Urology: staghorn calculus: 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: staghorn calculus

Sample item

A woman with recurrent UTIs has a large branched stone filling the renal pelvis and calyces. What is the preferred treatment?

APercutaneous nephrolithotomyBObservationCExtracorporeal shock wave lithotripsy as monotherapyDMedical dissolution only

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

The answer and the reasoning

A. Percutaneous nephrolithotomy

Staghorn calculi are usually infection stones made of struvite, and left untreated they destroy the kidney. PCNL is the first-line treatment, sometimes combined with ESWL, and the aim is to clear the entire stone. ESWL alone has poor clearance for large burdens.

Option by option

A. Percutaneous nephrolithotomy (correct)
Correct. PCNL gives the best clearance of large stones.
B. Observation
Observation risks sepsis and renal loss.
C. Extracorporeal shock wave lithotripsy as monotherapy
Lithotripsy alone leaves fragments that harbour infection.
D. Medical dissolution only
Dissolution is slow and unreliable for struvite.

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 A, Percutaneous nephrolithotomy. Staghorn calculi are usually infection stones made of struvite, and left untreated they destroy the kidney.

Why is "Observation" not the answer?

Observation risks sepsis and renal loss.

Why is "Extracorporeal shock wave lithotripsy as monotherapy" not the answer?

Lithotripsy alone leaves fragments that harbour infection.

Why is "Medical dissolution only" not the answer?

Dissolution is slow and unreliable for struvite.

What concept does this question test?

It tests Urology: staghorn calculus in General Surgery. PCNL is the first-line treatment, sometimes combined with ESWL, and the aim is to clear the entire stone. ESWL alone has poor clearance for large burdens.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. 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: staghorn calculus?

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.