High-Yield NEET SS Surgery Urology Questions

1. A 65-year-old male has come for the evaluation after a few episodes of blood in urine in the past few days. There is no painful or burning urination. The patient has temperature of 98 F, his blood pressure is 130/90 mmHg, and his pulse rate is 65/min. He is a chronic smoker with 35 pack year smoking history. The examination shows non-tender and soft abdomen throughout. Urinalysis is performed and it shows large number of isomorphic RBCs 40/HPF, no casts and negligible number of WBCs and pus cells. Abdominal and Pelvic ultrasound shows thickening of the bladder wall. What should be the next step in the evaluation of this patient?

1. Renal Ultrasound
2. Cystoscopy
3. Urine Culture and Sensitivity
4. No further evaluation is needed

2. A 45-year-old man presents with a history of recurrent urinary tract infections and difficulty with urination. He has a suspicion of urethral stricture and is considering surgical intervention. Which of the following imaging modalities would be the most appropriate for further evaluation of the urethra?

1. Computed Tomography
2. Magnetic Resonance Imaging
3. Retrograde Urethrography
4. Cystourethrography

3. A surgical team is performing laparoscopic surgery. Which of the following components of the laparoscope is responsible for creating a passage for the laparoscope and other instruments to enter the abdominal cavity?

1. Camera head
2. Distal tip
3. Light source
4. Trocar

4. A 32-year-old woman presented at 32 weeks of gestation with complaints of pain in the right flank region that radiates to the lower abdomen and groin, increased frequency of urination, nausea, vomiting and blood in the urine for 8 hours. A diagnosis of renal stones was made after a proper workup. Medications were started along with hydration but patient symptoms were not relieved. Interventional management was planned. Which of the following procedures will be contraindicated in this patient?

1. Percutaneous nephrostomy
2. Ureteral stenting
3. Extracorporeal shock wave lithotripsy
4. Ureteroscopy with laser lithotripsy

5. A 13-year-old female presents to the clinic due to fever, left renal pain and vomiting for 2 days. She also reports dysuria and urgency. She is given appropriate treatment, but she fails to improve. The clinician advised renal radionucleotide imaging. Which of the following is the preferred radionucleotide agent for this patient?

1. ^99mTc-Dimercaptosuccinic Acid (DMSA)

2. ^99mTc-(CO₃) Tricarbonylnitriloacetic Acid (NTA)

3. ^99mTc-_L,L- and _D,_D-Ethylenedicysteine (EC)

4. ⁵¹Cr-Ethylenediaminetetraacetic Acid (EDTA)

6. A 3-year-old kid is brought by her mother to the surgical emergency room complaining of painless blood in her urine and a recent two-week fever. She also describes losing her appetite and feeling generally weak. A lump is felt in the baby's abdomen, and further examination reveals that she is febrile with a temperature of 99 ^oC. Her urine analysis reveals gross hematuria. The abdominopelvic ultrasonography sees an abdominal tumour on the right renal side of the patient. In this disorder, a micro-deletion has caused a constellation deficiency on which of the following chromosomes?

1. Chromosome 9

2. Chromosome 8

3. Chromosome 10

4. Chromosome 11

7. A 57-year-old man visits the doctor after experiencing right flank pain for three months. A urine analysis reveals 60 RBC/hpf. A 3 cm, well-defined tumour is visible on renal ultrasonography at the right kidney's upper pole. A photomicrograph of a portion of the bulk that was removed is displayed. Which of the subsequent diagnosis is more likely?

1. Chromophobe renal cell carcinoma

2. Oncocytoma

3. Clear-cell renal carcinoma

4. Nephroblastoma

8. A 32-year-old lady is examined for right flank discomfort and a noticeable lump. Imaging tests show that the right kidney is producing a sizable mass, while the left kidney is producing comparable but smaller masses. The picture below shows a cross-section of the specimen after surgery to remove the right kidney and tumour on the right side.

A histopathologic analysis reveals that the mass is made up of blood vessels, smooth muscle, and fat. Which additional finding is most likely present in this patient?

1. Bilateral acoustic neuromas
2. Brain hamartomas and ash-leaf skin patches
3. Capillary angiomas of the face and choroid
4. Cerebellar hemangioblastomas and liver cysts

9. A 55-year-old male presents with a 9 cm angiomyolipoma involving his right kidney. The patient has a history of hypertension and chronic kidney disease stage 3. He reports occasional abdominal pain and discomfort in the right flank region. Imaging studies confirm the presence of the angiomyolipoma and reveal signs of tumour growth compared to prior imaging studies. The patient is concerned about the potential risks and complications associated with his condition and seeks treatment options. Which of the following treatment modalities would be the most appropriate initial management approach for this patient?

