High-Yield Image-Based Questions for INI-CET Surgery

Q1. A 35-year-old woman presents with recurrent urinary tract infections (UTIs), persistent back pain, and hematuria. Imaging reveals a large, branched stone occupying a significant portion of her right kidney. Urinalysis shows alkaline pH, the presence of bacteria, and crystals as shown below. Which of the following is the most likely composition of this stone?​

1. ​Calcium oxalate
2. Uric acid
3. Struvite
4. Cystine

Ans. 3) Struvite  

Q2. A 38-year-old male with a history of untreated pulmonary tuberculosis presents with symptoms of dysuria, hematuria, and flank pain, and notices a gradual worsening of his symptoms. His laboratory tests are consistent with renal impairment. Which of the following features are seen in this condition?​

1. ​Caseous necrosis and tissue destruction
2. Dystrophic calcification
3. Ureteric strictures and obstruction
4. All of the above

Ans. 4) All of the above​

Aslo read: Tips For Handling Burnout While Preparing for INI-CET

Q3. A 65-year-old man with a history of working in a dye factory for 30 years presents with flank pain and gross hematuria. Urinalysis confirms the presence of blood, and cytology shows atypical cells. A retrograde urogram was done given in the image below. He was diagnosed with carcinoma of the renal pelvis.​

Which of the following statements is incorrect regarding the diagnosis?

1. ​The radiographic image shows the Goblet sign.
2. Patients most commonly present with flank pain
3. CT urography is the investigation of choice for diagnosis
4. The most common histological type is transitional cell carcinoma

Ans. 2) Patients most commonly present with flank pain  

Q4. A 40-year-old male presents with right-sided flank pain and persistent hematuria. An intravenous urogram is done and given below. What is the definitive management of this condition?

1. ​Observation with serial imaging
2. Ureteric stent placement
3. Surgical repositioning of the ureter
4. Percutaneous nephrostomy

Ans. 3) Surgical repositioning of the ureter

Q5. A 5-year-old girl is brought to the pediatric urology clinic by her mother, who reports that the child has "never been dry" since birth. The mother notes that urine dribbles continuously via the vagina, but the child can also pass urine normally. An intravenous urogram is performed which is attached below.

Which of the following is the most likely diagnosis? 

1. ​Vesicoureteral reflux
2. Posterior urethral valves
3. Ectopic ureter from duplicated collecting system
4. Ureterocele

Ans. 3) Ectopic ureter from duplicated collecting system  

Also read: High-Yield Image-Based Questions for INI-CET Medicine​

Q6. Based on the images provided, where would each of the shown catheters be used?

Image 1:

Image 2: 

1. ​Image 1:Used for patients with acute urinary retention; Image 2:Used only in neurogenic bladder
2. Image 1: Used for patients with an enlarged prostate causing retention; Image 2: Used in cases of urethral stricture or trauma
3. Image 1: Used for short-term postoperative bladder drainage; Image 2:Used only when Foley's catheterization is contraindicated
4. Image 1: Used for patients with acute urinary retention; Image 2:Used for continuous bladder irrigation

Ans. 2) Image 1: Used for patients with an enlarged prostate causing retention; Image 2: Used in cases of urethral stricture or trauma  

Q7. A 45-year-old male tourist from rural Egypt presents with recurrent hematuria and lower abdominal pain. A pelvic radiograph shows a circular calcification resembling a fetal head in the pelvis with associated faint calcification of the distal right ureter. What is the most likely diagnosis and appropriate next step?​ 

1. ​Bladder stones; perform cystoscopy
2. Chronic schistosomiasis; obtain urine microscopy for ova
3. Pelvic tuberculosis; order interferon-gamma release assay
4. Calcified bladder tumor; schedule CT urography

Ans. 2) Chronic schistosomiasis; obtain urine microscopy for ova  

Also read: Essential Medicine Image-based Questions for NEET PG

Q8. A 35-year-old male presents to the emergency department after a motor vehicle accident with a pelvic fracture and gross hematuria. The CT cystogram showed the following characteristic findings. Which of the following statements regarding the diagnosis of this patient is incorrect?​ 

1. ​Retrograde cystography demonstrates extravasation of contrast limited to the perivesical space.
2. Catheter drainage for 10-14 days is the treatment of choice for uncomplicated cases.
3. Immediate surgical repair in cases of bladder neck injury.
4. Both urethral and suprapubic catheters are recommended in all cases.

Ans. 4) Both urethral and suprapubic catheters are recommended in all cases.​

Q9. In which of the following conditions are these CECT findings seen?​

1. Focal nodular hyperplasia
2. Serous cystadenoma of the pancreas
3. Renal oncocytoma
4. All of the above

​Ans. 4) All of the above

​Q10. From the below given triple phase CT scan, which of the following statements is true regarding Liver cancer?​

1. ​Hypodense in arterial phase in HCC
2. Hyperdense in arterial phase in Metastasis liver disease
3. Hyperdense in non-contrast CT in HCC
4. Hypodense in venous phase in Metastasis liver disease

Ans. 4) Hypodense in Venous phase in Metastasis liver disease​

Also read: Last 5 Year PYQs in Surgery for NEET PG

Q11. A 52-year-old man presents to the emergency department with worsening abdominal distension and visible abdominal veins. He has a history of chronic alcohol abuse and has been experiencing increasing fatigue and jaundice.​

Which of the following vessels is involved in this condition?

1. ​Left gastric vein
2. Superior and inferior epigastric vein
3. Superior mesenteric vein
4. Inferior vena cava

Ans. 2) Superior and inferior epigastric vein​

Q12. Which of the following statements is true about the image below?​

1. Technically difficult to perform
2. Decreased chances of perforation
3. Always preferred over ligation
4. Lack of depth perception is present

Ans. 4) Lack of depth perception is present

Q13. Identify the tube shown in the following image used in the management of portal hypertension.

1. Sengstaken-Blakemore tube
2. Minnesota tube
3. Linton-Nachlas tube
4. Nasogastric (Ryle's) tube

Ans. 1) Sengstaken-Blakemore tube

Also read: Surgery Important Question For NEET PG/FMGE 2025

Q14. A 50 y/o woman undergoing laparoscopic cholecystectomy is found to have a structure that appears to have a spiral configuration. What is the most likely anatomical feature being observed?​

1. ​Vasa vasorum
2. Sphincter of Oddi
3. Accessory Pancreatic Duct
4. Valves of Heister

Ans. 4) Valves of Heister​

Q15. A 58-year-old male, with past h/o cholesterol stones, presents with intermittent right upper quadrant pain and occasional nausea.USG reveals the gallbladder mucosa has a coarse, granular appearance with small nodules and some larger polypoid formations. On performing laparoscopic cholecystectomy of this patient, the following appearance of the gall bladder was observed. What is the most likely diagnosis?

1. Acute cholecystitis
2. Porcelain gallbladder
3. Cholesterolosis
4. Gallbladder carcinoma

Ans. 3) Cholesterolosis

Also read: What is renal/kidney cancer, types, and diagnosis?

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