Kidney, Bladder, & Male GU

Question 1

The mother of a 3-month old child palpated a mass on the left side of the child’s abdomen. What is the most likely diagnosis for this mass? What would the diagnosis be if this mass were a neoplasm?

Answer 1

Polycystic kidney, hydronephrosis, Wilms tumor (if a kidney neoplasm), or neuroblastoma (if an adrenal neoplasm)

Question 2

A 40-year old man has end-stage kidney failure and bilaterally enlarged kidneys. What is the most likely diagnosis?

Answer 2

Compensatory hypertrophy of the kidneys

Question 3

A 4-year old child developed puffiness around the eyes and became chronically sleepily 2 weeks after an episode of “strep-throat”. The mother noted that the child’s urine was dark brown and was being excreted in small amounts. What is the probably diagnosis?

Answer 3

Post-streptococcal glomerulonephritis

Question 4

A 40-year old man noticed generalized swelling, most prominently in his face and lower extremities. His physician discovered proteinuria and hypoalbuminemia. What is the most likely cause of edema in this case?

Answer 4

Nephrotic Syndrome

Question 5

A 46-year old man noticed brown-red urine and, over a period of 6 days, stopped urinating all together. What is the probable diagnosis?

Answer 5

Nephritic Syndrome

Question 6

Nephrotic Syndrome:

Answer 6

• Massive proteinuria
• Hypoalbuminemia
• Edema
• Hyperlipidemia

Question 7

Nephritic Syndrome:

Answer 7

• Hematuria
• Oliguria
• Proteinuria
• Hypertension

Question 8

A 50-year old man who underwent a routine medical check-up was found to have blood in his urine. X-ray studies revealed a renal mass on the left side. What is the probable cause of this hematuria?

Answer 8

Renal cell carcinoma

Question 9

A 20-year old woman complained of pain during urination. She also noticed blood in her urine. What is the most likely diagnosis?

Answer 9

Urinary tract infection (cystitis)

Question 10

Inflammation of the urinary bladder. The risk in females is increased because of a short urethra (especially during pregnancy). Bladder outlet obstruction associated with prostatic hyperplasia predisposes men:

Answer 10

Cystitis (UTI)

Question 11

Bladder dilatation, muscular hypertrophy, and trabeculation of the mucosal surface of the bladder results from:

Answer 11

Bladder outlet obstruction

Question 12

The failure of a testis to descend within the scrotum. Long-term complications if untreated include infertility and testicular cancer:

Answer 12

Cryptorchidism

Question 13

Acute or chronic inflammation of the testis, often secondary to urinary tract infection. Syphilis and mumps can both produce this disease:

Answer 13

Orchitis

Question 14

Neoplastic transformation of a male germ cell. Account for half of all germ cell tumors in males:

Answer 14

Seminoma

Question 15

Germ cell tumor characterized by tissues from all three embryonic germ layers: ectoderm, endoderm, and mesoderm.

Answer 15

Teratoma

Question 16

The most common germ cell tumors of infants:

Answer 16

Yolk sac tumors

Question 17

A highly malignant testicular tumor that represents extraembryonic differentiation to components of the placenta:

Answer 17

Choriocarcinoma

Question 18

Usually follows a lower urinary tract infection with reflux of infected urine into the prostate:

Answer 18

Prostatitis (infection of the prostate)

Question 19

A common disorder characterized clinically by enlargement of the gland with obstruction to the flow of urine through the bladder outlet. Characterized pathologically by the proliferation of both glands and stroma:

Answer 19

Nodular hyperplasia of the prostate

Question 20

Clinical symptoms of nodular hyperplasia of the prostate:

Answer 20

Decreased urinary stream, and increasing urinary frequency. Rectal examination reveals a firm, enlarged and nodular prostate.

Question 21

A disease of elderly men. Most cases are incidental findings at autopsy or are discovered in surgical specimens of nodular hyperplasia:

Answer 21

Prostate cancer (adenocarcinoma)

Question 22

The most common histologic type of bladder cancer:

Answer 22

Transitional cell carcinoma

Question 23

Painless hematuria in men or women can be a symptoms of:

Answer 23

Bladder cancer

Question 24

A 3-month old boy had a testis that was not palpable. What is the most likely diagnosis?

Answer 24

Cryptorchidism

Question 25

The testis is still in the inguinal canal at 1 year of age. Why should an orchiopexy (surgical correction) be performed?

Answer 25

Long-term complications of untreated cryptorchidism include infertility and testicular cancer.

Question 26

A 60-year old man complained of urgency and dribbling on urination. What is the most likely diagnosis?

Answer 26

Nodular hyperplasia of the prostate

Question 27

A testicular nodule was noticed by a 30-year old man on self-examination. What is the appropriate work-up for this painless nodule?

Answer 27

A radical inguinal orchiectomy following US

Question 28

Elevated serum levels of prostate-specific antigen (PSA) and prostatic acid phosphatase (PAP) were detected in a 60-year old man. What is the significance of these findings?

Answer 28

PSA increases with age because the prostate gradually enlarges as men grow older. Prostate cancer should be suspected at PSA levels (above 2 ng/mL) or when PSA is rising at all in men in their 40s.

Question 29

A 70-year old man with sclerosis of the lumbar vertebrae had a rock-hard prostate on palpation. Which serum enzyme tests should be expected to yield positive results?

Answer 29

Prostate specific antigen

Question 30

Name the renal lesion typically seen in patients with cardiogenic and hypovolemic shock:

Answer 30

Acute tubular necrosis

Question 31

A 4 y.o. developed proteinuria, hypoalbuminemia, and edema. The urine sediment contained no inflammatory or RBCs, but did contain lipid casts. What is the most likely diagnosis?

Answer 31

Minimal change nephrotic syndrome

Question 32

Name an autosomal dominant genetic disorder that inevitably leads to bilateral kidney enlargement and failure:

Answer 32

Adult polycystic kidney disease

Question 33

Clinical term meaning acute decline in the glomerular filtration rate with a resultant increase in BUN and serum creatinine values:

Answer 33

Renal failure

Question 34

Name the disease that is caused by bacterial infections (usually E. coli) ascending through the ureters and renal collecting ducts to the kidney:

Answer 34

Pyelonephritis

Question 35

Name the most common malignant tumor of the kidney in adults:

Answer 35

Renal cell carcinoma

Question 36

Name a testicular tumor that can cause symptoms of precocious puberty in an 8 y.o. boy:

Answer 36

Leydig cell tumor