OS206: Abdomen

rd
3 Exam: KUB Anatomy

1. A patient presented with a renal colic. An intravenous a) A radio opaque density may be seen along the course
pyelogram revealed a left ureteropelveocaliectasia (dilation of of the ureter
the ureter and pelvis). In such patients, whom you assess to b) The renal shadow will appear bigger than normal
have a stone, you would not consider an obstruction at this c) If there is a migration of the stone, this radio
course of the urinary tract opaque density will most likely be seen at the
a) Within the bladder cavity ureteropelvic junction
b) At the area of the pelvic inlet where the ureter cross d) The radio opaque density may be seen at the internal
the iliacs urethral orifice
c) At the ureterovesical junction e) You may see a lucent defect anywhere in the are of
d) At the ureteral orifice in the urinary bladder the renal shadow
e) At the Ureteropelvic junction
You can expect the stones to lodge at the narrowest parts of 9. During hysterectomy, this vessel may be injured:
the ureters, which are choices “b,” “c,” and “e.” a) Superior vesical artery
b) Obturator artery
2. When the kidneys malfunction, the patient can present with c) Uterine artery
any one of these findings. Which is not included? d) Internal iliac artery
a) Normal/elevated serum hemoglobin e) Obturator artery
b) Elevated H+ ions in the blood with the patient
becoming acidotic 11. The ligament that helps maintain the urinary bladder of
c) Abnormal retention of fluids in the body Juan Dela Cruz in its position is the
d) Deranged serum calcium level a) Pubovesical
e) Elevated serum creatinine b) Puboprostatic
c) Medial umbilical
3. In patients with obstructive uropathy, which of the following d) Lateral umbilical
radiologic findings is not expected to be seen e) Rectovesical
a) Pelveocaliectasia Puboprostatic ligament for Juan, pubovesical ligament for
b) Dilated ureter Maria
c) Cupping of minor calyces
d) Thinned out renal cortices 12. Muscular component of bladder receives motor supply from
e) Enlarged renal shadow a) Sacral nerve
b) Pelvic splanchnic nerve
4. When there is an expanding perirenal hematoma, in which c) Vesical plexus
direction would be the preferential dissection of the expanding d) Vagus nerve
blood volume? e) NOTA
a) Laterally into the lateral abdominal wall
b) Medially and anteriorly to the posterior parietal 13. Encounter the following in succession when doing
peritoneum nephrectomy using lumbar/flank approach
c) Medially and laterally to the fascial plane of the lateral a) Peritoneum, pararenal fat, perirenal fat, Gerota’s
abdominal wall fascia
d) Medially and inferiorly to the pelvic brim b) Lateral abdominal wall fascia, Perirenal fat,
e) Inferiorly to the pelvic cavity Zuckerkandl’s fascia, peritoneum
c) Lateral abdominal wall fascia, peritoneum, pararenal
5. When there is drooping of the kidney, one may complain of fat, Gerota’s fascia, perirenal fat
renal pain. This is brought about by the: d) Lateral abdominal wall fascia, pararenal fat,
a) Movement of the kidney itself Zuckerkandl’s fascia, perirenal fat
b) Kinking of the ureter when the kidney droops e) Posterior peritoneum, pararenal fat, Gerota’s fascia,
c) Traction on the renal vessels during the descent perirenal fat
of the kidney
d) Irritation of the posterior peritoneum by the renal 14. During a left nephrectomy or surgical removal of a kidney,
movement one must be careful in the point of ligation of the renal vein.
e) Irritation of the renal plexus during descent of the This vein must be ligated closer to the renal hilum so as not to
kidney injure which organ?
a) Spleen
6. During renal transplant, why is the kidney placed in the iliac b) Pancreas
fossa? c) Gonad
Prevent traction on surgically anastomosed vessels d) Adrenal gland
e) Lumbar sympathetic trunk
7. A patient was stabbed in the LUQ and blood was seen in the Not sure with this. 
urine. What is to be the least injured organ?
a) Pancreas 16. A 75 kg male goes to void 10 times a day. What volume is
b) Spleen expected to be expelled during each visit?
c) Descending colon a) 100
d) Descending duodenum b) 130
e) First part of jejunum c) 150
d) 180
8. A patient presented at the ER with severe renal colic. He is e) 200
a rabid consumer of cheese and dairy products. You suspect
him to have a renal stone. If you were to take a plain film of the 18. Normal bladder compliance is essential during filling
abdomen, which of these statements is valid? because

