Urology

Urology Indian Medical PG Question 1: The length of the female urethra is :

• A. 20 mm
• B. 60 mm
• C. 45 mm
• D. 40 mm (Correct Answer)

Urology Explanation: ***40 mm*** - The typical length of the **female urethra** is approximately **40 mm** (or 4 cm). - This relatively short length is a key reason why females are more susceptible to **urinary tract infections** compared to males. *20 mm* - **20 mm** (2 cm) is significantly shorter than the average female urethral length. - Such a short urethra would drastically increase the risk of **ascending infections** into the bladder. *60 mm* - **60 mm** (6 cm) is longer than the typical female urethra. - A urethra of this length would be more comparable to conditions in males or specific anatomical variations, not the average female. *45 mm* - While closer to the correct answer, **45 mm** is still slightly longer than the generally accepted average length for the female urethra. - The textbook average is usually cited as **4 cm** or 40 mm.

Urology Indian Medical PG Question 2: In response to an increase in glomerular filtration rate, the proximal tubule and the loop of Henle demonstrate an increase in the rate of sodium reabsorption. This phenomenon is called?

• A. Glomerulotubular balance (Correct Answer)
• B. Autoregulation of renal blood flow
• C. Mineralocorticoid escape (response to aldosterone)
• D. Saturation of tubular transport capacity

Urology Explanation: ***Glomerulotubular balance*** - This mechanism ensures that a relatively constant fraction of the filtered load of sodium and water is reabsorbed by the proximal tubule and loop of Henle, despite variations in GFR. - An increased GFR leads to an increased filtered load of sodium, which in turn stimulates greater reabsorption in these segments, maintaining constancy. *Autoregulation of renal blood flow* - This refers to the kidney's intrinsic ability to maintain a relatively constant **glomerular filtration rate (GFR)** and **renal blood flow (RBF)** despite fluctuations in systemic arterial pressure. - It involves mechanisms like the **myogenic response** and **tubuloglomerular feedback** at the afferent arteriole, but does not directly describe the proportional reabsorption of sodium. *Mineralocorticoid escape (response to aldosterone)* - This phenomenon describes the **limited effectiveness of aldosterone** in causing sustained sodium retention or edema due to compensatory mechanisms. - It involves an increase in atrial natriuretic peptide (ANP), pressure natriuresis, and decreased proximal tubule reabsorption in response to chronic aldosterone excess. *Saturation of tubular transport capacity* - This occurs when the amount of a substance filtered into the tubules exceeds the maximum rate at which the tubules can reabsorb or secrete it, leading to its excretion in urine. - This concept describes the **limit of tubular transport**, not the proportional adjustment in reabsorption in response to GFR changes.

Urology Indian Medical PG Question 3: Consider the following statements in respect of prostatic carcinoma : 1. Most originate from peripheral zone 2. Prostatic needle biopsy is better performed under trans rectal ultrasound 3. Prostate specific antigen is the specific test 4. L.H.R.H. analogues are used as medical treatment for metastatic disease Which of the statements given above is/are correct ?

• A. 1 and 3
• B. 1 and 2 only
• C. 1, 2 and 4 (Correct Answer)
• D. 2, 3 and 4

Urology Explanation: ***1, 2 and 4*** - **Most prostatic carcinomas originate from the peripheral zone** (approximately 70%), making this statement correct. This zone is palpable on digital rectal examination. - **Prostatic needle biopsy is indeed better performed under transrectal ultrasound (TRUS) guidance**, which allows for targeted and accurate sampling of suspicious areas. - **LHRH (Luteinizing Hormone-Releasing Hormone) analogues are a cornerstone of medical treatment for metastatic prostate cancer** as they suppress testosterone production, which fuels tumor growth. *1 and 3* - While statement 1 is correct (most prostate cancers originate from the peripheral zone), **prostate-specific antigen (PSA) is not a specific test** for prostate cancer. - **Elevated PSA can be caused by various conditions** such as benign prostatic hyperplasia (BPH), prostatitis, and even normal aging, making it a marker for prostate health rather than a definitive diagnostic test for cancer. *1 and 2 only* - Statements 1 and 2 are correct individually, but this option **incorrectly excludes statement 4**, which is also correct regarding the use of LHRH analogues in metastatic disease. - Therefore, this option is incomplete as it misses a true statement about prostate cancer management. *2, 3 and 4* - This option is incorrect because **statement 3 regarding PSA being a specific test is false**. - While PSA is used for screening and monitoring, its lack of specificity means it cannot definitively diagnose cancer.