1. Nephron-sparing surgery (partial nephrectomy)

2. Embolization

3. mTOR inhibitor therapy

4. Radical nephrectomy

10. A 68-year-old female presents with recurrent urinary tract infections and left-sided flank pain. A CT scan is performed to evaluate the urinary tract. The scan reveals a suspicious mass in the renal pelvis with suspected Invasion into the renal parenchyma. Further imaging is recommended to assess the extent of the tumour and its involvement with surrounding structures. Which of the following imaging modalities is considered the gold standard for staging UTUC and provides detailed information about tumour size, location, and local Invasion?

1. Contrast-enhanced CT urography
2. Magnetic resonance imaging
3. Positron emission tomography (PET) scan
4. Intravenous pyelogram

11. A 10-month-old boy is brought to the clinic for a follow-up after completing a course of antibiotics for a febrile urinary tract infection. The infant's mother reports no recurrence of symptoms. This was the infant's first febrile urinary tract infection. Vital signs and physical examination are normal. A renal ultrasound is performed and shows mild right hydronephrosis. A voiding cystourethrogram shows retrograde urine flow into the right ureter and collecting system with dilation and blunting of the renal calices. If untreated, which of the following is the most likely long-term complication of this infant's condition?

1. Fibrosis of renal interstitial space

2. Inflammation of renal glomerulus

3. No long term complications

4. Development of renal cysts

12. A 48-year-old man presented to the surgical outpatient department with a complaint of bloating, nausea, vomiting and a sense of fullness after intake of meals. The doctor suspected gallstones, and an ultrasound abdomen was advised. A small incidental mass was found over the right kidney during the scan, along with gallstones. Further radiological investigations were carried out that revealed small sized malignant mass <3 cm in diameter that is only limited to the kidney. What is the appropriate step of management in such a case?

1. Radical nephrectomy

2. Chemotherapy

3. Radiofrequency ablation or cryoablation

4. Palliative management

13. A 70-year-old man came for a follow-up of his laboratory investigations. The creatine concentration in the urine is 150mg/dl, the urine flow rate is 2ml/min, GFR is 60 mL/min/1.73m², and the plasma concentration of creatinine is 25mg/dl. What would be the excretion rate of creatinine in this patient?

1. 300mg/min excretion rate

2. 1200mg/min resorbtion

3. 500mg/min

4. 12ml/min clearance rate

14. A 58-year-old male presents to the urology clinic complaining of persistent right-sided flank pain and hematuria for the past few weeks. He has no significant medical history and denies any weight loss or constitutional symptoms. Physical examination reveals a palpable right-sided flank mass. Laboratory investigations are within normal limits, except for microscopic hematuria on urinalysis. A contrast-enhanced CT scan of the abdomen and pelvis reveals a 6 cm solid mass in the right kidney consistent with renal cell carcinoma (RCC). There is no evidence of lymph node involvement or distant metastasis on imaging. The patient is otherwise in good health and has a performance status 0. Which of the following is the most appropriate management for this patient?

1. Systemic chemotherapy

2. External beam radiation therapy

3. Radical nephrectomy

4. Targeted therapy with tyrosine kinase inhibitors

15. A 25-year-old woman presents to OPD with complaints of flank pain and a short history of uncontrolled hypertension. She has taken several different types of antihypertensive medications, but she is nonresponsive to them. Her doctor advised her angiography, which showed the distal part of the left renal artery involved; however, the left and right renal artery branches were spared. CT scan shows the normal size of both kidneys. She was diagnosed with fibromuscular dysplasia, and her subtype was found to be perimedial fibroplasia. What will be the next course of management for her?

1. Medical management

2. Percutaneous transluminal angioplasty

3. Nephrectomy

4. Surgical renal revascularisation

16. A 62-year-old man visits the clinic after a screening test revealed higher levels of prostate-specific antigen. The patient adds, "It often takes a little while before my urine starts flowing," when questioned about genitourinary symptoms, but he has no additional issues. Examinations of the external and abdominal genitalia are unremarkable. Hard prostate nodules are seen during a digital rectal exam. After a biopsy confirms the presence of cancer, the patient has a radical prostatectomy. The nerves in the fascia around the gland are unintentionally damaged during the procedure. Which of the following effects of nerve damage is most likely to occur?

1. Detrusor muscle overactivity

2. Erectile dysfunction

3. External urethral sphincter paralysis

4. Loss of cremasteric reflex

17. A 65-year-old male an occupational textile worker, is presented in a surgical emergency with complaints of painless bleeding during urination and urinary hesitancy with a weak stream for 3 days. He also has suprapubic and pelvic pain. His cystoscopy shows a large, broad-based tumour with an ulcerated irregular appearance of the bladder wall. Which of the following is the most probable type of bladder carcinoma in this patient?

