100+ Free Arab Board Urology Final Written Practice Questions

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Sample Arab Board Urology Final Written Practice Questions

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1According to the EAU and AUA prostate cancer guidelines, which patient with newly diagnosed localized prostate cancer is an ideal candidate for Active Surveillance (AS)?

A.ISUP Grade Group 1 (Gleason 3+3=6), PSA < 10 ng/mL, clinical stage cT1c–cT2a, and low-volume disease (<3 positive cores with <50% involvement per core)

B.ISUP Grade Group 3 (Gleason 4+3=7), PSA 12 ng/mL, clinical stage cT2b

C.ISUP Grade Group 2 (Gleason 3+4=7) with cribriform architecture and intraductal carcinoma on biopsy

D.ISUP Grade Group 1 with PSA 25 ng/mL and palpable cT3a disease

Explanation: Active Surveillance (AS) is the preferred management strategy for men with very low-risk and low-risk localized prostate cancer (ISUP Grade Group 1 / Gleason 3+3=6, PSA < 10 ng/mL, clinical stage cT1c-cT2a, low biopsy volume). Favorable intermediate-risk patients (selected low-volume Grade Group 2 without adverse pathological features such as cribriform or intraductal histology) may also be considered after informed shared decision-making.

2On multiparametric MRI (mpMRI) of the prostate, what is the dominant imaging sequence used for assigning the PI-RADS v2.1 score in the Peripheral Zone (PZ) versus the Transition Zone (TZ)?

A.Diffusion-Weighted Imaging (DWI/ADC) for the Peripheral Zone; T2-Weighted Imaging (T2WI) for the Transition Zone

B.T2-Weighted Imaging for the Peripheral Zone; Dynamic Contrast-Enhanced (DCE) for the Transition Zone

C.Dynamic Contrast-Enhanced for the Peripheral Zone; Diffusion-Weighted Imaging for the Transition Zone

D.Magnetic Resonance Spectroscopy for both Peripheral and Transition Zones

Explanation: Under PI-RADS v2.1 guidelines, the dominant (primary) sequence for scoring lesions in the Peripheral Zone (PZ) is Diffusion-Weighted Imaging / Apparent Diffusion Coefficient (DWI/ADC), with Dynamic Contrast-Enhanced (DCE) acting as a tie-breaker for PI-RADS 3 lesions. In the Transition Zone (TZ), T2-Weighted Imaging (T2WI) is the dominant primary sequence, with DWI/ADC serving as the secondary tie-breaker for PI-RADS 3 lesions.

3What is the standard anatomical template for an Extended Pelvic Lymph Node Dissection (ePLND) during radical prostatectomy for intermediate- and high-risk prostate cancer?

A.External iliac, obturator fossa, and internal iliac (hypogastric) lymph nodes bilaterally up to the common iliac bifurcation

B.Obturator fossa lymph nodes alone bilaterally

C.External iliac lymph nodes alone bilaterally

D.Common iliac and retroperitoneal para-aortic nodes only

Explanation: An extended pelvic lymph node dissection (ePLND) template includes removal of the fibrofatty nodal tissue from: (1) the external iliac vein, (2) the obturator fossa (above and below the obturator nerve), and (3) the internal iliac (hypogastric) artery vessels bilaterally, bounded proximally by the common iliac bifurcation, distally by the node of Cloquet/Cooper's ligament, and laterally by the genitofemoral nerve. This template captures ~75-80% of primary lymphatic landing zones.

4What is the consensus definition of Biochemical Recurrence (BCR) following Radical Prostatectomy versus following primary External Beam Radiation Therapy (EBRT)?

