Urology MCQs

Surgery · 5 free questions with answers & explanations.

1. A 65-year-old man presents with a 3-month history of painless total haematuria. He is a heavy smoker (40 pack-years). Cystoscopy reveals a papillary lesion on the posterior wall of the bladder. Transurethral resection of the bladder tumour (TURBT) histology shows transitional cell carcinoma, grade 2, invading the lamina propria but not the muscularis propria. Staging CT shows no lymphadenopathy or distant metastases. What is the correct staging and recommended adjuvant treatment after TURBT?
2. A 55-year-old man is found to have a serum PSA of 12 ng/mL on routine screening. Digital rectal examination reveals a hard nodule in the right lobe of the prostate. Transrectal ultrasound-guided biopsy shows adenocarcinoma with a Gleason score of 3+4=7 in 4 of 12 cores. Bone scan and CT pelvis show no evidence of metastatic disease. His life expectancy is more than 10 years. What is the most appropriate management?
3. A 25-year-old man presents to the emergency department with a 4-hour history of sudden-onset severe left scrotal pain, nausea, and vomiting. On examination the left testis is high-riding and exquisitely tender; the cremasteric reflex is absent on the left. What is the immediate management?
4. A 48-year-old woman presents with recurrent episodes of right flank pain radiating to the groin, haematuria, and nausea over the past 8 months. CT urogram shows a 7 mm calculus at the right vesicoureteric junction (VUJ) with moderate proximal hydronephrosis. Renal function is normal. What is the most appropriate management?
5. A 60-year-old man presents with a 3-month history of a painless solid mass in the right testis. Serum tumour markers are: beta-hCG 1,200 IU/L, AFP 0.8 ng/mL (normal), LDH mildly elevated. Scrotal ultrasound confirms a solid hypoechoic right testicular mass. CT chest, abdomen, and pelvis shows no lymphadenopathy or metastases. What is the most likely histological subtype?