Urology (Prometric)

A high-risk recurrent calcium-stone former begins pharmacological recurrence prevention after a complete metabolic evaluation. The urologist wants to determine whether urinary risk factors have normalized and whether treatment needs adjustment. When should the first follow-up 24-hour urine collection usually be obtained?

A 64-year-old woman completed bladder-preserving trimodality therapy for cT2 urothelial carcinoma and initially achieved a complete response. Eighteen months later, surveillance identifies a new muscle-invasive recurrence confined to the bladder without distant metastases. She remains fit for major surgery. What is the preferred curative management?

A man develops left-sided haematuria and flank discomfort from compression of the left renal vein between two major vessels. Which anatomical relationship underlies the classic anterior nutcracker mechanism?

A man with recurrent calcium stones is prescribed a thiazide because 24-hour urine testing demonstrates marked hypercalciuria. Which renal tubular effect principally explains the reduction in urinary calcium?

A 65-year-old woman is scheduled for radical nephroureterectomy for high-risk non-metastatic upper urinary tract urothelial carcinoma. Which surgical principle is essential to reduce local and intravesical recurrence risk?

A 52-year-old obese man has adult acquired buried penis with recurrent hygiene difficulties and voiding problems. Reconstructive surgery is being considered. Which preoperative measure is strongly recommended to reduce surgical complications and improve outcomes?

A 66-year-old continent woman with stage III pelvic organ prolapse is planning prolapse surgery. She denies stress urinary leakage during ordinary activities. Which preoperative assessment can identify occult stress urinary incontinence and improve counselling about concomitant continence surgery?

A 45-year-old woman has recurrent UTIs, postmicturition dribble, dyspareunia and a palpable anterior vaginal wall mass. Urethral diverticulum is suspected and precise anatomical characterisation is required before surgery. Which investigation is preferred?

A 68-year-old postmenopausal woman has stress urinary incontinence accompanied by vaginal dryness, dyspareunia and examination findings of vulvovaginal atrophy. She wishes to try additional conservative medical therapy. Which hormonal approach is appropriate?

A 30-year-old man presents with recurrent painful vesicular genital lesions suspicious for genital herpes. Several intact lesions are available for sampling. Which laboratory test is preferred to confirm the localised infection?