A.Post-Radical Prostatectomy: two consecutive rising PSA values >= 0.2 ng/mL; Post-EBRT: PSA nadir plus 2.0 ng/mL (Phoenix definition)

B.Post-Radical Prostatectomy: PSA nadir plus 2.0 ng/mL; Post-EBRT: PSA >= 0.2 ng/mL

C.Post-Radical Prostatectomy: PSA > 1.0 ng/mL; Post-EBRT: any detectable PSA above zero

D.Post-Radical Prostatectomy: PSA doubling time < 6 months; Post-EBRT: PSA > 4.0 ng/mL

Explanation: Following radical prostatectomy (where all prostatic tissue is removed), biochemical recurrence (BCR) is standardly defined by AUA/EAU as two consecutive rising serum PSA measurements >= 0.2 ng/mL. Following definitive radiation therapy (where benign prostatic tissue remains and continues producing baseline PSA), BCR is defined by the Phoenix consensus criteria as a rise in PSA of >= 2.0 ng/mL above the post-treatment nadir value.

5In a patient presenting with newly diagnosed, high-volume metastatic Hormone-Sensitive Prostate Cancer (mHSPC) per CHAARTED criteria, what is the guideline-recommended first-line standard of care systemic therapy?

A.Androgen Deprivation Therapy (ADT) combined with an Androgen Receptor Pathway Inhibitor (ARPI, e.g., enzalutamide, apalutamide, or abiraterone) OR triplet therapy (ADT + docetaxel + darolutamide/abiraterone)

B.ADT monotherapy (LHRH agonist alone) with delayed treatment until symptoms develop

C.First-line single-agent Cabazitaxel chemotherapy without ADT

D.Immediate bilateral radical nephrectomy and pelvic exenteration

Explanation: High-volume mHSPC (defined by CHAARTED as >=4 bone metastases with >=1 beyond the axial skeleton/pelvis, or visceral metastases) requires intensified systemic therapy: ADT doublet with an ARPI (abiraterone, enzalutamide, apalutamide) or triplet therapy (ADT + docetaxel 6 cycles + darolutamide [ARASENS trial] or abiraterone [PEACE-1 trial]), which provides dramatic overall survival superiority over ADT monotherapy.

6Which biomarker is predictive of therapeutic response to PARP inhibitors (e.g., olaparib, rucaparib) in patients with metastatic Castration-Resistant Prostate Cancer (mCRPC)?

A.Deleterious germline or somatic mutations in Homologous Recombination Repair (HRR) genes, predominantly BRCA2 and BRCA1

B.Overexpression of serum alkaline phosphatase alone

C.Presence of the TMPRSS2-ERG gene fusion

D.HER2/neu gene amplification on FISH

Explanation: PARP (Poly [ADP-ribose] polymerase) inhibitors exploit synthetic lethality in tumors harboring defects in Homologous Recombination Repair (HRR) genes. In the PROfound trial, olaparib demonstrated significant progression-free and overall survival benefits in mCRPC patients with deleterious alterations in BRCA2, BRCA1, or ATM who had progressed on prior novel hormonal agents.

7Which radioligand therapeutic agent is FDA- and EMA-approved for progressive PSMA-positive metastatic castration-resistant prostate cancer (mCRPC) previously treated with an ARPI and taxane chemotherapy?

A.Lutetium-177 vipivotide tetraxetan (177Lu-PSMA-617)

B.Radium-223 dichloride (alpha-emitter restricted to bone-only metastases)

C.Strontium-89 chloride

D.Iodine-131 MIBG

Explanation: In the landmark VISION and TheraP trials, 177Lu-PSMA-617 (a beta-emitting radioligand that selectively binds Prostate-Specific Membrane Antigen on prostate cancer cell surfaces) significantly prolonged overall survival and radiographic progression-free survival in patients with PSMA-positive mCRPC previously treated with ARPI and taxane-based chemotherapy.

8According to the EAU risk groups for Non-Muscle Invasive Bladder Cancer (NMIBC), which of the following patients is categorized as VERY HIGH RISK?

