Pathology Urology MCQs

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					1- The risk of developing a second cancer within 10 years after a diagnosis of Wilms' tumour is: (a) Less than that in the general population. (b) Similar to that in the general population. (c) Increased 10-fold compared with the general population. (d) Increased fivefold compared with the general population 2- Neuroblastoma screening programmes in infancy: a)Double the incidence of the disease. (b)Should be applied for infants < 6 months old. (c)Are the standards of care in most Western countries? (d)Is a useful tool to identify the metastatic form of the disease at an earlier stage? 3- RCC in children: (a) Are almost as frequent as Wilms' tumours. (b) Are usually treated with nephrectomy. (c) Show a characteristic pattern in diagnostic imaging. (d) Share very similar histological features with RCC in adults 4- Chromophobe cell carcinoma of the kidney is a distinct entity of renal cell carcinoma and is proposed to arise from: a. Mesenchymal derivatives. b. Proximal tubular epithelium. c. Glomerulus and/or loop of Henle. d. Distal tubular and /or collecting duct epithelium. 5- Recent studies provide evidence that a hereditary prostate cancer susceptibility gene is likely to be contained in chromosome: a. 1q b. 8p. c. 10q. d. 16q. 6- Which is the most common cytogenetic anomaly in RCC? (a) Chromosome 3p deletions. (b) Chromosome 12p deletions. (c) Chromosome 5q translocations. (d) Anomalies of X chromosome.

7- Genetic alterations which are associated with high tumor grade in bladder cancer include: a. 8p LOH, 11P LOH, RB1 inactivation, 4p LOH. b. Amplification of the cyclin Dl gene, RB1 inactivation, TP53 mutation. c. Amplification of the ERBB2 gene, 9q LOH, 18q LOH, RBl inaClivation. d. Amplification of the ERBB2 gene, RB1 inactivation, TP53 mutation, 8p LOH, 11P LOH. 8- Which of the following symptoms might indicate the presence of a renal angiomyolipoma? a. Polycythemia. ," b. Hypovolemic shock. c. Weight loss and anemia. d. Slight fever in the eveening. 9- Renal cell carcinoma is often resistant to more than one type of chemotherapeutic drug. The responsible multi drug resistance gene (MDR 1) encod 8s the multi drug transporter: a. Calmodulin. b. Lymphokine. c. P-glycoprotein. d. Buthionine sulfoximine (B50). 10- The most common paratesticular solid mass is: a) hydrocele. b) varicocele. c) adenomatoid tumor. d) rhabdomyosarcoma. e) leiomyosarcoma 11- Most urachal carcinomas are: a) squamous carcinoma. b) sarcoma. c) transitional cell carcinoma. d) mucin producing adenocarcinoma. e) nonmucin producing adenocarcinoma.

12- What-is the percentage incidence of angiomyolipomas of the kidney in patients with tuberous sclerosis? a. < 10 %. b. 11-30%. c. 30 - 40 %. d. > 40 %. 13- The most common urological site for malakoplakia is the a. Testis b. Renal parenchyma c. Bladder d. Renal pelvis e. Epididymis 14- Xanthogranulomatous pyelonephritis is associated with all of the following except a. Intraparenchymal gas formation b. Renal calculi c. Chronic urinary tract infection d. The presence of renal obstruction e. Involved kidney is nonfunctional 15- In XGP the most commonly identified organism is a. E. coli b. Klebsiella c. Serratia d. Proteus e. Citrobacter 16- XGP a. Most commonly occurs in children b. Does not commonly affect diabetics c. Has a 4:1 predilection for females d. Is most commonly bilateral e. Is rarely associated with nephrolithiasis 17- Malignant pheochromocytomas most frequently metastasize to a. Bone b. Lung c. Peritoneum

d. Liver e. Regional lymph nodes 18- Overall, the most accurate biochemical test for detecting pheochromocytoma is a. Urinary-free metanephrines b. Plasma catecholamines c. Urinary vanillylmandelic acid d. Plasma metanephrines e. Urinary total metanephrines 19- Which imaging modality has the highest specificity for malignant pheochromocytoma? a. Ultrasound b. CT c. Somatostatin scintigraphy d. PET e. 131 I-MIBG 20- According to Weiss et al, which histological parameter is the strongest predictor of malignancy in Adrenal cancers? a. Abnormal mitotic figures b. Less than 25% clear cells c. Necrosis d. Capsular invasion e. Mitotic rate >20/50 hpf 21- In adults which of the following is most suggestive of malignancy in Adrenal Ca? a. Virilism b. Feminization c. Pain d. Palpable mass e. Hyperaldosteronism 22- Relative to the same tumors in adults, virilizing tumors in children are more likely to be a. Calcified b. Benign c. Larger than 5 cm