Urology Indian Medical PG Question 4: Which of the following are correct about ectopic ureters? 1. They are more common in males 2. They drain the upper pole of the kidney 3. They are associated with duplex ureter 4. They may cause incontinence

• A. 1, 3 and 4
• B. 1, 2 and 3
• C. 2, 3 and 4 (Correct Answer)
• D. 1, 2 and 4

Urology Explanation: ***2, 3 and 4*** - Ectopic ureters primarily drain the **upper pole** of a **duplicated kidney** and are nearly always associated with some degree of renal dysplasia. - They are commonly associated with **duplex ureters** and can cause **incontinence**, especially in females, as they often bypass the bladder sphincter. *1, 3 and 4* - This option is incorrect because ectopic ureters are **more common in females** than males, particularly symptomatic cases involving incontinence. - While they are associated with duplex ureters and incontinence, the statement about being more common in males is inaccurate. *1, 2 and 3* - This option is incorrect because ectopic ureters are **more prevalent in females** and are a significant cause of continuous urinary incontinence in this population. - While they drain the upper pole and are associated with duplex ureters, the claim of being more common in males is false. *1, 2 and 4* - This option is incorrect as ectopic ureters are typically found more often in **females** and are a recognized cause of **incontinence** in affected individuals. - Although they drain the upper pole and may cause incontinence, the assertion that they are more common in males is inaccurate.

Urology Indian Medical PG Question 5: In human males, testosterone is mainly produced by

• A. Leydig cells (Correct Answer)
• B. Seminiferous tubules
• C. Epididymis
• D. Sertoli cells

Urology Explanation: ***Leydig cells*** - **Leydig cells** are located in the **interstitial tissue** between the seminiferous tubules in the testes and are responsible for producing **testosterone** in response to luteinizing hormone (LH). - These cells are crucial for the development of male secondary sexual characteristics and spermatogenesis. *Seminiferous tubules* - The **seminiferous tubules** are the primary sites of **spermatogenesis**, the process of sperm production. - While essential for male fertility, they do not directly produce testosterone. *Epididymis* - The **epididymis** is a coiled tube located on the posterior aspect of each testis, where **sperm mature** and are stored. - It plays no role in the production of testosterone. *Sertoli cells* - **Sertoli cells** are found within the **seminiferous tubules** and provide support, nourishment, and protection to developing sperm. - They also produce **androgen-binding protein (ABP)** and inhibin, but not testosterone.

Urology Flashcard 1 of 5

Question: Duplex collecting system is strongly associated with vesicoureteral _____ and/or ureteral obstruction

Answer: reflux

Urology Flashcard 2 of 5

Question: Because PSA can be also elevated in _____ and prostatitis besides Prostate Cancer, there is a questional risk/benefit for screening

Answer: BPH

Urology Flashcard 3 of 5

Question: _____ repair is done for stress urinary incontinence includes apposing medial fibres of puborectalis muscles in the midline under the bladder neck region to elevate it via a vaginal approach.

Answer: Pacey's

Urology Flashcard 4 of 5

Question: _____ stone is a type of renal stone that is protein rich and associated with recurrent infections

Answer: Matrix

Urology Flashcard 5 of 5

Question: In acute urinary retention due to a stricture, it is dilated with cystoscope, guide wires and urethral dilators and a _____ catheter is inserted

Answer: counsel tip