A.T1 high-grade tumor associated with concurrent Carcinoma In Situ (CIS) in the prostatic urethra or lymphovascular invasion (LVI)

B.Primary, solitary Ta low-grade tumor < 3 cm without CIS

C.Recurrent Ta low-grade tumor 2 cm without CIS

D.Solitary, primary T1 high-grade tumor 2.5 cm without CIS or LVI

Explanation: Under EAU NMIBC guidelines, the Very High-Risk group includes patients with: T1 high-grade with concurrent CIS, T1 high-grade with lymphovascular invasion (LVI), aggressive histological variants (micropapillary, plasmacytoid, sarcomatoid, nested), or high-grade tumor involving the prostatic urethra. For these patients, immediate upfront radical cystectomy should be discussed.

9What is the guideline-recommended management strategy for a patient who undergoes initial TURBT showing T1 high-grade urothelial carcinoma with muscularis propria present and uninvolved in the specimen?

A.Perform a mandatory second-look TURBT (re-TURBT) within 2 to 6 weeks to rule out understaging and ensure complete resection prior to adjuvant intravesical BCG

B.Proceed directly to 3 years of maintenance BCG without repeat resection

C.Perform immediate radical nephroureterectomy

D.Administer systemic gemcitabine-cisplatin neoadjuvant chemotherapy without surgery

Explanation: A second-look TURBT (re-TURBT) is mandatory for all T1 tumors (and any high-grade Ta or incomplete resection) within 2 to 6 weeks after primary resection. Re-TURBT reveals residual tumor in up to 50-70% of cases and muscle-invasive disease (T2 understaging) in 10-25% of patients, altering management to upfront cystectomy.

10What is the consensus definition of 'BCG-Unresponsive' Non-Muscle Invasive Bladder Cancer according to FDA and international urologic guidelines?

A.Persistent or recurrent high-grade Ta/T1 disease within 6 months OR persistent CIS within 12 months, despite receiving adequate BCG (>=5 of 6 induction doses plus >=2 of 3 maintenance doses)

B.Recurrence of low-grade Ta disease 3 years after a single 6-week induction course of BCG

C.Development of mild irritative cystitis and low-grade fever during week 3 of BCG induction

D.Persistent microscopic hematuria on urinalysis with negative cytology and normal cystoscopy

Explanation: BCG-unresponsive NMIBC requires: (1) adequate BCG exposure (at least 5 of 6 induction doses PLUS at least 2 of 3 maintenance doses or at least 2 of 6 second induction doses), with (2) recurrence of high-grade T1 at the 3-month evaluation, persistent/recurrent high-grade Ta/T1 within 6 months, persistent/recurrent CIS within 12 months, or any progression to muscle-invasive disease. Radical cystectomy is the standard recommendation for BCG-unresponsive disease.

About the Arab Board Urology Final Written Exam

The Arab Board Urology Final Written Examination is the culminating theoretical exit qualification required for specialist certification by the Arab Board of Health Specializations (ABHS). Run by the Scientific Council of Urology, it is delivered in English as two computer-based multiple-choice papers of 100 single-best-answer items each, 2.5 hours per paper, on a single day, and 60% is required to pass. Senior urology residents are assessed on complex clinical diagnosis, guideline-directed oncologic therapy, endourological instrumentation, pediatric urology, reconstructive pelvic surgery, renal transplantation, and emergency urologic management. ABHS does not publish percentage weightings for the urology paper, so the topic areas below follow the council's own reference list — Campbell-Walsh Urology, Smith and Tanagho's General Urology, Blandy's Operative Urology, Glenn's Urologic Surgery, and the EAU and AUA-NCCN guidelines — together with the procedures recorded in the official ABHS urology logbook.

Assessment

Comprehensive exit written examination sat after the five-year residency and logbook acceptance. Two computer-based multiple-choice papers of 100 single-best-answer items each, 2.5 hours per paper, both on one day, testing advanced clinical decision-making, guideline-directed management, operative technique, oncology, endourology, pediatric urology, reconstruction, and renal transplantation. The written exam is held once a year, and passing it is the prerequisite for the separate Final Clinical and Oral examination.

