Free Intercollegiate Specialty Examination in Urology — Section 1 Practice Questions

Sample Practice Questions

Try these 10 sample questions from the Intercollegiate Specialty Examination in Urology — Section 1 practice bank. Each includes the answer and explanation. Continue with the interactive practice above to review the full question set.

1. 1During cystoscopy, the surgeon identifies both ureteric orifices and the internal urethral opening. Which bladder region is bounded by these three landmarks?

   1. A.TrigoneCorrect answer: A
   2. B.Dome
   3. C.Urachus
   4. D.Detrusor

   Explanation: OpenStax Anatomy and Physiology 2e states: "the three points of a triangular-shaped area at the base of the bladder called the trigone" These three openings define the trigone, rather than the superior dome or a tissue layer.

   Reference: OpenStax Anatomy and Physiology 2e — 25.2, Urethra

2. 2A woman with uncomplicated stress urinary incontinence chooses supervised pelvic-floor muscle training. What is the minimum recommended initial treatment duration?

   1. A.One month
   2. B.Two months
   3. C.Three monthsCorrect answer: C
   4. D.Six months

   Explanation: EAU Guidelines on Non-neurogenic Female LUTS states: "lasting at least three months" Supervised intensive PFMT should last at least three months; six months exceeds the minimum.

   Reference: EAU Guidelines on Non-neurogenic Female LUTS — 4.2.4.a, PFMT recommendations

3. 3A woman with postmicturition dribbling, recurrent UTI and a palpable anterior vaginal-wall mass has a suspected urethral diverticulum. Which imaging modality best defines its extent for surgical planning?

   1. A.Intravenous urography
   2. B.Non-contrast CT
   3. C.Plain pelvic radiography
   4. D.Magnetic resonance imagingCorrect answer: D

   Explanation: EAU Guidelines on Non-neurogenic Female LUTS states: "Magnetic resonance imaging is the gold standard for the diagnosis and planning of surgical repair" MRI best characterises periurethral diverticular anatomy; the alternatives provide less suitable anatomical detail for this purpose.

   Reference: EAU Guidelines on Non-neurogenic Female LUTS — 4.9.3.a, Anatomical evaluation

4. 4A man has a first, single, non-obliterative 1-cm bulbar urethral stricture. Which endoscopic treatment is guideline-supported for this presentation?

   1. A.Direct vision internal urethrotomyCorrect answer: A
   2. B.Transurethral prostate resection
   3. C.Bladder-neck incision
   4. D.Ureteroscopic laser incision

   Explanation: EAU Urethral Strictures: Disease Management in Males states: "Perform DVIU/dilatation for a primary, single, short (< 2cm) and nonobliterative stricture at the bulbar urethra." This is the selected short bulbar-stricture indication for DVIU. The other procedures treat different anatomical obstructions.

   Reference: EAU Urethral Strictures: Disease Management in Males — 6.2.1, recommendations

5. 5An adult with acute renal colic has normal renal function and no gastrointestinal or cardiovascular contraindication. Which drug class is recommended first for analgesia?

   1. A.Opioids
   2. B.Paracetamol
   3. C.Antispasmodics
   4. D.Non-steroidal anti-inflammatory drugsCorrect answer: D

   Explanation: EAU Urolithiasis: Guidelines states: "Offer a nonsteroidal, anti-inflammatory as the first drug of choice" NSAIDs are first choice when appropriate. Opioids are second choice; the other classes do not replace recommended first-line analgesia.

   Reference: EAU Urolithiasis: Guidelines — 3.4.1.a, recommendations

6. 6Initial semen microscopy reports no sperm. Which additional laboratory step distinguishes absolute azoospermia from cryptozoospermia?

   1. A.Seminal fructose measurement
   2. B.Sperm DNA-fragmentation testing
   3. C.Antisperm antibody testing
   4. D.Semen centrifugation and pellet microscopyCorrect answer: D

   Explanation: EAU Sexual and Reproductive Health: Male Infertility states: "a thorough microscopic examination by phase contrast optics at ×200 magnification of the pellet" Pellet examination after centrifugation can reveal rare sperm missed on initial microscopy; the other tests do not establish absolute absence of sperm.

   Reference: EAU Sexual and Reproductive Health: Male Infertility — 11.3, Semen analysis

7. 7A term infant has a persistent undescended testis at six months. By what latest age should orchidopexy ordinarily be completed under EAU guidance?

   1. A.12 months
   2. B.18 monthsCorrect answer: B
   3. C.24 months
   4. D.36 months

   Explanation: EAU Paediatric Urology: Undescended Testes states: "before the age of 12 months, and by 18 months at the latest" Surgery is preferred before 12 months, with 18 months the latest recommended completion point. The question asks the outer limit.

   Reference: EAU Paediatric Urology: Undescended Testes — Management, recommendations for undescended testes

8. 8A patient has persistent ischaemic priapism despite corporal aspiration. Which intracavernosal adrenergic agonist is the recommended drug of choice?

   1. A.PhenylephrineCorrect answer: A
   2. B.Epinephrine
   3. C.Norepinephrine
   4. D.Ephedrine

   Explanation: EAU Sexual and Reproductive Health: Priapism states: "Phenylephrine is the recommended adrenergic agonist drug of choice" Its alpha-1 selectivity makes phenylephrine preferred among real sympathomimetic alternatives; cardiovascular monitoring remains necessary.

   Reference: EAU Sexual and Reproductive Health: Priapism — 10.1.3.a.3, Phenylephrine

9. 9A patient with haematuria asks which urothelial tumour category urine cytology detects most effectively. Which category is the main diagnostic strength of cytology?

   1. A.Low-grade papillary tumours
   2. B.High-grade tumours including CISCorrect answer: B
   3. C.Benign urothelial papillomas
   4. D.Inverted urothelial papillomas

   Explanation: EAU Non-muscle-invasive Bladder Cancer: Diagnosis states: "Urinary cytology has high sensitivity in HG tumours, including CIS." Cytology is most useful for high-grade disease and CIS, with lower sensitivity for low-grade tumours.

   Reference: EAU Non-muscle-invasive Bladder Cancer: Diagnosis — 5.9, evidence

10. 10A patient has an indeterminate penile lesion and topical cancer treatment is being considered. What is required to establish the diagnosis before such treatment?

    1. A.Penile magnetic resonance imaging
    2. B.Inguinal lymph-node ultrasonography
    3. C.Histological biopsy of the lesionCorrect answer: C
    4. D.Surface swab bacterial culture

    Explanation: EAU states: "Histological confirmation is also necessary to guide management when treatment is planned with topical agents, radiotherapy or laser surgery". Biopsy establishes histology before these treatments; the alternatives do not establish the lesion diagnosis.

    Reference: EAU Penile Cancer: Diagnostic Evaluation and Staging — 5.1.3, Penile biopsy indications