A 68 years old male presented with gross painless hematuria for last 7 days. On evaluation 3.5 cm × 2.5 cm growth detected on base of urinary bladder. Post TURBT histopathological report suggestive of non-muscle invasive micropapillary variant of urothelial carcinoma. Metastatic workups were negative. The next best treatment option for him is

Correct Answer: B

Rationale: Micropapillary urothelial carcinoma (non-muscle-invasive) warrants radical cystectomy aggressive, high recurrence/progression risk despite NMIBC status. BCG is standard for typical NMIBC insufficient here. Neoadjuvant chemo suits muscle-invasive overkill now. Re-TURBT assesses residual, but micropapillary's behavior pushes cystectomy. Radical approach distinguishes it, key to curbing this variant's potential, unlike conservative or staging options.

Correct Answer: B

Rationale: Post-obstructive diuresis is >200 mL/hr for 2+ hours physiologic response to relieve backlog post-obstruction (e.g., BPH relief). >100 mL/hr is normal too low. >400/500 mL/hr is excessive pathologic threshold, not standard. 200 mL/hr distinguishes it, critical for monitoring fluid loss, unlike normal or extreme rates.

Correct Answer: D

Rationale: MIBG scintigraphy is the gold standard for pheochromocytoma targets catecholamine uptake, specific for functionality. MRI/CECT show anatomy less functional. FDG PET detects metabolism non-specific, malignant focus. MIBG's specificity distinguishes it, critical for localizing active tumors, unlike structural or metabolic imaging.

Correct Answer: C

Rationale: Fetal uropathy typically denotes posterior urethral valve (PUV) obstructs fetal bladder outflow, causing hydronephrosis. Renal agenesis is lethal broader term. VUR is reflux, not primary obstruction secondary. Exstrophy is structural distinct. PUV's obstructive impact distinguishes it, key to fetal urinary pathology, unlike agenesis, reflux, or malformation.

Correct Answer: C

Rationale: Serum PSA strongly predicts BPH progression reflects prostate volume, risk of acute retention/surgery. Age correlates less specific. Flow rates indicate obstruction variable progression link. Symptom score (IPSS) tracks bother not progression strength. PSA's predictive power distinguishes it, critical for risk stratification, unlike age, flow, or symptom metrics.