Neoplasia

Question 1

Presents with the classic triad of hematuria, palpable mass, and flank pain

Answer 1

RCC - hematuria is most common

Question 2

Associated with paraneoplastic syndromes (ACTH, PTHrP, EPO, renin)

Answer 2

RCC

Question 3

Most common renal malignancy

Answer 3

RCC

Question 4

Gross exam reveals a yellow mass; microscopically, the most common variant reveals clear cytoplasm

Answer 4

RCC

Question 5

Originates from the proximal tubule

Answer 5

RCC

Question 6

Most common in men 50-70 years, increased incidence with smoking and obesity

Answer 6

RCC

Question 7

Invades renal vein then IVC and spreads hematogenously to lung and bone, most commonly

Answer 7

RCC

Question 8

Rarely may present with left-sided varicocele

Answer 8

RCC

Question 9

RCC is associated with sporadic or inherited gene mutation on chromosome ____ of ______

Answer 9

3

VHL

Question 10

Location of sporadic RCC . Major risk factor?

Answer 10

Upper pole of kidney

Smoking

Question 11

Hereditary RCC are often bilateral and VHL is also associated with __________ in the cerebellum

Answer 11

Hemangioblastoma

Question 12

Most common site of lymph node spread in RCC?

Answer 12

Retroperitoneal lymph nodes

Question 13

Most common renal malignancy of early childhood (ages 2-4)

Answer 13

Wilms Tumor

Question 14

Wilms Tumor Contains embryonic glomerular structures - main cell type is called a __________

Answer 14

Blastema (immature mesenchyme)

Question 15

Associated with WT1 mutation, a tumor suppressor on chromosome 11

Answer 15

Wilms Tumor

Question 16

WAGR syndrome - associated with WT1 loss

Answer 16

Wilms tumor
Aniridia (no iris)
Genital abnormalities
Mental and motor Retardation

Question 17

Beckwith-Wiedemann syndrome - associated with WT1 loss

Answer 17

Wilms tumor
Neonatal hypoglycemia
Muscular hemihypertrophy
Organomegaly (including tongue)

Question 18

Most common type of lower urinary tract cancer, usually arises in the bladder (can arise anywhere along the renal pelvis, ureter, bladder, urethra)

Answer 18

Urothelial (Transitional Cell) Carcinoma

Question 19

Risk factors for urothelial carcinoma?

Answer 19

Cigarette smoke is major

Pee SAC

P - Phenacetin
S - Smoking
A - Aniline dyes (AZO)
C - Cyclophosphamide

Question 20

Develops as a high-grade flat tumor and then invades, associated with p53 mutation

Answer 20

Flat pathway for urothelial carcinoma

Question 21

Develops as a low grade tumor that progresses to a high-grade papillary tumor and then invades; not associated with early p53 mutations

Answer 21

Papillary pathway for urothelial carcinoma

Question 22

Tumors are often multifocal and recur due to “field defect” phenomena

Answer 22

urothelial carcinoma

Question 23

Malignant proliferation of squamous cells, usually involving the bladder

Answer 23

SCC

Question 24

Painless hematuria (no casts) suggests…

Answer 24

bladder cancer

Question 25

Arises in the background of squamous metaplasia, so risk factors for SCC of bladder include...

Answer 25

Chronic cystitis Schistosoma hematobium (Egyptian male) Long-standing nephrolithiasis

Question 26

Malignant proliferation of glands, usually involving bladder

Answer 26

Adenocarcinoma

Question 27

Urachal remnant increases risk for____________

Answer 27

adenocarcinoma of bladder - tumor develops at DOME of the bladder

Question 28

Cystitis glanduralis and Exstrophy (congenital failure of caudal portion of abdominal/bladder walls to form) of bladder increase risk for______________

Answer 28

Adenocarcinoma of bladder