Surgery — Urology, NMC MBBS licence examination syllabus (Nepal Medical Council).
Urology — NMC-style practice questions
Practice questions written for this chapter. These are not past NMC papers.
📋 About these questions: These are practice questions written to test the reasoning in this chapter. They are NOT reproduced from any past Nepal Medical Council examination, and no verified past NMC questions were supplied for this chapter.
Level 1–2 — recall and understanding
Q1. PAINLESS visible haematuria should be regarded as:
A. Urinary infection
B. URINARY TRACT CANCER until proven otherwise
C. Normal if it settles
D. Due to dehydration
ANSWER: B.
Why: bladder and kidney tumours characteristically bleed
intermittently, so the bleeding stopping is exactly what a
cancer does. It requires full investigation regardless.
LEARNING POINT: ask about smoking — a major risk factor for
bladder cancer.
Q2. A patient with renal colic characteristically:
A. Lies completely still
B. CANNOT KEEP STILL and moves constantly
C. Sits leaning forward
D. Has no pain between episodes
ANSWER: B — restless.
Why: colicky visceral pain makes patients move about looking
for relief, whereas peritonitis makes them lie still because
movement worsens the pain.
LEARNING POINT: restless with colic, still with peritonitis.
Level 3–4 — application and clinical reasoning
Q3. A woman with an obstructing ureteric stone is febrile,
tachycardic and hypotensive. Management requires:
A. Antibiotics and observation
B. Antibiotics AND URGENT DRAINAGE of the obstructed
system
C. Analgesia alone
D. Elective stone removal in six weeks
ANSWER: B.
Why: this is an obstructed, infected kidney — infected urine
behind an obstruction that antibiotics cannot sterilise. It
progresses rapidly to septic shock.
LEARNING POINT: the same source control principle as an
undrained abscess.
Q4. After catheterising an elderly man with painless chronic
retention and a very large residual volume, you must:
A. Discharge him immediately
B. MONITOR urine output, fluids and electrolytes for
post-obstructive diuresis
C. Remove the catheter after one hour
D. Restrict fluids
ANSWER: B.
Why: after decompression the kidneys may produce very large
volumes for hours, causing volume depletion and electrolyte
disturbance if unmonitored.
LEARNING POINT: check renal function in every patient with
retention.
Q5. A 15-year-old has sudden severe scrotal pain, vomiting, a
high-riding testis and an absent cremasteric reflex. The
correct action is:
A. Await ultrasound before deciding
B. IMMEDIATE surgical exploration
C. Antibiotics for epididymo-orchitis
D. Analgesia and review in the morning
ANSWER: B — immediate exploration.
Why: this is testicular torsion until proven otherwise.
Viability falls with every hour, and a normal ultrasound does
NOT exclude it.
LEARNING POINT: clinical suspicion goes straight to theatre.
Level 5 — exception-based
Q6. A 68-year-old man presents with a first episode of
"renal colic". Which diagnosis must be excluded?
A. Appendicitis
B. LEAKING ABDOMINAL AORTIC ANEURYSM
C. Testicular torsion
D. Pyelonephritis
ANSWER: B.
Why: a leaking aortic aneurysm can present with loin pain
identical to renal colic, and a first attack in an older
patient should raise the possibility.
LEARNING POINT: it is the diagnosis you cannot afford to
miss.
Q7. A man with known prostate cancer develops back pain with
new leg weakness and difficulty passing urine. This
suggests:
A. Simple mechanical back pain
B. SPINAL CORD COMPRESSION from metastasis
C. Urinary infection
D. Benign prostatic enlargement
ANSWER: B — cord compression.
Why: prostate cancer metastasises to bone. Back pain with
neurological signs or retention is cord compression until
proven otherwise, and it is an emergency.
LEARNING POINT: retention plus back pain always demands a
neurological assessment.
Syllabus points
Recall and understanding questions
Application and clinical reasoning questions
Exception-based questions
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