Time Limit

2.5 hours per paper for two papers, sat on the same day

Passing Score

60%. The ABHS examination-affairs decisions fix the pass mark at 60% for the primary written, final written, and clinical/oral examinations of every scientific council; a marking adjustment of up to 5 marks may be applied after item analysis removes defective questions.

Exam Fee

Set by ABHS and collected through the local health authority; not published as a single regional figure (Arab Board of Health Specializations (ABHS) - Scientific Council of Urology)

Arab Board Urology Final Written Exam Content Outline

11% of this bank

Urologic Oncology — Prostate Cancer

PSA kinetics, mpMRI/PI-RADS interpretation, targeted biopsy, active surveillance protocols, nerve-sparing radical prostatectomy, radiation therapy + ADT, biochemical recurrence, and advanced systemic therapies (mHSPC, nmCRPC, mCRPC with novel ARPIs, PARP inhibitors, Lu-177 PSMA).

13% of this bank

Urologic Oncology — Bladder, Upper Tract, Testis & Penile Cancers

NMIBC risk stratification, intravesical BCG regimens and BCG-unresponsive salvage options, radical cystectomy templates, orthotopic neobladders vs ileal conduits, UTUC kidney-sparing vs nephroureterectomy, testicular germ cell tumor staging/chemotherapy/RPLND, and penile SCC staging and lymphadenectomy.

11% of this bank

Urologic Oncology — Renal & Adrenal Masses

Bosniak classification of cystic renal masses (v2019), small renal masses, partial vs radical nephrectomy, warm/cold ischemia time, IVC tumor thrombus levels I–IV, systemic IO/TKI targeted regimens for mRCC, adrenal incidentalomas, and functional adrenal neoplasms (pheochromocytoma, Cushing's, Conn's).

13% of this bank

Endourology & Nephrolithiasis

Acute obstructing infected stone management, semirigid and flexible URS/RIRS, laser lithotripsy parameter settings (dusting vs fragmentation), PCNL access techniques and complication management, shock wave lithotripsy, metabolic 24-hour urine evaluation, and encrusted stent retrieval.

9% of this bank

Pediatric Urology

Antenatal hydronephrosis workup, vesicoureteral reflux (VUR) grading and endoscopic/open management, posterior urethral valves (PUV) ablation, ureteropelvic junction obstruction (UPJO) pyeloplasty, hypospadias repair techniques, bladder exstrophy closure, cryptorchidism orchidopexy timing, testicular torsion, and neuropathic bladder.

10% of this bank

Functional & Female Urology, Incontinence & Urodynamics

Urodynamic study (UDS) curve interpretation (BOOI, BCI, DSD, filling cystometry), stress urinary incontinence surgery (midurethral slings, fascial slings, AUS, Bulkamid), refractory overactive bladder pathways (onabotulinumtoxinA, SNM, PTNS), vesicovaginal fistula repair, POP-Q assessment, and urethral diverticulectomy.

14% of this bank

Andrology, Male Infertility & Sexual Medicine

Azoospermia diagnostic algorithms (obstructive vs non-obstructive), Y-chromosome microdeletions and CFTR-related CBAVD, micro-TESE, varicocelectomy indications, erectile dysfunction stepwise treatment (PDE5i, intracavernosal injections, inflatable penile prosthesis IPP), testosterone therapy and fertility preservation, Peyronie's disease plaque surgery, and acute priapism management.

19% of this bank

BPH/LUTS, Urological Emergencies, Trauma, Reconstruction & Transplantation

Guideline-directed medical management of BPH, modern surgical therapies (TURP, HoLEP, Aquablation, Rezūm), renal/ureteral/bladder/urethral trauma grading and reconstruction (Boari flap, psoas hitch, anastomotic urethroplasty, substitution urethroplasty), penile fracture, necrotizing fasciitis (Fournier's gangrene), urosepsis resuscitation, and renal transplantation (Lich-Gregoir reimplantation, delayed graft function).

