Free Practice Questions for Iran Specialty Board - Urology

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Key Facts: Iran Specialty Board - Urology Exam

152 MCQs

Written Exam Volume

Sanjesh Pezeshki Examination Regulations

210 Min

Exam Duration

Council for Medical and Specialized Education

70% (105/150)

Written Passing Standard

Secretariat for Specialized Medical Education

OSCE / Oral

Stage 2 Assessment

National Board Examination Committee

Campbell-Walsh

Designated Reference Core

MOHME Urology Board Curriculum

The Iranian Urology Specialty Board is a two-stage examination (152-question MCQ written exam over 240 minutes followed by a multi-station OSCE/oral examination). Candidates require 70% (105/150) on the written component to advance. This OpenExamPrep practice bank delivers 100 rigorous English-language practice questions based on the official MOHME syllabus and Campbell-Walsh-Wein Urology.

Sample Iran Specialty Board - Urology Practice Questions

Try these sample questions to review concepts for the Iran Specialty Board - Urology exam. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1A 58-year-old man undergoes prostate biopsy showing Gleason score 3+3=6 (Grade Group 1) adenocarcinoma in 2 of 12 cores, involving less than 20% of each core. His serum PSA is 5.2 ng/mL and digital rectal examination is normal (cT1c). Which management strategy is considered the preferred standard of care according to international and national guidelines?

A.Active surveillance with serial PSA, digital rectal examination, and surveillance multiparametric MRI / biopsies

B.Immediate radical retropubic prostatectomy with bilateral pelvic lymphadenectomy

C.Definitive external beam radiation therapy with 24 months of androgen deprivation therapy

D.Primary whole-gland cryoablation or high-intensity focused ultrasound

Explanation: Active surveillance is the preferred standard of care for low-risk prostate cancer (cT1c-cT2a, Grade Group 1, PSA < 10 ng/mL, and low core volume). It safely avoids overtreatment-related urinary and erectile morbidity while maintaining curative potential through systematic reassessment with PSA, imaging, and repeat biopsy.

2During nerve-sparing radical prostatectomy, which anatomical fascial landmark directly envelops the neurovascular bundles responsible for erectile function?

A.Denonvilliers' fascia posteriorly and umbilical prevesical fascia anteriorly

B.Prostatic fascial capsule medially and the levator ani fascia laterally

C.Buck's fascia and the tunica albuginea

D.Transversalis fascia and endopelvic fascia

Explanation: The cavernous neurovascular bundles travel along the posterolateral aspect of the prostate within the triangular space bounded medially by the prostatic fascia (capsule) and laterally by the levator ani fascia. Dissection within the interfascial or intrafascial plane preserves these bundles while maintaining negative margins.

3A 64-year-old man had a radical prostatectomy 18 months ago for pT2c pN0 Grade Group 2 prostate cancer with negative surgical margins. His initial postoperative PSA was undetectable (< 0.01 ng/mL). Which threshold of serum PSA elevation defines biochemical recurrence following radical prostatectomy?

A.Any detectable PSA level greater than 0.05 ng/mL on a single ultrasensitive assay

B.A confirmed rise of 2.0 ng/mL above the postoperative nadir

C.A confirmed serum PSA value of 0.2 ng/mL or higher

D.A continuous rise across three consecutive monthly measurements regardless of absolute value

Explanation: Biochemical recurrence after radical prostatectomy is defined by the American Urological Association and European Association of Urology as an initial confirmed PSA value of 0.2 ng/mL or greater, followed by a subsequent confirmatory value. This distinguishes true recurrence from assay variability.

4A 71-year-old man with metastatic castration-resistant prostate cancer (mCRPC) progresses while receiving enzalutamide. Genomic testing demonstrates a deleterious germline BRCA2 alteration. Which class of therapeutic agents provides proven overall survival and radiographic progression-free survival benefits in this specific patient setting?

A.First-generation antiandrogens such as bicalutamide or nilutamide

B.Somatostatin receptor antagonists

C.Selective estrogen receptor modulators

D.Poly (ADP-ribose) polymerase (PARP) inhibitors such as olaparib or rucaparib

Explanation: PARP inhibitors such as olaparib and rucaparib exploit synthetic lethality in tumors harboring homologous recombination repair (HRR) gene alterations, notably BRCA1, BRCA2, and ATM. In the PROFOUND phase 3 trial, olaparib significantly improved overall survival compared to physician choice of enzalutamide or abiraterone in men with mCRPC with BRCA1/2 or ATM alterations.