d. Malignant e. Necrotic 23- Risk of malignancy in adrenal incidentalomas is closely related to a. Light bulb signal intensity on T2-weighted MRI b. Chemical shift on MRI c. Increased urinary metanephrines d. Size >5 cm e. Contrast enhancement followed by rapid washout on CT 24- The most common primary malignancy identified in adrenal metastases is a. Breast carcinoma b. Melanoma c. Renal cell carcinoma d. Pancreatic carcinoma e. Lung carcinoma 25- The most reliable immunohistochemical staining in distinguishing sarcomatoid variants of renal cell carcinomas from primary renal or retroperitoneal sarcoma is: a. CEA and vimentin. b. Cytokeratin and muscle common antigen. c. Cytokeratin and leukocyte common antigen. d. Cytokeratin and epithelial membrane antigen. 26- Of the following tumours, which can present bilaterally, which is the commonest? a.Teratoma. b. Seminoma. c. Lymphoma. d. 'Yolk Sac' tumour. 27- Which of the following statements concerning urothelial carcinoma of the bladder, ureter and renal pelvis is correct? a. 5-10% of renal tumours are renal pelvis tumours. b. 7-10% of carcinomas of the bladder are transitional cell carcinomas. c. Carcinomas of the renal pelvis account for approximately 12% of all urothelial tumours. d. Patients with primary bladder cancer are at high risk of developing upper urinary tract cancers

28- Which is the most common type of testis tumour found in children? a. Seminoma. b. Lymphoma. c. Yolk Sac tumour. d. Teratocarcinoma 29- Which one of following histological types of renal cell carcinoma is associated with a poor prognosis? a. Mixed type. b. Clear cell type. . c. Spindle cell type. d. Granular cell type. 30- Which of the following statements is true? a. Wilms' tumours only occur in children. b. The most frequently found tumour of the kidney is the benign cyst. c. Transitional cell carcinoma of the renal pelvis only presents incidentally. d. Adenomas and oncocytomas of the kidney are always benign tumours. 31- Flow cystometry of urine is most accurate in the diagnosis of which type of bladder carcinoma? a. Squamous. b. Adenocarcinoma. c. Carcinomain situ. d. Papillary transitioal. 32- A 66 years old man is found to have renal cell carcinoma and tumour thrombus in the inferior vena cava. Which of the following has the most adverse effect upon prognosis? a. Nodal metastases. b. Capsular invasion. c. Contralateral renal involvement. d. Extent of thrombus in the vena cava 33- The p53 gene is a/an: a. Ras gene. b. Oncogene. c. Proto-oncogene. d. Tumour suppressor gene.

34- Carcinoma in situ of the testicle is: (a) Accompanied by normal fertility. (b) Frequent among middle-aged patients. (c) A precursor of testicular germ cell cancers. (d) Followed by invasive carcinoma in 90% within 2 years 35- Carcinoma in situ of the contralateral testis in a patient with testicular tumour is associated with an incidence of subsequent tumour development at 5 years of: a. 20%. b. 35%. c. 50%. d. 75%. 36- The classical symptoms of diffuse bladder carcinoma in situ are: a. Hematuria and fever. b. Urine retention and pyuria. c. Pneumaturia and suprapubic pain. d. Frequency, nocturia and painful micturition. 37- Which answer about exfoliative urinary cytology is correct? a. Specificity is independent on former diagnostic procedures. b. The highest sensitivity is reached in grade 1 and grade 2 tumours. c. Sensitivity in carcinoma in situ of the urinary bladder exceeds more than 90%. d. Nuclear-cytoplasmic ratio is the main feature of malignancy in urinary cytology. 38- Which of the following statements is correct? a. The cortex of the kidney is less susceptible than the medulla to infection. b. Cystitis in women usually occurs as 2.result of blood-borne spread of bacteria. c. Enterococci are among the most frequently encountered Gram negative bacteria in the urinary tract. d. Staphylococcus saprophyticus is a rare cause of community-acquired urinary tract infection (UTI). 39- Which of the following statements concerning P fimbriae is true? a. P fimbriae consists mainly of lipopolysaccharide. b. The genes coding P fimbriae are usually located on plasmids. c. P fimbriae bind to receptors containing galactosyl galactose structures.

d. P fimbriae have been epidemiologically linked to urinary tract infections (UTI) in immunocompromised patients more frequently than in previously healthy individuals. 40- Urease splits urea into a. Cyanide and water b. Methane and nitric oxide. c. Ammonia and carbon dioxide. d. Nitric acid and carbon dioxide. 41- In a specimen of bladder urine obtained by suprapubic needle aspiration, infection is considered to .be present when the colony count is: a. > 1,000 col/ml. b. > 10,000 col/ml. c. > 100,000 col/ml. d. Any bacterial count is significant. 42- In retroperitoneal fibrosis the best diagnostic information is currently given by: a. MRI. b. Galliumscintigraphy. c. IVP and cavography. d. Computer Tomography. 43- Which one of the following is the most frequent complaint of a patient with bilharzial SCC of the bladder? (a) Necroturia (b) Clot retention (c) Burning of micturition (d) Difficulty of micturition 44- In female patients the most frequently encountered urethral cancer histopathology is a. Transitional cell carcinoma b. Squamous carcinoma c. Adenocarcinoma d. Clear cell carcinoma e. Endometrioid carcinoma

