MBBS 2021 UROLOGY OSCE AND PICTURE TEST

STATION 1

A 50year old man with a 16month history of difficulty passing urine characterized by weak
stream, intermittency, feeling of incomplete emptying and a single episode of haematuria,
had no urgency no urge incontinence. He had a 6month history of weak erection including
loss of early morning erection but intact ejaculation. His IPSS was 15/35. He was a known
hypertensive on hydrochlorothiazide.

Digital rectal examination revealed an enlarged prostate, smooth, obliterated median groove,
non tender, mobile rectal mucosa, normal anal sphincteric tone and intact peri-anal sensation.

Investigations done: PSA 4.8ng/ml

Urea 45mg/dL

Creatinine 1.0mg/dL

PCV 42%

Platelets 220,000/mm3

Abdominopelvic ultrasound: Prostate volume 55mls

Post-void residual 200mls

STATION 2

Concerning the patient in the previous station

1. The most likely diagnosis is

A. Advanced prostate cancer
B. Benign prostatic enlargement B
C. Urethral stricture
D. Early prostate cancer
E. Haematuria of unknown aetiology
2. The best initial therapy includes
A. Tamsulosin alone
B. Tamsulosin and finasteride
C. Tamsulosin, finasteride and tadalafil C
D. Open prostatectomy
E. Transurethral resection of the prostate
3. Following commencement of treatment in this patient, these complications may arise
EXCEPT
 A. Retrograde ejaculation
B. Dizziness
C. Loss of libido
D. Hypertension D
E. Gynaecomastia
4. The patient has
A. Mild symptoms
B. Moderate symptoms B
C. Severe symptoms
D. Both mild and moderate symptoms
E. All of the above
5. The patient may benefit from the following investigations EXCEPT
A. Cystoscopy
B. Uroflowmetry
C. Abdomino-pelvic CT scan C
D. Penile doppler ultrasound
E. Frequency-volume chart

STATION 3
1. The incision is known as
A. Left anterior subcostal incision A
B. Right anterior subcostal incision
C. Left pararectal incision
D. Left flank incision
E. Midline incision
2. Which of the following operations cannot be done via the incision?
A. Left radical nephrectomy
B. Left simple nephrectomy
C. Left pyeloplasty
D. Left percutaneous nephrolithotomy D
E. Left adrenalectomy
3. The skin was closed with
A. Vicryl 2/0
B. Nylon 2/0
C. Skin staples C
 D. Copper wires
E. Daflon 6/0
4. The Foley’s catheter shown
A. Is most likely in the peritoneal cavity
B. Is most likely in the renal bed B
C. Is draining urine from the bladder
D. Is acting as a dialyser
E. Is usually left in situ for 1 month
5. The most worrisome complication of this type of incision in the immediate
post operative period is
A. Incisional hernia
B. Primary haemorrhage
C. Atelectasis C
D. Reactionary haemorrhage
E. Keloid formation

STATION 4
 1. Which of the following is the most likely cause of the above problem in a 44 yearr old
man?
A. Prostate cancer
B. Benign prostatic enlargement
C. Bladder calculi C
D. Acute glomerulonephritis
E. Renal trauma
2. Which test is being performed above?
A. Urinalysis A
B. Urine MCS
C. Urine cytology
D. Florescence urine hybridization
E. Urodynamic studies
3. If the patient had a history of colicky flank pain radiating to the perineum, the most
likely diagnosis is
A. Ureteric stone A
B. Renal stone
C. Pyelonephritis
D. Bladder tumour
E. Renal cell carcinoma
4. Which of the following investigations is NOT indicated in this patient?
A. Urethrocystoscopy
B. CT urography
C. Haemoglobin level
D. PSA
E. Bone scan E
5. The next step in the management of this patient includes
A. Suprapubic cystostomy
B. Bladder irrigation with 0.9% normal saline A
C. Cystodiathermy of the bleeding vessels
D. Transurethral resection of the prostate
E. Radical prostatectomy

STATION 5

Concerning the device shown and the pathology shown

1. The device is a
A. Chiba needle
B. Trucut biopsy needle B
C. Bladder access needle
D. Nephrostomy needle
E. Cytology needle
2. The recommended size of the needle in the diagnosis of the above pathology is
A. Size 14G
B. Size 16 G
C. Size 18G C
D. Size 20G
E. Size 22G
3. Complications following use of the device include, EXCEPT
A. Haematuria
B. Dysuria B
C. Haematospermia
D. Haematochezia
E. Urinary retention
4. The most common histology of the above pathology is
A. Squamous cell carcinoma
B. Adenocarcinoma B
C. Adenosquamous carcinoma
D. Transitional cell carcinoma
 E. Small cell carcinoma
5. The patient with the above pathology presented with weight loss, bone pains and
progressive lower limb weakness and oedema up to the mid-thigh. Which of the
following will be the treatment modality?
A. Radical nephrectomy
B. Radical prostatectomy
C. Radical radiotherapy
D. Androgen deprivation therapy D
E. Active surveillance