45 yr old male with H/o repeated attacks of UTI, X-ray KUB showing radio opaque shadow -

Ans. is 'a' i.e., Ureteric pathology Ureteric Stones* Almost always associated with UTI* Usually radio opaque X ray KUB* CT KUB is the gold standard for imaging ureteric stones, with the vast majority (99%) being radiodense. Stones > 1 mm in size are visualised, with the specificity of helical CT as high as 100%* Calculi size and location as well as ureter anatomy are important factors in determining likelihood of spontaneous calculi passage with stones less than 5 mm having high likelihood of passing down the ureter. However even small calculi may be impossible to pass if it is located at the pelvicoureteric junction or in patients with ureteral strictures. Passage of calculi may be facilitated with tamsulosin and nifedipine.* In calculi >10 mm or with failed conservative management, urological procedures such as extracorporeal shock wave lithotripsy (ESWL), ureteroscopic lithotripsy or percutaenous nephrostomy may be required.