1. Non-muscle-invasive bladder cancer

2. Muscle-invasive bladder cancer

3. Carcinoma in situ

4. Non-muscle-invasive bladder cancer with carcinoma in situ

18. A 70-year-old male patient presents to the outpatient department with complaints of urinary frequency, urinary urgency, nocturia and urge incontinence. The patient also had a neurological condition in which there is dopamine deficiency and increased cholinergic activity in the corpus striatum. His CT scan revealed no abnormality in the spinal cord, and ultrasound for kidneys, ureters, and bladder is also unremarkable. From which one of the following conditions is the patient suffering?

1. Detrusor hyperreflexia and urethral sphincter bradykinesia

2. Detrusor areflexia with urethral sphincter hyperkinesia

3. Detrusor sphincter dyssynergia–detrusor hyperreflexia

4. Detrusor areflexia

19. A 48-year-old female presents to the outpatient department complaining of wetting herself on standing up from a sitting position for the last weeks. She gives a history of peeing on herself while coughing, laughing, sneezing, and occasionally during walking for the last two months. She is reluctant to drink fluids to avoid these accidental leakages. Her urine analysis and bladder scans are normal. Conservative management and pharmacological treatment advised by her primary care physician have failed. What is the minimally invasive next step in management?

1. Intraurethral injection therapy

2.  Synthetic mid-urethral sling

3. Retro pubic suspension procedures

4. Autologous fascial sling

20. A 71-year-old male presents with increased frequency of urination, weak urine flow, and difficulty initiating urination. Upon further evaluation, benign prostatic hyperplasia (BPH) is diagnosed. During embryonic development, the urogenital sinus gives rise to several structures, including the prostate gland. Which specific region of the urogenital sinus is responsible for developing the epithelial component of the prostate gland?

1. Sinus tubercle

2. Sinus membrane

3. Sinus prostaticus

4. Sinus spongiosum

21. A 65-year-old man presents with lower urinary tract obstruction symptoms caused by benign prostate hyperplasia (BPH). He is concerned about potential side effects and the procedure's recovery time. He is hesitant about being hospitalised. Which of the following options would be the most appropriate for treating BPH in this case?

1. Transurethral Resection of the Prostate

2. Open Prostatectomy

3. Transurethral Needle Ablation

4. Watchful Waiting

22. A 62-year-old male has difficulty passing urine, nocturia, and increased urinary frequency. A digital rectal exam (DRE) reveals an enlarged, healthy prostate gland. Serum prostate-specific antigen (PSA) level is elevated at 12 ng/mL. A prostate gland biopsy is performed, and histologic findings reveal acinar adenocarcinoma with a Gleason score of 7. Which statements regarding the histologic findings of prostate adenocarcinoma are true?

1. Papillary projections and glandular crowding characterise prostate adenocarcinoma.

2. The presence of stromal invasion and cellular atypia characterises prostate adenocarcinoma.

3. Prostate adenocarcinoma is characterised by spindle cells and sarcomatoid differentiation.

4. Small, uniform glands characterise prostate adenocarcinoma with basally located nuclei

23. A Uroflowmetry is a diagnostic screening procedure that determines the volume of urine released from the body, the rate at which it is released, and the length of time it takes to release the urine. Uroflowmetry is carried out by urinating into a special urinal, toilet, or disposable device equipped with a measuring device. A urinary flow graph is shown below. What does the graph interpret?

1. A regular urinary flow pattern.
2. A urinary flow rate trace from a patient with urethral Stricture.
3. Obstruction due to prostate hyperplasia
4. Obstruction at the neck of the bladder

24. A 55-year-old man presents with a progressively worsening ability to maintain erections secondary to Peyronie's disease for the past 2 years. He has been on oral therapy with minimal response. The patient is interested in surgical options for Peyronie's disease. Which of the following options would be the most appropriate for this patient?

1. Nesbit Procedure

2. Plaque Incision and Grafting

3. Tunica Albuginea Plication

4. Penile Venous Ligation

25. A 55-year-old man with a history of hypertension and hyperlipidemia presents with a chief complaint of difficulty in achieving and maintaining an erection. He has tried oral phosphodiesterase type 5 (PDE5) inhibitors with limited success. On physical examination, the penis appears normal without any palpable masses or plaque. The results of laboratory tests, including fasting glucose and testosterone levels, are within normal limits. The patient underwent a Doppler ultrasound, what findings on Doppler ultrasound would be consistent with the diagnosis of erectile dysfunction (ED)?

1. Normal Doppler waveform with absence of venous leak

2. Normal Doppler waveform with the presence of venous leak

3. Abnormal Doppler waveform with the absence of venous leak

4. Abnormal Doppler waveform with the presence of venous leak

If you are preparing for NEET-SS 2024 and ahead, check out SS ELITE Plan (Version 3.0) and what makes it the perfect study resource for your super speciality preparation. 

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