Paediatric imaging: posterior urethral valves: practice question

A Radiology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Radiology · Paediatric imaging: posterior urethral valves

Sample item

A male newborn has a palpable bladder and a poor urinary stream. Ultrasound shows a thick-walled distended bladder with a dilated posterior urethra, the keyhole sign, and bilateral hydronephrosis. What is the most likely diagnosis?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Posterior urethral valves

Posterior urethral valves obstruct the male urethra and cause bladder wall thickening, hydroureteronephrosis and a keyhole-shaped dilated posterior urethra. A voiding cystourethrogram confirms the valves. Early decompression protects renal function.

Option by option

  • A. Prune belly syndrome

    Prune belly syndrome shows abdominal wall deficiency and a large flaccid bladder.

  • B. Bilateral pelviureteric junction obstruction

    PUJ obstruction does not distend the bladder.

  • C. Neurogenic bladder from spina bifida

    Neurogenic bladder is not suggested without spinal signs.

  • D. Posterior urethral valves (correct)

    Correct. The keyhole sign with a thick-walled bladder is typical of valves.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Radiology question

What is the answer to this Radiology question?

The best answer is D, Posterior urethral valves. Posterior urethral valves obstruct the male urethra and cause bladder wall thickening, hydroureteronephrosis and a keyhole-shaped dilated posterior urethra.

Why is "Prune belly syndrome" not the answer?

Prune belly syndrome shows abdominal wall deficiency and a large flaccid bladder.

Why is "Bilateral pelviureteric junction obstruction" not the answer?

PUJ obstruction does not distend the bladder.

Why is "Neurogenic bladder from spina bifida" not the answer?

Neurogenic bladder is not suggested without spinal signs.

What concept does this question test?

It tests Paediatric imaging: posterior urethral valves in Radiology. A voiding cystourethrogram confirms the valves. Early decompression protects renal function.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Paediatric imaging: posterior urethral valves?

Learn signs with the image, and the disease they point to. Then use the flashcards and the other Radiology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.