscle weakness, not primarily vomiting and altered sensorium in this rapid onset. *Over dosage of spinal anaesthetic agent* - An overdose of spinal anesthetic agent would likely manifest earlier during or immediately after the spinal injection, with symptoms like **hypotension**, **bradycardia**, or **respiratory depression**. - **Altered sensorium** and vomiting occurring one hour post-procedure with intact initial recovery from anesthesia are less typical for acute spinal overdose. *Rupture of bladder* - A **bladder rupture** during TURP would typically present with acute lower abdominal pain, abdominal distension, and signs of **peritonitis**, or oliguria/anuria. - While it can cause systemic effects, vomiting and altered sensorium as the primary symptoms one hour later are not the most characteristic presentation for bladder perforation.
Question 996: A man is brought to the emergency after he fell into a man hole and injured his perineum. He feels the urge to micturate but is unable to pass urine and there is blood at the tip of the meatus with extensive swelling of the penis and scrotum. What is the location of the injury?
- A. Membranous urethra
- B. Prostatic urethra
- C. Bulbar urethra (Correct Answer)
- D. Bladder
Explanation: ***Bulbar urethra*** - Injury to the **bulbar (spongy) urethra** in the perineum, often from a straddle injury or fall into a manhole, typically causes the extravasation of urine and blood into the **superficial perineal pouch**. - This leads to **extensive swelling of the penis and scrotum** (butterfly hematoma) because the superficial perineal fascia (Colles' fascia) is continuous with dartos fascia of the penis and scrotum, preventing blood from extending into the thighs or abdominal wall, combined with an inability to micturate with blood at the meatus. *Membranous urethra* - Injury to the **membranous urethra** is usually associated with **pelvic fractures** and tends to cause extravasation into the **deep perineal space** and then the retroperitoneum, leading to swelling in the lower abdomen or around the anus, not primarily the penis and scrotum. - While it can cause inability to micturate and blood at the meatus, the characteristic extensive swelling of the penis and scrotum points away from this location. *Prostatic urethra* - Injuries to the **prostatic urethra** are rare and typically occur with **severe pelvic crush injuries** given its protected position deep within the pelvis. - While it would cause inability to urinate, the nature of the fall and the distribution of swelling (predominantly penis and scrotum) are not typical for prostatic urethral injury. *Bladder* - A bladder injury from a fall would likely present with suprapubic pain and hematuria, but the inability to urinate combined with **blood at the meatus** and extensive swelling limited to the penis and scrotum is not characteristic of isolated bladder trauma. - **Blood at the meatus** is a classic sign of urethral, not typically bladder, injury.
Question 997: A patient presents with a palpable mass in the right scrotum, separate from and above the testis. Ultrasound confirms a diagnosis of varicocele. Which structure is most likely involved?
- A. Vas deferens
- B. Spermatic cord (Correct Answer)
- C. Prostate
- D. Epididymis
Explanation: ***Spermatic cord*** - A **varicocele** is defined as the dilation of the **pampiniform venous plexus**, which is a network of veins found within the spermatic cord. - The dilated veins in the spermatic cord are responsible for the **palpable mass** and the characteristic "bag of worms" sensation associated with varicocele. *Vas deferens* - The **vas deferens** is a muscular tube that transports sperm from the epididymis to the ejaculatory duct; it is not directly involved in varicocele formation. - While it is a component of the spermatic cord, a varicocele specifically refers to the **venous dilation**, not the vas deferens itself. *Prostate* - The **prostate gland** is located below the bladder and encircles the urethra, playing a role in semen production, but it is anatomically separate from the testis and the spermatic cord. - Prostate issues would typically present with **urinary symptoms** or pelvic pain, not a scrotal mass of dilated veins. *Epididymis* - The **epididymis** is a coiled tube located on the posterior aspect of the testis, responsible for sperm maturation and storage. - While it can be affected by conditions like epididymitis (inflammation), it is not the primary structure involved in the venous dilation characteristic of a varicocele.
Question 998: A 45-year-old man presents with gross hematuria and a palpable abdominal mass. A CT scan reveals a renal mass with metastasis to the lungs. What is the most appropriate treatment strategy for this patient?