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 OS206: 3rd Exam – KUB Anatomy
a) It allows slow rise in detrusor pressure as bladder
volume increases in preparation for voiding
b) It maintains low bladder pressures even at increasing
bladder volume
c) It will allow complete and sustained emptying during
void phase
d) It prevents distension of the bladder
The bladder relaxes to accommodate urine as it is being filled.
30. The richly folded epithelium
This structure is important in the urethral seal effect, especially
in menopausal women. The structure is weakened in these
women and they develop stress incontinence (they pee when
they cough).
Matching

20. Urethral competence during coughing is achieved through: E. Reabsorbs most urinary filtrate
a) Contraction of rhabdosphincter
b) Folding of urethral epithelium 31. PCT (e)
c) Cushioning effect of urethral submucosa
d) Relaxation of pubovisceralis muscle A. Adrenal gland (c)

21. This group of muscles prevent backflow of urine from For numbers 31-35,
bladder to ureters during voiding: a) Selectively permeable to water descending limb of
a) Detrusor syncytium loop of Henle
b) Trigone b) ADH Sensitive
c) Rhabdosphincter c) Restores medullary osmotic pressure
d) Pubovisceralis d) Aldosterone sensitive DCT
The detrusor syncitium allows the action potential to spread e) Reabsorbs most of the filtrate
throughout the detrusor muscle faster, allowing contraction of
the bladder at once during voiding. Contraction of the 35. Collecting Duct (b)
pubovisceralis closes the urethra and other openings in the
filling phase. For number 36-40,
a) DCT
24. During normal filling of the bladder, the pelvic organs b) Hypothalamus
a) Detrusor contracts, sphincter contracts c) Lungs
b) Detrusor relaxes, sphincter relaxes d) Liver
c) Detrusor contracts, sphincter relaxes e) Adrenal Gland
d) Detrusor relaxes, sphincter contracts
Structure(s) Action Control 36. Renin (a)
- No abnormal, 37. Angiotensin II (c)
uncontrolled 38. Aldosterone (e)
- Compliant
contractions 39. ADH (b)
Detrusor - Relaxes and
- Nerves supplying 40. Angiotensinogen (d)
accommodates
detrusor should
be quiet
- Competent
B. Squamous Epithelium
Urethra and - Contracts as
- Contracts to
sphincter needed 42. Loop of Henle, thin limb (B)
remain closed
- Contracts
- Contraction of 46. Most cost effective way to examine the urinary bladder
- Contracts more as
Pelvic floor pubovisceralis
needed
a) Xray
group closes b) Ultrasound
urethra c) CT scan
d) MRI
25. The initial event in the lower urinary tract that occurs during
voiding 47. For a well enough assessment of kidney length, which is
a) Detrusor contraction the most appropriate?
b) Trigone contraction a) Plain x-ray
c) Bladder neck opening b) IVP
d) Rhabdosphincter relaxation c) Ultrasound
Trigone contracts after hypogastric nerve stimulation is d) CT Scan
inhibited, and the bladder neck opens. The detrusor muscles Not sure. 
then contact after stimulation by the pelvic nerves, and the
external urethral sphincter and pelvic floor muscles relax 50. On plain xray, the kidneys are seen at this level
following pudendal nerve inhibition. a) T11-L2
b) L2-L5
26. If cortex is damaged
a) Automatically void when bladder is full 51. At 3 minutes, what do you expect to see?
b) Not void despite full bladder Kidney
c) Continually leak Time Location of contrast
3 minute In the kidneys
27. Detrusor contraction during normal voiding is mediated by
5 minute Excreted by the kidneys
a) Somatic
b) Parasympethatic 10 minute Down the ureter
c) Sympathetic 15 minute Entering the bladder
d) Autonomic
52. Which of the following modalities would best show calcified
29. Once you have completely emptied your bladder, the renal stones?
cortex behaves: a) Plain KUB
a) It ceases to send impulses to pons b) IVP
b) It sends inhibitory impulses to pons c) Ultrasound
c) It stimulates the spinal cord d) MRI
d) It relays inhibitory signals to the spinal cord

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 OS206: 3rd Exam – KUB Anatomy
53. In plain KUB, if you do not see the flank stripe clearly, you
would think of
a) Liver infection
b) Kidney infection
c) Colonic infection
d) Peritoneal infection

55. On radiologic imaging, ureters can only be seen in

a) Plain KUB
b) IVP
c) Ultrasound
d) NOTA

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