The hallmark of bladder outlet obstruction is

Correct Answer: D

Rationale: Bladder outlet obstruction (BOO) shows high pressure, low flow on urodynamics effort against resistance (e.g., BPH). Low pressure/low flow suggests detrusor underactivity opposite. Incomplete emptying and high residuals are results, not hallmarks secondary. High pressure/low flow distinguishes BOO, key to its urodynamic signature, unlike underactivity or outcome-focused options.

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.

Correct Answer: A

Rationale: Serum ACTH isn't a screening test for Cushing's differentiates cause (pituitary vs. adrenal) post-diagnosis. Late-night salivary cortisol, low-dose dexamethasone suppression, and dexamethasone-CRH screen hypercortisolism detect excess. ACTH's diagnostic role distinguishes it, key to etiology, not initial screening, unlike cortisol-based tests.