Question 1 of 81
A 39 year old man notices a swelling in his left hemiscrotum. On examination he has a left sided
varicocele. The ipsilateral testis is normal on palpation. What is the most appropriate course of
action?
Scrotal exploration and ligation of the varicocele
Abdominal ultrasound
Scrotal ultrasound
Left orchidectomy
Discharge
Submit answer
Question 2-4 of 81
Theme: Management of urinary tract calculi
A. Nephrectomy
B. Open ureteric exploration
C. Extra corporeal shock wave lithotripsy
D. Percutaneous nephrostomy
E. Pyeloplasty
F. Conservative management
G. Percutaneous nephrolithotomy
Please select the most appropriate management for the scenario given. Each option may be used
once, more than once or not at all.
2. A 23 year old male is admitted with left sided loin pain and fever. His investigations
demonstrate a left sided ureteric calculi that measures 0.7cm in diameter and associated
hydronephrosis.
,3. A 23 year old man is admitted with left sided loin pain that radiates to his groin. His
investigations demonstrate a 1cm left sided ureteric calculus with no associated
hydronephrosis.
4. A 30 year old male presents with left sided loin pain. His investigations demonstrate a large
left sided staghorn calculus that measures 2.3cm in diameter.
Submit answer
Question 5-7 of 81
Theme: Testicular disorders
A. Antibiotics
B. Aspiration
C. Testicular exploration after 6 hours
D. Testicular exploration within 6 hours
E. Orchidectomy via inguinal approach
F. Orchidectomy via scrotal approach
G. No treatment needed
H. Ligation of patent processus vaginalis via inguinal approach
I. Jaboulay procedure via scrotal approach
For each scenario please select the most appropriate management. Each option may be used once,
more than once or not at all.
5. A parent brings her 4 year old child to the surgical clinic. She has noticed an intermittent
swelling in the right scrotum that is worse in the evening. On examination he has a soft
fluctuant swelling in the right scrotum that cannot be separated from the testis. It
transilluminates when a pen torch is held against it.
6. A 20 year old complains of severe pain in the right scrotal area after jumping onto his
moped. He has noticed discomfort intermittently in this area over the past few months.
Clinically the testis is tender.
, 7. A 44 year old man is referred to the clinic because of an swelling in the right scrotum. This
is present most of the time and he is otherwise well with no urinary symptoms. On
examination he has a soft, fluctuant swelling in the right scrotum that transilluminates
easily. An ultrasound is performed that confirms that the underlying testicle is structurally
normal.
Submit answer
Question 8-10 of 81
Theme: Urinary tract trauma
A. Urinary tract infection
B. Bladder outlet obstruction
C. Bulbar urethral rupture
D. Membranous urethral rupture
E. Bladder rupture
F. Bladder contusion
For the scenario given please select the most likely injury. Each option may be used once, more
than once or not at all.
8. A 56 year old man is involved in a road traffic accident. He is found to have a pelvic
fracture. He reports that he has some lower abdominal pain. He has peritonism in the lower
abdomen. The nursing staff report that he has not passed any urine. A CT scan shows
evidence of free fluid.
9. A 52 year old man falls off his bike. He is found to have a pelvic fracture. On examination
he is found to have perineal oedema and on PR the prostate is not palpable. A urine
dipstick shows blood.
10. A 52 year old woman falls out of a tree while rescuing a cat. Imaging shows no bony
injury. She has suprapubic tenderness and complains of dysuria. Her abdomen is soft and
non tender. A urine dipstick shows blood, nitrites and leucocytes.
A 39 year old man notices a swelling in his left hemiscrotum. On examination he has a left sided
varicocele. The ipsilateral testis is normal on palpation. What is the most appropriate course of
action?
Scrotal exploration and ligation of the varicocele
Abdominal ultrasound
Scrotal ultrasound
Left orchidectomy
Discharge
Submit answer
Question 2-4 of 81
Theme: Management of urinary tract calculi
A. Nephrectomy
B. Open ureteric exploration
C. Extra corporeal shock wave lithotripsy
D. Percutaneous nephrostomy
E. Pyeloplasty
F. Conservative management
G. Percutaneous nephrolithotomy
Please select the most appropriate management for the scenario given. Each option may be used
once, more than once or not at all.
2. A 23 year old male is admitted with left sided loin pain and fever. His investigations
demonstrate a left sided ureteric calculi that measures 0.7cm in diameter and associated
hydronephrosis.
,3. A 23 year old man is admitted with left sided loin pain that radiates to his groin. His
investigations demonstrate a 1cm left sided ureteric calculus with no associated
hydronephrosis.
4. A 30 year old male presents with left sided loin pain. His investigations demonstrate a large
left sided staghorn calculus that measures 2.3cm in diameter.
Submit answer
Question 5-7 of 81
Theme: Testicular disorders
A. Antibiotics
B. Aspiration
C. Testicular exploration after 6 hours
D. Testicular exploration within 6 hours
E. Orchidectomy via inguinal approach
F. Orchidectomy via scrotal approach
G. No treatment needed
H. Ligation of patent processus vaginalis via inguinal approach
I. Jaboulay procedure via scrotal approach
For each scenario please select the most appropriate management. Each option may be used once,
more than once or not at all.
5. A parent brings her 4 year old child to the surgical clinic. She has noticed an intermittent
swelling in the right scrotum that is worse in the evening. On examination he has a soft
fluctuant swelling in the right scrotum that cannot be separated from the testis. It
transilluminates when a pen torch is held against it.
6. A 20 year old complains of severe pain in the right scrotal area after jumping onto his
moped. He has noticed discomfort intermittently in this area over the past few months.
Clinically the testis is tender.
, 7. A 44 year old man is referred to the clinic because of an swelling in the right scrotum. This
is present most of the time and he is otherwise well with no urinary symptoms. On
examination he has a soft, fluctuant swelling in the right scrotum that transilluminates
easily. An ultrasound is performed that confirms that the underlying testicle is structurally
normal.
Submit answer
Question 8-10 of 81
Theme: Urinary tract trauma
A. Urinary tract infection
B. Bladder outlet obstruction
C. Bulbar urethral rupture
D. Membranous urethral rupture
E. Bladder rupture
F. Bladder contusion
For the scenario given please select the most likely injury. Each option may be used once, more
than once or not at all.
8. A 56 year old man is involved in a road traffic accident. He is found to have a pelvic
fracture. He reports that he has some lower abdominal pain. He has peritonism in the lower
abdomen. The nursing staff report that he has not passed any urine. A CT scan shows
evidence of free fluid.
9. A 52 year old man falls off his bike. He is found to have a pelvic fracture. On examination
he is found to have perineal oedema and on PR the prostate is not palpable. A urine
dipstick shows blood.
10. A 52 year old woman falls out of a tree while rescuing a cat. Imaging shows no bony
injury. She has suprapubic tenderness and complains of dysuria. Her abdomen is soft and
non tender. A urine dipstick shows blood, nitrites and leucocytes.
