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ABU Urology Certification EXAM LATEST
VERSION WITH 300 QUESTIONS AND CORRECT
RATIONALIZED SOLUTIONS JUST RELEASED
THIS YEAR (2026-2027)
ABU Urology Certification Exam - 300 Practice Questions
STARTING FROM QUESTION 1 THROUGH 300
QUESTION 1
A 69-year-old diabetic male is evaluated for a 30-pound weight loss over 6 months and vague
right flank pain. Workup reveals a 1 cm right UPJ stone with moderate hydronephrosis and a 10
cm irregular, enhancing right midpole renal mass. Mag-3 lasix scan shows a non-functioning
right kidney and normal left kidney. Urine culture is negative and the patient is afebrile. What is
the next step in management?
A) Right percutaneous nephrostomy tube and chronic antibiotics
B) Laparoscopic right radical nephrectomy
C) Laparoscopic right partial nephrectomy
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D) Open right radical nephrectomy
E) Right ureteral stent placement
Answer: D
This presentation is concerning for xanthogranulomatous pyelonephritis (XGP); however, XGP
cannot be differentiated from renal malignancy on imaging. The kidney is nonfunctional and
there is no evidence of active infection, so PCN or stent would not be indicated. An open
approach is generally recommended in the setting of possible XGP as the inflammatory reaction
can extend beyond Gerota's fascia into adjacent structures, making surgical removal
challenging.
QUESTION 2
A patient undergoes a nephrectomy for a solid renal mass identified incidentally during a
workup for kidney transplant. The tumor is a 4 cm solitary renal cell carcinoma with no evidence
of spread, Fuhrman grade 1. What waiting period is required before transplant clearance?
A) No waiting period – patient can be cleared immediately
B) 2 years
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C) 5 years
D) Patient can never be considered for transplant
Answer: A
Patients with cancers discovered pre-kidney transplant listing need evaluation for risk of
recurrence after transplant. For a low-grade, small, solitary renal cell carcinoma with no
evidence of spread, no waiting period is required before transplant clearance.
QUESTION 3
During investigation for a urinary tract infection, a child is found to have a renal abscess in the
upper pole of one kidney. The child is febrile, has flank tenderness, but is clinically stable. What
is the most appropriate next step?
A) Immediate surgical drainage
B) Percutaneous drainage
C) Broad-spectrum intravenous antibiotics
D) Observation with oral antibiotics
Answer: C
For a clinically stable child with a renal abscess, broad-spectrum intravenous antibiotics are the
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appropriate initial management. Surgical or percutaneous drainage is reserved for abscesses
that do not respond to antibiotics or for larger abscesses (>3-5 cm) that are at risk of rupture.
QUESTION 4
Which of the following is the most common cause of painless gross hematuria in adults over
50?
A) Urinary tract infection
B) Urolithiasis
C) Bladder cancer
D) Benign prostatic hyperplasia
Answer: C
In adults over 50, painless gross hematuria is highly suspicious for malignancy, most commonly
bladder cancer. UTI and stones often cause painful hematuria. Any patient presenting with
painless gross hematuria should undergo a full urologic evaluation, including cystoscopy and
upper tract imaging.
4
SUCCESS!
ABU Urology Certification EXAM LATEST
VERSION WITH 300 QUESTIONS AND CORRECT
RATIONALIZED SOLUTIONS JUST RELEASED
THIS YEAR (2026-2027)
ABU Urology Certification Exam - 300 Practice Questions
STARTING FROM QUESTION 1 THROUGH 300
QUESTION 1
A 69-year-old diabetic male is evaluated for a 30-pound weight loss over 6 months and vague
right flank pain. Workup reveals a 1 cm right UPJ stone with moderate hydronephrosis and a 10
cm irregular, enhancing right midpole renal mass. Mag-3 lasix scan shows a non-functioning
right kidney and normal left kidney. Urine culture is negative and the patient is afebrile. What is
the next step in management?
A) Right percutaneous nephrostomy tube and chronic antibiotics
B) Laparoscopic right radical nephrectomy
C) Laparoscopic right partial nephrectomy
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SUCCESS!
,Page 2 of 229
D) Open right radical nephrectomy
E) Right ureteral stent placement
Answer: D
This presentation is concerning for xanthogranulomatous pyelonephritis (XGP); however, XGP
cannot be differentiated from renal malignancy on imaging. The kidney is nonfunctional and
there is no evidence of active infection, so PCN or stent would not be indicated. An open
approach is generally recommended in the setting of possible XGP as the inflammatory reaction
can extend beyond Gerota's fascia into adjacent structures, making surgical removal
challenging.
QUESTION 2
A patient undergoes a nephrectomy for a solid renal mass identified incidentally during a
workup for kidney transplant. The tumor is a 4 cm solitary renal cell carcinoma with no evidence
of spread, Fuhrman grade 1. What waiting period is required before transplant clearance?
A) No waiting period – patient can be cleared immediately
B) 2 years
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C) 5 years
D) Patient can never be considered for transplant
Answer: A
Patients with cancers discovered pre-kidney transplant listing need evaluation for risk of
recurrence after transplant. For a low-grade, small, solitary renal cell carcinoma with no
evidence of spread, no waiting period is required before transplant clearance.
QUESTION 3
During investigation for a urinary tract infection, a child is found to have a renal abscess in the
upper pole of one kidney. The child is febrile, has flank tenderness, but is clinically stable. What
is the most appropriate next step?
A) Immediate surgical drainage
B) Percutaneous drainage
C) Broad-spectrum intravenous antibiotics
D) Observation with oral antibiotics
Answer: C
For a clinically stable child with a renal abscess, broad-spectrum intravenous antibiotics are the
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appropriate initial management. Surgical or percutaneous drainage is reserved for abscesses
that do not respond to antibiotics or for larger abscesses (>3-5 cm) that are at risk of rupture.
QUESTION 4
Which of the following is the most common cause of painless gross hematuria in adults over
50?
A) Urinary tract infection
B) Urolithiasis
C) Bladder cancer
D) Benign prostatic hyperplasia
Answer: C
In adults over 50, painless gross hematuria is highly suspicious for malignancy, most commonly
bladder cancer. UTI and stones often cause painful hematuria. Any patient presenting with
painless gross hematuria should undergo a full urologic evaluation, including cystoscopy and
upper tract imaging.
4
SUCCESS!
