18. d. neurosarcoma
A. . What is false concerning targeted molecular therapy?
B. is a personalized medical therapy devised to meet each persons individual needs for cancer`s specifications
C. treats cancer by interrupting unique molecular abnormalities that drive cancer growth
D. some cancer types have different molecular targets
Answer : D
19. d. hypertension
A. . Metastatic tumors to the kidney are common from all of the following organs, EXCEPT:
B. lungs
C. thyroid
D. breasts
Answer : B
20. What is false concerning ADPKD patients?
A. hepatic cysts are the most common extra-renal manifestation
B. might experience cyst hemorrhage, renal infection, or nephrolithiasis
C. typically, complain of flank pain or intermittent hematuria in the early twenties
D. hypertension and CRF commonly occur in the fifth decade of life
Answer : C
21. In RCC cases where IVC involvement with tumor thrombi are suspected, venacavography:
A. is the first and most reliable radiologic examination to study IVC thrombi
B. is reserved for patients with equivocal MRI or CT findings
C. is obsolete and has fallen out of use
D. carries a risk of IVC terrible bleeding that outweighs the diagnostic merits
Answer : B
22. On histological examination of a resected renal tumor, positive staining for human melanoma black (HMB)-45 is a distinctive and diagnostic feature for:
A. multiloculated cystic nephromas
B. angiomyolipoma
C. metanephric adenoma
D. adenoma with clear cell
Answer : B
23. According to Fuhrmans classification system for nuclear grading in RCC, nuclear size of 20 ?g with irregular outline and prominent nucleoli is grade:
A. 1
B. 2
C. 3
D. 4
Answer : C
24. What is (are) true regarding the etiology of medullary cystic kidney disease (MCKD)?
A. mutations in the MCKD1 (chromosome 1q21) gene
B. mutations in the MCKD2 (chromosome 16q12) gene
C. inherited in an autosomal dominant fashion
D. all of the above
Answer : D
25. d. all of the above
A. . What is the most common histologic subtype of renal sarcomas?
B. rhabdomyosarcoma
C. nephrosarcoma
D. leiomyosarcoma
Answer : C
26. Antenatal sonography is the diagnostic tool for the following condition:
A. glomerulocystic kidney disease
B. developmental cystic renal disease
C. Juvenile nephronophthisis
D. medullary cystic kidney disease
Answer : B
27. d. 19 - 26%
A. . What is false regarding radical nephrectomy operation?
B. nodal involvement doesn`t influence prognosis
C. renal artery should be ligated before the vein to avoid kidney ballooning
D. cardiopulmonary bypass with deep hypothermic circulatory arrest is performed in patients with supra-diaphragmatic tumor thrombi
Answer : A
28. d. 30 - 40%
A. . What is false concerning imaging studies for preoperative evaluation of RCC case?
B. in case of bone pain or elevated serum calcium and/or alkaline phosphatase levels, an isotopic bone scan is required
C. renal arteriography accurately localizes central scaring and tumor necrosis
D. trans-esophageal echocardiography helps assess vena caval and right atrial tumor thrombi
Answer : B
29. Fuhrmans grading system for renal cell carcinoma relies on:
A. nuclear size, outline, and nucleoli
B. cohesiveness and the degree of cellular atypia
C. chromatin structure and content of the interphase nucleus
D. multinucleation and mitosis
Answer : A
30. On ultrasonography, what are the percentages of incidentally discovered renal masses that will later be malignant on further workup?
