A 26 year female reports constant leakage of urine per vagina following an emergency caesarean section for foetal distress during labour. Her vitals are stable and physical examination reveals no abnormalities. Ultrasound demonstrates bilateral normal kidneys and bladder. The most likely diagnosis is

Correct Answer: D

Rationale: Vesicouterine fistula fits constant leakage post-C-section uterine incision injures bladder, leaking into uterus/vagina, less common but specific. Ureterovaginal shows flank pain kidneys normal here. Urethrovaginal is trauma-related vaginal delivery, not C-section. Vesicovaginal is commoner (obstructed labor), but uterine link post-C-section points elsewhere. Vesicouterine's surgical etiology distinguishes it, key to this scenario, unlike ureteral, urethral, or labor causes.

Correct Answer: A

Rationale: STAMPEDE' trial (Systemic Therapy in Advancing or Metastatic Prostate cancer) tests treatments (e.g., ADT + docetaxel) prostate-specific. Renal cell trials (e.g., CheckMate) focus immunotherapy distinct. Bladder cancer uses other protocols (e.g., BCG) unrelated. Prostate focus distinguishes STAMPEDE, key to its landmark status, unlike renal or bladder studies.

Correct Answer: D

Rationale: MSKCC model predicts metastatic RCC survival post-nephrectomy, not localized. UISS, Leibovich, and VENUSS assess localized RCC recurrence stage, grade, size-based. MSKCC's metastatic focus distinguishes it, key to its exclusion for localized disease, unlike tailored prognostic tools.

Correct Answer: B

Rationale: Gemcitabine least causes cystitis better tolerated intravesically, less irritative than anthracyclines or alkylators. Doxorubicin, mitomycin, and epirubicin (similar class) frequently irritate bladder chemical cystitis common. Gemcitabine's milder profile distinguishes it, critical for patient comfort in NMIBC, unlike irritative agents.

Correct Answer: C

Rationale: BPH (benign prostatic hyperplasia) is the top cause of obstructive uropathy enlarged prostate blocks bladder outflow, common in aging men. Posterior urethral valve is pediatric congenital. Neurogenic bladder disrupts control less obstructive. Urethral stricture narrows less frequent. BPH's prevalence distinguishes it, key to adult obstruction, unlike child, neuro, or stricture causes.