Any savvy Urologist knows that the only way to pass the Urology Board Certification Exam is to study. Then study again. Then study even more.
While the studying can prove tedious, it doesn’t have to be a jumble of notes and open books. Many physicians favor question banks as a favorite resource. Taking practice questions simulates real exam conditions as the exam will consist of 300 multiple choice questions you must master.
Here are three free sample questions taken from the soon to be released BoardVitals ABU Urology Exam question bank. [Register now to be the first to know when the BoardVitals Urology question bank is released.]
A 69-year-old diabetic male is evaluated by his primary care doctor for a 30-pound weight loss over the past 6 months and vague right flank pain. Workup reveals a 1 cm right UPJ stone associated with moderate hydronephrosis and 10 cm irregular, enhancing right midpole renal mass. Mag-3 lasix scan shows a non-functioning right kidney and normal left kidney with appropriate drainage parameters. Urine culture is negative and the patient is afebrile with normal vital signs. What is the next step in management?
A.) Right percutaneous nephrostomy tube and chronic antibiotics
B.) Laparoscopic right radical nephrectomy
C.) Laparoscopic right partial nephrectomy
D.) Open right radical nephrectomy
E.) Right ureteral stent placement
Correct answer: (D) Open right radical nephrectomy. Explanation: This presentation is concerning for xanthogranulomatous pyelonephritis (XGP), however XGP cannot be differentiated from renal malignancy on imaging. The kidney is nonfunctional and there is no evidence of active infection, so PCN or stent would not be indicated. The patient requires surgical removal of the right kidney. An open approach is generally recommended in setting of possible XGP as the inflammatory reaction can extend beyond Gerota’s fascia into adjacent structures making surgical removal challenging.
Schaeffer AJ and Schaeffer EM. Infections of the Urinary Tract. Campbell-Walsh Urology, 10th Edition: 257-326,2011.
A patient undergoes a nephrectomy for a solid renal mass, which was identified incidentally during a workup for kidney transplant. The tumor is noted to be a 4 cm solitary renal cell carcinoma with no evidence of spread, Furhman grade 1. What sort of waiting period would this patient require before being cleared for transplant?
A.) No waiting period – patient can be cleared immediately.
B.) 2 years
C.) 5 years
D.) Patient can never be considered for transplant as there is always going to be a risk of recurrence after transplant immunosuppression.
(A) No waiting period – patient can be cleared immediately. Explanation: Patients with cancers discovered pre-kidney transplant listing will need evaluation for risk of recurrence after transplant. This will vary based on type, grade and stage of the cancer. An incidentally discovered renal cell cancer < 5 cm and low Fuhrman grade will need no waiting period before clearance for transplant.
Bunnapradist S, et al. Am J Kid Dis 2007; 50(5): 890-898.
A 45 year old woman has recurrent calcium oxalate kidney stones. Her serum calcium is 9 mg/dL, urine calcium is 300 mg/24 hr and her PTH is 90 pg/mL (normal < 65). You start her on hydrochlorothiazide 25 mg twice daily and two weeks later her calcium level has gone up to 11 mg/dL. What management does she need?
A.) Increase her dose of thiazide
B.) Decrease her dose of thiazide
C.) Dietary calcium restriction
D.) Change to a different thiazide
- This is incorrect. The patient has had an increase in serum calcium on a thiazide, so this suggests she has primary hyperparathyroidism. B. This is incorrect. The patient has had an increase in serum calcium on a thiazide, so this suggests she has primary hyperparathyroidism and needs surgery, not a medication change. C. This is incorrect. The patient has had an increase in serum calcium on a thiazide, so this suggests she has primary hyperparathyroidism and needs surgery, not dietary changes. D. This is incorrect. The patient has had an increase in serum calcium on a thiazide, so this suggests she has primary hyperparathyroidism and needs surgery, not a medication change. E. This is the correct answer. The patient underwent a “thiazide challenge test” and failed. This creates mild hypercalcemia and allows the diagnosis of primary hyperparathyroidism in cases where the serum calcium and PTH levels are not sufficient for diagnosis.
Eisner and Stoller, J Endourol. 2009 Feb;23(2):191-2.
How did you do? Keep studying and you’ll be board-certified in no time! Looking for more help? Sign up with Urology as your specialty to be the first to know when the BoardVitals Urology question bank is released.