papillary subtype of RCC has a tendency to multifocality
chromosome 13 alterations are common in the development of clear cell renal carcinoma
a solid mass on CT that enhances more than 15 HU is suggestive of RCC
bilateral involvement in RCC either synchronously or metachronously occurs in 2% to 4% of patients
B. chromosome 13 alterations are common in the development of clear cell renal carcinoma
never
unlikely
likely
always
. What is NOT an indication for simple nephrectomy?
symptomatic chronic renal infection with poor function
some cases of renovascular hypertension
symptomatic calculus disease with poor renal function
male gender
hypertension
renal insufficiency
all of the above
progress to ESRD in the sixth decade of life
hypertension is seen in 80% of patients with ADPKD aged 20-34 years
aortic valve stenosis in 25%
manifestations are more significant in patients with the PKD2 genotype
margin status and grade
tumor size
tumor stage
the time interval between the tumor emergence and excision
70 - 85%
55 - 70%
40 - 55%
25 - 40%
RCC occurs in < 5% of patients with tuberous sclerosis
in glomerulocystic kidney disease, renal tumors are typically solitary, large, with central necrosis
in Von Hippel-Lindau syndrome, renal tumors are frequently bilateral and multicentric
in acquired cystic disease, tumors are commonly bilateral, and metastatic in 15% of cases
. Metastatic tumors to the kidney are common from all of the following organs, EXCEPT:
lungs
thyroid
breasts
they follow a benign clinical course
they have a bimodal age distribution
they are more common in men than in women
none of the above
acquired cystic renal disease
juvenile nephronophthisis
medullary sponge kidney
bilateral multicystic dysplastic kidney
adenoma with clear cell
papillary adenoma
metanephric adenoma
none of the above
type II DM, especially in males
hypertension
obesity, especially in females
cigarette smoking
most lesions ≤ 4 cm are asymptomatic
renal masses with fat content is pathognomonic for AML
renal biopsy from AML carries a high risk of hemorrhage
may coexist with malignant lesions, such as sarcomas and RCCs
autosomal dominant polycystic kidney disease (ADPKD)
developmental cystic renal disease
inherited cystic renal disease
systemic disease with associated renal cysts
. The second most common RCC subtype is:
collecting duct b. clear cell
papillary
chromophobe
. What is an indication for radical nephrectomy?
a 6-cm, polar tumor
bilateral RCC
locally advanced RCC
is the first and most reliable radiologic examination to study IVC thrombi
is reserved for patients with equivocal MRI or CT findings
is obsolete and has fallen out of use
carries a risk of IVC terrible bleeding that outweighs the diagnostic merits
. What is false regarding radical nephrectomy operation?
nodal involvement doesn`t influence prognosis
renal artery should be ligated before the vein to avoid kidney ballooning
cardiopulmonary bypass with deep hypothermic circulatory arrest is performed in patients with supra-diaphragmatic tumor thrombi
the quality of the kidney and renal function prior to surgery
the quantity of vascularized parenchymal mass preserved after excision
the tumor
warm ischemia time
most classic AMLs eventually undergo malignant transformation to sarcomatoid and epithelioid AML
the preferred treatment is nephroureterectomy followed by active surveillance
angiographic embolization and/or nephron-sparing surgery is advised for symptomatic AMLs greater than 4 cm
extra-renal sites include the pancreas, salivary glands, and thyroids
physically active patients with good performance status
extirpation of the primary tumor
long disease-free interval between initial nephrectomy and the emergence of secondaries
all of the above
acquired cystic renal disease
juvenile nephronophthisis
medullary sponge kidney
bilateral multicystic dysplastic kidney
the central scar on CT or MRI, and the spoke-wheel pattern of vessels on angiograms are not specific to oncocytoma
calcification, necrosis, and hemorrhage are rare in oncocytomas
it is thought to arise from the basement membrane of proximal convoluted tubules
treatment is partial nephrectomy or tumor excision
. In RCC, ipsilateral adrenal metastasis occurs in:
0.3 - 2%
2 - 10%
11 - 18%
I
II
III
IV
autosomal recessive polycystic kidney disease
autosomal dominant polycystic kidney disease
multicystic dysplastic kidney disease
juvenile nephronophthisis
glomerulocystic kidney disease
developmental cystic renal disease
Juvenile nephronophthisis
medullary cystic kidney disease
right hydrocele
left varicocele
painless hematuria
hypertension
. What is the relapse rate for completely resected RCC after radical nephrectomy?
1- 10%
10 - 20%
20 - 30%
ARPKD accounts for 5% of ESRD in children
more than one-half of patients with ARPKD require kidney transplant before age 20 years
ADPKD is a common cause of ESRD
uncommonly, juvenile nephronophthisis causes ESRD in children