How to Pass the Arab Board Urology Final Written Exam

What You Need to Know

Passing score: 60%. The ABHS examination-affairs decisions fix the pass mark at 60% for the primary written, final written, and clinical/oral examinations of every scientific council; a marking adjustment of up to 5 marks may be applied after item analysis removes defective questions.
Assessment: Comprehensive exit written examination sat after the five-year residency and logbook acceptance. Two computer-based multiple-choice papers of 100 single-best-answer items each, 2.5 hours per paper, both on one day, testing advanced clinical decision-making, guideline-directed management, operative technique, oncology, endourology, pediatric urology, reconstruction, and renal transplantation. The written exam is held once a year, and passing it is the prerequisite for the separate Final Clinical and Oral examination.
Time limit: 2.5 hours per paper for two papers, sat on the same day
Exam fee: Set by ABHS and collected through the local health authority; not published as a single regional figure

Keys to Passing

Work through all 100 available questions
Review every answer and explanation
Track weak areas and revisit them
Use our AI tutor for tough concepts

Arab Board Urology Final Written Study Tips from Top Performers

1Work from the council's own reading list: the ABHS urology guidebook names Campbell-Walsh Urology, Smith and Tanagho's General Urology, Blandy's Operative Urology, Glenn's Urologic Surgery, and the EAU and AUA-NCCN guidelines as the sources for this paper.

2Master current clinical practice guidelines: thoroughly review EAU and AUA guidance on prostate cancer (mHSPC and mCRPC pathways), NMIBC/MIBC, renal cell carcinoma, urolithiasis, and pediatric urology.

3Drill the classification systems that generate single-best-answer items: Bosniak v2019, ISUP grade groups, AAST renal trauma grades, Neves-Zincke IVC thrombus levels, the International Reflux Study VUR grades, and the BOOI and BCI urodynamic indices.

4Review surgical algorithms for reconstructive and trauma cases: practice decision pathways for ureteral injuries (Boari flap vs psoas hitch vs nephrostomy), anterior vs posterior urethral strictures, and pelvic fracture urethral distraction injuries.

5Budget your time against the real paper: 100 items in 2.5 hours is about 90 seconds per question, so practise reading long clinical stems quickly and committing to a single best answer.

Frequently Asked Questions

What is the structure of the Arab Board Urology Final Written Examination?

It is a computer-based multiple-choice examination of two papers, each containing 100 single-best-answer items and lasting 2.5 hours, both sat on the same day for 200 items in total. The Scientific Council of Urology publishes this structure in its specialty guidebook and repeats it in each sitting announcement.

What language is the ABHS Urology Final Written Exam delivered in?

English. The ABHS Consultative Scientific Council adopted English for multiple-choice papers because translating items reliably was not possible, and the 2026 urology sitting announcement states explicitly that the exam is in English. Arabic remains the board's base language and may be used for written-answer questions, which this MCQ-only paper does not contain.

What is the passing standard for the ABHS Urology Final Written Exam?

60%. The ABHS examination-affairs decisions fix the pass mark at 60% for the primary written, final written, and clinical and oral examinations across every scientific council, so it is not set separately by the urology council.

How often is the Final Written Examination held, and who is eligible?

It is held once a year, with a second sitting only where justified. Candidates must have completed the full five years of accredited ABHS urology training, passed the Primary examination, had their logbook accepted by the competent committee, paid all outstanding fees, and activated their ABHS institutional email account.

What is the next step after passing the Final Written Examination?

Passing the Final Written Examination grants eligibility to sit the Arab Board Urology Final Clinical and Oral Examination, which is scored across pathology and imaging slides, a long case, an OSCE, and a general oral. That is the final step to the Certificate of the Arab Board of Urology.

100+ Free Arab Board Urology Final Written Practice Questions

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