5According to contemporary European and Campbell-Walsh surgical guidelines, at which nomogram-predicted threshold of pelvic lymph node involvement (e.g., Briganti nomogram) is an extended pelvic lymph node dissection (ePLND) formally recommended during radical prostatectomy?

A.Greater than 5% (or 7% depending on the specific validated nomogram version)

B.Greater than 20% exclusively

C.Only when preoperative pelvic MRI reveals enlarged nodes exceeding 15 mm in short axis

D.Only when serum PSA exceeds 50 ng/mL

Explanation: Extended pelvic lymph node dissection (ePLND) is recommended when the estimated risk of lymph node involvement exceeds 5% (using the updated Briganti 2019/2017 models) or 7% (using the classic Briganti 2012 model). The dissection template should include external iliac, obturator, and internal iliac packets to achieve accurate staging.

6A 62-year-old woman undergoes complete transurethral resection of a bladder tumor (TURBT) showing high-grade T1 urothelial carcinoma without muscularis propria invasion. Following a negative restaging TURBT, she receives an induction course of intravesical Bacillus Calmette-Guérin (BCG). According to the classic SWOG 8507 protocol, which maintenance schedule is indicated?

A.Weekly instillations for 6 weeks repeated every 6 months for 1 year

B.Three weekly instillations at 3, 6, 12, 18, 24, 30, and 36 months

C.Single monthly instillations indefinitely until disease recurrence

D.Two weekly instillations every 4 months for a total duration of 18 months

Explanation: The Southwest Oncology Group (SWOG 8507) protocol established that high-risk non-muscle-invasive bladder cancer requires maintenance BCG consisting of 3 weekly instillations at 3, 6, 12, 18, 24, 30, and 36 months following the initial 6-week induction. This regimen significantly reduces recurrence and progression rates compared to induction alone.

7A 68-year-old man with high-grade T1 urothelial carcinoma completes full induction BCG and a 3-month maintenance course. Repeat cystoscopy and biopsy at 6 months reveal persistent high-grade T1 urothelial carcinoma. What is the gold-standard recommendation for this patient with BCG-unresponsive bladder cancer?

A.A second 6-week course of induction intravesical BCG

B.Immediate switch to intravesical mitomycin C monotherapy at room temperature

C.Radical cystectomy with pelvic bilateral lymph node dissection

D.Systemic platinum-based chemotherapy followed by surveillance

Explanation: For patients with BCG-unresponsive non-muscle-invasive bladder cancer (persistent or recurrent high-grade T1 disease at 3-6 months), prompt radical cystectomy with bilateral pelvic lymphadenectomy is the standard-of-care recommendation. Delaying cystectomy beyond this point is associated with progression to muscle-invasive or metastatic disease and compromised cancer-specific survival.

8A 59-year-old woman with normal renal function (eGFR 82 mL/min) is diagnosed with clinical T2bN0M0 muscle-invasive urothelial carcinoma of the bladder. Which multimodal management approach provides Level 1 evidence of an overall survival advantage over surgery alone?

A.Upfront radical cystectomy followed by adjuvant gemcitabine monotherapy

B.Upfront radical cystectomy followed by adjuvant radiation therapy to 45 Gy

C.Adjuvant cisplatin-based chemotherapy only if final surgical pathology shows pT3 or N+ disease

D.Neoadjuvant cisplatin-based combination chemotherapy followed by radical cystectomy

Explanation: Multiple prospective randomized controlled trials and meta-analyses have established that neoadjuvant cisplatin-based combination chemotherapy (such as accelerated MVAC or gemcitabine-cisplatin) followed by radical cystectomy confers a 5% to 8% absolute 5-year overall survival advantage over cystectomy alone in muscle-invasive bladder cancer.

9Which clinical scenario represents an absolute oncologic contraindication to orthotopic neobladder reconstruction following radical cystectomy in a male patient?

