Urology: obstructing stone in a solitary kidney: practice question

A General Surgery 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.

Try it

General Surgery · Urology: obstructing stone in a solitary kidney

Sample item

A man with a single functioning kidney has 12 hours of anuria and loin pain. CT shows a 7 mm stone at the lower ureter with hydronephrosis, and creatinine has risen from 1.1 to 5.2 mg/dL. What is the most appropriate immediate management?

AMedical expulsive therapy with tamsulosin and fluidsBUrgent decompression with a ureteric stent or percutaneous nephrostomyCIncreased oral fluids and regular NSAIDsDElective shock wave lithotripsy on the next routine list

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

The answer and the reasoning

B. Urgent decompression with a ureteric stent or percutaneous nephrostomy

Obstruction of a solitary kidney with acute kidney injury is an emergency. Decompression by retrograde stent or nephrostomy restores drainage, and definitive stone treatment follows when the kidney has recovered. Waiting risks irreversible loss of renal function.

Option by option

A. Medical expulsive therapy with tamsulosin and fluids
Medical expulsive therapy is only for stable patients with preserved renal function and no obstruction injury.
B. Urgent decompression with a ureteric stent or percutaneous nephrostomy (correct)
Correct. Drainage of the obstructed single kidney is urgent to rescue renal function.
C. Increased oral fluids and regular NSAIDs
NSAIDs can worsen acute kidney injury and do not relieve obstruction.
D. Elective shock wave lithotripsy on the next routine list
Waiting for an elective list leaves the only kidney obstructed.

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.

Questions about this General Surgery question

What is the answer to this General Surgery question?

The best answer is B, Urgent decompression with a ureteric stent or percutaneous nephrostomy. Obstruction of a solitary kidney with acute kidney injury is an emergency.

Why is "Medical expulsive therapy with tamsulosin and fluids" not the answer?

Medical expulsive therapy is only for stable patients with preserved renal function and no obstruction injury.

Why is "Increased oral fluids and regular NSAIDs" not the answer?

NSAIDs can worsen acute kidney injury and do not relieve obstruction.

Why is "Elective shock wave lithotripsy on the next routine list" not the answer?

Waiting for an elective list leaves the only kidney obstructed.

What concept does this question test?

It tests Urology: obstructing stone in a solitary kidney in General Surgery. Decompression by retrograde stent or nephrostomy restores drainage, and definitive stone treatment follows when the kidney has recovered. Waiting risks irreversible loss of 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 Urology: obstructing stone in a solitary kidney?

Learn classic signs and eponyms alongside what they diagnose. Then use the flashcards and the other General Surgery 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.