A. 70 - 85%
B. 55 - 70%
C. 40 - 55%
D. 25 - 40%
Answer : A
31. Routine metastatic evaluation in RCC cases should include all of the following, EXCEPT:
A. abdominal CT
B. chest X-ray
C. renal function test
D. liver function test
Answer : C
32. Regarding simple renal cysts, fluid attenuation on non-contrast CT series is:
A. < - 10 HU
B. < - 20 HU
C. < 10 HU
D. < 20 HU
Answer : D
33. What is false concerning renal cancers?
A. papillary subtype of RCC has a tendency to multifocality
B. chromosome 13 alterations are common in the development of clear cell renal carcinoma
C. a solid mass on CT that enhances more than 15 HU is suggestive of RCC
D. bilateral involvement in RCC either synchronously or metachronously occurs in 2% to 4% of patients
Answer : B
34. d. CT can detect renal vein involvement in 82-95% of cases and vena caval involvement in 95-100% of cases
A. . In RCC, ipsilateral adrenal metastasis occurs in:
B. 0.3 - 2%
C. 2 - 10%
D. 11 - 18%
Answer : B
35. Which of the following conditions carries the worst prognosis?
A. acquired cystic renal disease
B. juvenile nephronophthisis
C. medullary sponge kidney
D. bilateral multicystic dysplastic kidney
Answer : D
36. Which of the following renal tumors carries the best prognosis?
A. fibrosarcoma
B. leiomyosarcoma
C. carcinoid
D. adult Wilm`s tumor
Answer : C
37. What can NOT be a manifestation of a renal tumor?
A. right hydrocele
B. left varicocele
C. painless hematuria
D. hypertension
Answer : A
38. What is true regarding ADPKD patients?
A. progress to ESRD in the sixth decade of life
B. hypertenson is seen in 80% of patients with ADPKD aged 20-34 years
C. aortic valve stenosis in 25%
D. manifestations are more significant in patients with the PKD2 genotype
Answer : A
39. What is the likelihood that Bosniak type III renal cysts accompany malignant masses?
A. never
B. unlikely
C. likely
D. always
Answer : C
40. What is false concerning end-stage renal disease (ESRD)?
A. ARPKD accounts for 5% of ESRD in children
B. more than one-half of patients with ARPKD require kidney transplant before age 20 years
C. ADPKD is a common cause of ESRD
D. uncommonly, juvenile nephronophthisis causes ESRD in children
Answer : D
41. d. prior to kidney transplant
A. . What is an indication for radical nephrectomy?
B. a 6-cm, polar tumor
C. bilateral RCC
D. locally advanced RCC
Answer : C
42. Which of the following conditions carries the best prognosis?
A. acquired cystic renal disease
B. juvenile nephronophthisis
C. medullary sponge kidney
D. bilateral multicystic dysplastic kidney
Answer : C
43. What is the most powerful single predictor of oncologic outcomes in RCC cases?
A. margin status and grade
B. tumor size
C. tumor stage
D. the time interval between the tumor emergence and excision
Answer : C
44. What is the proper terminology of a renal cyst with the following characteristics: well-marginated, anechoic, with thin visible back wall, positive posterior acoustic enhancement, no septations, and no calcifications?
A. hyperattenuating renal cyst
B. solitary renal cyst
C. uncomplicated renal cyst
D. focal renal cyst
Answer : C
45. In a localized RCC, local recurrence after tumor ablation therapy is managed by any of the following options, EXCEPT:
A. repeat ablation
B. active surveillance
C. salvage surgery
D. radical nephrectomy
Answer : D
46. The diagnosis of renal adenoma is commonly made:
A. at autopsy
B. by staining positive for human melanoma black (HMB)-45
C. by fine-needle aspiration cytology
D. by exclusion
Answer : A
47. CT shows a renal mass with calcifications associated with fat. What could the lesion be?
A. RCC
B. AML
C. teratoma
D. any of the above
Answer : A
48. What type of Bosniak renal cysts accompanies tumor masses in 5% of cases?
A. I
B. II
C. III
D. IV
Answer : B
49. What is the most common cause of genetic ESRD in children?
A. autosomal recessive polycystic kidney disease
B. autosomal dominant polycystic kidney disease
C. multicystic dysplastic kidney disease
D. juvenile nephronophthisis
Answer : D
50. What is the likelihood that simple renal cysts increase in size and number over time?
A. never
B. unlikely
C. likely
D. always
Answer : D