A.Histologically positive frozen-section margin of the prostatic urethra / apex

B.Tumor involvement of the bladder dome without lymph node metastases

C.History of prior open appendectomy

D.Age greater than 65 years

Explanation: An oncologically positive urethral apical margin on intraoperative frozen section indicates residual malignancy at the planned urethral anastomosis site. Because the urethra cannot be cleared without leaving gross or microscopic disease, orthotopic neobladder reconstruction is contraindicated, and complete urethrectomy with an alternative cutaneous diversion (such as an ileal conduit) must be performed.

10A 66-year-old man presents with gross hematuria. CT urography demonstrates a 3 cm filling defect in the left renal pelvis with normal contralateral kidney function. Ureteroscopy confirms high-grade invasive urothelial carcinoma. What is the standard-of-care curative surgical procedure?

A.Left radical nephrectomy with transection of the ureter at the level of the iliac vessels

B.Left radical nephroureterectomy with excision of a formal bladder cuff

C.Left partial nephrectomy with renal pelvic reconstruction

D.Endoscopic laser ablation with intracavitary mitomycin instillation

Explanation: Radical nephroureterectomy with formal excision of an ipsilateral bladder cuff is the gold standard surgical management for high-grade upper tract urothelial carcinoma (UTUC). Incomplete removal of the distal ureter and intramural tunnel leaves an ipsilateral ureteral stump recurrence risk of 30% to 75%.

About the Iran Specialty Board - Urology Exam

The Iranian Medical Specialty Board Examination in Urology (آزمون دانشنامه تخصصی جراحی کلیه و مجاری ادراری) is the premier national exit credential for urologic surgeons in the Islamic Republic of Iran. Administered annually in Tehran by Sanjesh Pezeshki under the auspices of the Secretariat of the Council for Medical and Specialized Education (Ministry of Health and Medical Education - MOHME), this high-stakes examination distinguishes specialist certification (Govahi-nameh) from the prestigious Board Certification (Daneshnameh). Candidates who pass the 152-question written stage with a score of 70% (105/150) or higher earn eligibility to sit the multi-station Objective Structured Clinical Examination (OSCE), structured vivas, and surgical case scenario evaluations. The definitive reference standard is Campbell-Walsh-Wein Urology. Please note that OpenExamPrep is an independent educational initiative; this English-language practice question bank is an educational study adaptation designed to master high-yield Campbell-Walsh urology concepts tested on the exam.

Exam sponsor: National Center for Health Assessment (Sanjesh Pezeshki) & Secretariat of the Council for Medical and Specialized Education. The requirements and fees below concern the certification or admission exam, separate from our free practice resources.

Assessment

Single-session written examination of 152 MCQs over 240 minutes with no negative scoring, followed by a multi-station clinical OSCE and structured oral examination for candidates achieving at least 70% (105/150).

Time Limit

240 minutes

Passing Score

70% of the written total (105 of 150 points)

Exam / Certification Fees

Standard annual specialist examination fee established by the Secretariat of the Council for Medical and Specialized Education (MOHME).

Exam sponsor website

Fees, eligibility, and exam policies can change. Confirm them with the exam sponsor before applying or paying.

Official sources

Our practice resources: topics covered

We aim to reflect publicly available exam outlines and topic information in our study resources. Coverage, format, and difficulty may differ from the actual exam, and we cannot guarantee that every detail is accurate or current. Confirm exam requirements, fees, and policies with the official exam sponsor.

25%

Urologic Oncology

Prostate adenocarcinoma, urothelial carcinoma of the bladder and upper tract, renal cell carcinoma, testicular germ cell tumors, and penile malignancies.

20%

Urolithiasis & Endourology

Surgical stone management (PCNL, mini-PCNL, URS, RIRS, ESWL), metabolic stone evaluation, stents, and endourological instrumentation.

15%

BPH, LUTS & Voiding Dysfunction / Neurourology

Benign prostatic hyperplasia medical and surgical interventions (TURP, enucleation), urodynamic investigations, neurogenic lower urinary tract dysfunction, and incontinence.

15%

Pediatric Urology

Cryptorchidism, hypospadias repair, ureteropelvic junction obstruction (UPJO), vesicoureteral reflux (VUR), posterior urethral valves (PUV), and pediatric urogenital anomalies.