- A. Partial nephrectomy and radiation therapy
- B. Total nephrectomy and immunotherapy (Correct Answer)
- C. Transplantation with immunosuppression
- D. Chemotherapy only
Explanation: **Total nephrectomy and immunotherapy** - The presence of a **palpable abdominal mass**, gross hematuria, and **pulmonary metastases** indicates advanced renal cell carcinoma, making **total nephrectomy** essential for tumor burden reduction. - **Immunotherapy** (e.g., PD-1 inhibitors) is the first-line systemic treatment for metastatic renal cell carcinoma, offering improved survival outcomes compared to traditional chemotherapy. *Partial nephrectomy and radiation therapy* - **Partial nephrectomy** is typically reserved for smaller, localized renal masses to preserve renal function, which is not indicated in the presence of **metastatic disease**. - **Radiation therapy** has a limited role in the primary treatment of renal cell carcinoma and is mostly used for **palliative care** for bone or brain metastases, not as a primary treatment for the renal tumor. *Transplantation with immunosuppression* - **Kidney transplantation** is only considered in patients with end-stage renal disease (ESRD) and no malignancy, or in highly selected cases of small, localized renal tumors in the explanted kidney, not for **metastatic cancer**. - **Immunosuppression** in the context of transplantation would actually be detrimental in a patient with metastatic cancer as it could accelerate tumor growth. *Chemotherapy only* - **Renal cell carcinoma** is notoriously **chemotherapy-resistant**, making it ineffective as a primary treatment for metastatic disease. - Targeted therapies or **immunotherapy** have largely replaced chemotherapy in the management of advanced renal cell carcinoma due to superior efficacy.
Question 999: A 30-year-old male presents with an acute onset of severe scrotal pain. The scrotum is swollen and tender. What is the most likely diagnosis?
- A. Epididymitis
- B. Testicular torsion (Correct Answer)
- C. Hydrocele
- D. Inguinal hernia
Explanation: ***Testicular torsion*** - The sudden onset of **severe scrotal pain** in a young male, accompanied by **swelling and tenderness**, is highly suggestive of testicular torsion. - Testicular torsion is a **surgical emergency** requiring prompt intervention to preserve testicular viability. *Epididymitis* - While epididymitis also causes scrotal pain and swelling, its onset is typically more **gradual** and is often associated with **dysuria or fever**. - Physical examination may reveal a **positive Prehn's sign** (pain relief with elevation of the testicle), which is usually absent in torsion. *Hydrocele* - A hydrocele is a collection of fluid around the testis, usually presenting as a **painless scrotal swelling** that can be transilluminated. - It does not typically cause acute, severe pain unless it becomes infected or acutely enlarges due to trauma. *Inguinal hernia* - An inguinal hernia can cause scrotal swelling, but the pain is often described as a **dull ache** or a feeling of heaviness, especially with straining, rather than acute severe pain. - A hernia typically presents as a **reducible mass** that may extend into the scrotum.
Question 1000: A 45-year-old man presents with a painless, enlarged scrotum. The transillumination test reveals a cystic mass. What is the most likely diagnosis?
- A. Inguinal hernia
- B. Varicocele
- C. Hydrocele (Correct Answer)
- D. Testicular torsion
Explanation: ***Hydrocele*** - A **hydrocele** is a collection of fluid in the **tunica vaginalis**, which typically presents as a **painless, enlarged scrotum** that transilluminates. - The **transillumination test** is positive because the fluid within the hydrocele allows light to pass through. *Inguinal hernia* - An **inguinal hernia** usually presents as a scrotal swelling that does not transilluminate and may be **reducible**. - It involves the protrusion of abdominal contents, not fluid, into the scrotum. *Varicocele* - A **varicocele** is an enlargement of the **pampiniform plexus veins** within the scrotum, often described as feeling like a "bag of worms." - It does not transilluminate and is more commonly associated with a dull ache or heaviness, and can be associated with infertility. *Testicular torsion* - **Testicular torsion** is an acute, painful condition caused by the twisting of the **spermatic cord**, leading to inadequate blood flow to the testis. - It is characterized by sudden, severe pain and tenderness, and is a medical emergency that does not transilluminate.
Practice by Chapter
Urological Anatomy
Practice Questions
Hematuria Evaluation
Practice Questions
Urinary Calculi
Practice Questions
Benign Prostatic Hyperplasia
Practice Questions
Prostate Cancer
Practice Questions
Bladder Cancer
Practice Questions
Renal Cell Carcinoma
Practice Questions
Testicular Tumors
Practice Questions
Urinary Tract Infections
Practice Questions
Urinary Incontinence
Practice Questions
Genitourinary Trauma
Practice Questions
Pediatric Urology Basics
Practice Questions
Want unlimited practice?
Get full access to all questions, explanations, and performance tracking.
Start For Free