45- The most common presenting symptom of proximal urethral cancer in women is a. Bleeding b. Mass c. Obstruction d. Dyspareunia e. Dysuria 46- In males squamous carcinoma of the urethra has been associated with a. Concomitant adenocarcinoma of the prostate b. Instrumentation c. Uncircumcised penis d. Urethral stricture e. History of syphilis 47- Recurrance rate in urethral segment retained following cystectomy is: a) 10 % b) 30% c) 50% d) 80% e) 100% 48- The human papilloma virus types demonstrate specificity to site and lesion morphology. Which papilloma virus types are responsible for most genital tract warts? a. 1 and 2. b. 3 and 10. c. 4 and 13. d. 6 and 11. 49- Which of the following is a pathogen in urethritis: a. E. coli. b. Proteus Mirabillis. c. Chlamydia trachomatis. d. Staphylococcus aureus. 50- Which of the following statements about oncogenes is TRUE? aThey are mutated forms of abnormal genes , known as proto-oncogenes.


They can be produced by an inactivating mutation of a proto-oncogene, resulting in the silencing pf the gene. They can be produced by gene amplification, resulting in many copies of the gene, or by chromosomal rearrangement. They are always due to retroviruses, capable of inducing malignant transformation of normal cells. They are endogenous cancer-fighting genes.

51- Which of the following statements about hypermethylation is TRUE? aIt is a direct change to the DNA sequence, similar to a mutation. bIt occurs exclusively on cytosine nucleotides in the dinucleotide sequence CG. cSomatic methylation of CpG dinucleotides in the regulatory regions of genes is very often associated with increased transcriptional activity, leading to increased expression of that gene. dIn cancer, hypermethylation is associated with enhanced activity of oncongenes, and demethylation may be an effective strategy for the treatment of cancer. eIt marks cells for ubiquitinization. 52- Von Hippel-Lindau disease predisposes patients to: aEpididymal carcinoma. bClear cell renal carcinoma. cPapillary renal cell carcinoma. dAdrenocortical carcinoma eAll of the above. 53- Wilms' tumor has been linked to which of the following hereditary tumor syndromes? aWAGR syndrome bDenys-Drash syndrome cBeckwith-Wiedemann syndrome dNone of the above e- All of the above 54- What are the most common types of synthetic prostheses for urologic use made of? aLatex bSilicone


Urethane Biodegradable polymers Polyvinyl

55- What does tissue engineering involve? aThe principles of cell transplantation bThe principles of materials science cThe use of matrices alone dThe use of matrices with cells eAll of the above 56- Types of biomaterials that have been utilized for engineering genitourinary tissues include which of the following ? aNaturally derived materials bAcellular tissue matrices cSynthetic polymers dAll of the above eNone of the above 57- The only animal with a known syndrome that appears to mimic IC is the: acat brabbit cdog dgoat erat 58- The cell most likely to play a central role in the pathogenesis of IC is the : agranulocyte blymphocyte cmast cell dplatelet eeosinophil 59- The disorder most commonly associated with PBS/IC is airritable bowel syndrome bincontinence clupus dallergy eflbromyalgia

60- The most common endoscopic finding in PBS/IC is : aglomerulations with distention under regional anesthesia bglomerulations under local cystoscopy cHunner's ulceration with distention under regional or general anesthesia dNormal mucosa appearance with distention under regional or local anesthesia eDiffuse mucosal hemorrhage under local anesthesia 61- What is the primary proangiogenic molecule in conventional renal cell carcinoma? aBasic fibroblast growth factor bHepatocyte growth factor cVascular endothelial cell growth factor dEpidermal growth factor eTransforming growth factor –B 62- Which of the following cytogenetic abnormalities is among those commonly associated with papillary renal cell carcinoma? aTrisomy of chromosome7 bTrisomy of the Y chromosome cLoss of chromosome 17 dLoss of all or part of chromosome3 eLoss of chromosome 7 63- The most consistent predictor of invasiveness in upper tract cancer is: adeep tumor biopsy btumor ploidy cCT estimation of depth of invasion dtumor grade enuclear matrix protein level 64- The most important prognostic factor in Predicting survival after treatment of an upper tract cancer is tumor: aploidy bgrade cchromosome 9 deletion dTP53 status eStage

65- In former cigarette smokers, a significant decline in the risk of developing bladder cancer does not occur until smoking has been discontinued for how long? a1 year b2 to 4 years c5 to 9 years d10 to 20 years e21 to 30 years 66- Aberrations of which chromosome or chromosome segment are associated most closely with papillary low-grade, superficial urothelial tumors? a17p b13q c9q d9p e7

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