12%

Andrology, Male Infertility & Sexual Dysfunction

Male factor infertility, varicocele, obstructive and non-obstructive azoospermia, erectile dysfunction, priapism, Peyronie disease, and testosterone deficiency.

13%

Renal Transplantation, Urologic Trauma, Reconstructive Urology & Infections

Renal transplant techniques and complications, renovascular trauma, bladder and urethral injury, urethral stricture reconstruction, complicated UTIs, and Fournier gangrene.

Preparing for the Iran Specialty Board - Urology Exam

What You Need to Know

Passing score: 70% of the written total (105 of 150 points)
Assessment: Single-session written examination of 152 MCQs over 240 minutes with no negative scoring, followed by a multi-station clinical OSCE and structured oral examination for candidates achieving at least 70% (105/150).
Time limit: 240 minutes
Exam / certification fees: Standard annual specialist examination fee established by the Secretariat of the Council for Medical and Specialized Education (MOHME). Official sources

Using Our Practice Resources

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Iran Specialty Board - Urology: Suggested Study Strategy

1Dedicate systematic review blocks to Campbell-Walsh-Wein Urology chapters, focusing on clinical algorithms, staging classification tables, and high-yield randomized trial outcomes.

2Master urologic oncology staging (TNM 8th edition), risk stratification for prostate cancer (EAU/AUA/NCCN guidelines), and chemotherapy protocols for non-seminomatous germ cell tumors (BEP regimens).

3Consistently drill endourology procedural nuances, including laser physics (Holmium:YAG vs. Thulium fiber laser), access tract dilatation in PCNL, and prevention of fluid extravasation and sepsis.

4Review pediatric surgical timelines strictly: orchidopexy timing for undescended testis (6-18 months), initial valve ablation in PUV, and deflux indications versus ureteral reimplantation in VUR.

5Simulate timed 152-question test blocks under strict 240-minute conditions (approximately 95 seconds per question) to train rapid vignette recognition and eliminate fatigue before test day.

Frequently Asked Questions

What is the structure of the Iranian Urology Specialty Board examination?

The examination is divided into two sequential stages: a 152-question written multiple-choice examination completed in 240 minutes, followed by a multi-station clinical OSCE and structured oral examination (viva voce) conducted over subsequent days in Tehran. Only candidates scoring at least 70% (105/150) on the written paper are admitted to the oral and clinical stations.

What is the difference between Daneshnameh and Govahi-nameh?

Govahi-nameh (گواهی‌نامه تخصصی) is the Specialist Completion Certificate awarded to residents who successfully finish their clinical training and pass the certifying exit examination at a baseline passing standard, allowing them to practice as licensed urologists. Daneshnameh (دانشنامه تخصصی or National Board) is the elite academic credential awarded only to those who attain at least 70% on the national board written exam and subsequently pass the clinical OSCE, qualifying them for university faculty appointments, subspecialty fellowship entrance, and academic leadership.

Is there negative marking on the Iranian Urology Board written exam?

No. In accordance with Sanjesh Pezeshki specialty board examination rules, there is no negative marking penalty for incorrect responses. Candidates are advised to answer all 152 questions.

What is the official reference textbook for the exam?

The designated core curriculum reference is the latest edition of Campbell-Walsh-Wein Urology (published by Elsevier), supplemented by clinical practice guidelines adopted by the Iranian Urological Association (IUA) and European Association of Urology (EAU) where specified by the board committee.

How does this OpenExamPrep question bank relate to the official exam?

This module is an independent English-language educational adaptation designed to test core diagnostic, surgical, and management concepts emphasized in Campbell-Walsh-Wein Urology and tested by Sanjesh Pezeshki. It is not affiliated with or endorsed by Sanjesh Pezeshki or MOHME, but mirrors the official topic weights and cognitive complexity of board-level testing.

What subspecialty fellowship opportunities in Iran require the Daneshnameh?

Holding the Daneshnameh Takhasosi in Urology is mandatory to sit national fellowship examinations in Endourology & Urolithiasis, Pediatric Urology, Urologic Oncology, Female Pelvic Medicine & Reconstructive Surgery, Andrology & Infertility, and Renal Transplantation.

Free Practice Questions for Iran Specialty Board - Urology

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