Urology: medical expulsive therapy: 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.

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General Surgery · Urology: medical expulsive therapy

Sample item

A patient with an uncomplicated 6 mm distal ureteric stone has controlled pain, normal renal function and no infection. What is a reasonable management?

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

The answer and the reasoning

A. Analgesia with an alpha blocker such as tamsulosin and observation

Stones under 10 mm in the distal ureter often pass spontaneously, and alpha blockers relax ureteric smooth muscle to promote passage. NSAIDs give effective analgesia. Intervention is needed for infection, obstruction with renal impairment, intractable pain or failure to pass.

Option by option

  • A. Analgesia with an alpha blocker such as tamsulosin and observation (correct)

    Correct. Conservative treatment with medical expulsive therapy is appropriate.

  • B. Immediate open ureterolithotomy

    Open surgery is obsolete for such a stone.

  • C. Nephrectomy

    Nephrectomy is not warranted.

  • D. Percutaneous nephrolithotomy

    PCNL is for large renal stones.

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 General Surgery question

What is the answer to this General Surgery question?

The best answer is A, Analgesia with an alpha blocker such as tamsulosin and observation. Stones under 10 mm in the distal ureter often pass spontaneously, and alpha blockers relax ureteric smooth muscle to promote passage.

Why is "Immediate open ureterolithotomy" not the answer?

Open surgery is obsolete for such a stone.

Why is "Nephrectomy" not the answer?

Nephrectomy is not warranted.

Why is "Percutaneous nephrolithotomy" not the answer?

PCNL is for large renal stones.

What concept does this question test?

It tests Urology: medical expulsive therapy in General Surgery. NSAIDs give effective analgesia. Intervention is needed for infection, obstruction with renal impairment, intractable pain or failure to pass.

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: medical expulsive therapy?

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.