MCQ-Loin Masses (M.Attya)

MCQ (Loin masses)
By Dr. Mohamed Attya

1. CT-guided biopsy from a renal mass is absolutely indicated in one of the following
situations:
a. Suspected renal hydatid cyst
b. Renal mass with spoke-wheel appearance on CT image
c. Before starting targeted therapy in setting of metastatic RCC
d. Bilateral renal tumors
2. The most common benign renal mass is:
a. Angiomyolipoma
b. Renal leiomyoma
c. Simple renal cyst
d. Oncocytoma
3. Prognosis of malignant renal mass is not affected by:
a. Surgical approach
b. Tumor size
c. Invasion of pelvicalyceal system
d. Fuhrman grade
4. Oncologist can start targeted therapy for metastatic RCC, only with biopsy-
proven:
a. Papillary RCC
b. Renal cell sarcoma
c. Clear cell RCC
d. Chromophobe RCC
5. One of the main differences between adult RCC and pediatric wilms’ tumor is:
a. RCC send metastasis to the chest first
b. RCC is chemoradioresistant
c. RCC never to be bilateral
d. RCC may be associated with tumor thrombus
6. 44-year-old male patient with lymphocytosis and large bilateral renal masses, how
can you proceed?
a. Prepare for renal biopsy
b. Send for radiotherapy
c. Prepare for bilateral radical nephrectomy and hemodialysis
d. Send for neoadjuvant chemotherapy
7. The surgeon can perform nephron sparing surgery for non-hilar renal tumor if the
residual renal mass is more than:
a. 5%
b. 20%
c. 50%
d. 80%
8. On CT with contrast, enhancement of renal mass is measured based on:
a. Comparison to liver
b. Comparison to the other kidney
c. Comparison to the heart
d. Comparison to itself in precontrast and nephrogenic phases
9. The main concern related to large renal angiomyolipoma is:
a. Retroperitoneal hemorrhage
b. Difficult surgical excision
c. Distant metastasis
d. End-stage kidney disease
10. Renal angiomyolipoma is more liable to rupture in pregnant lady in view of:
a. Mechanical compression by the gravid uterus
b. Dextrorotation of the uterus
c. The mass has lot of estrogen receptors
d. Hyperdynamic circulation
11. 35-year-old female patient who underwent laparoscopic left partial nephrectomy
last week, the pathology report confirmed renal oncocytoma. The patient asked you
for the next step:
a. Send her for chemotherapy
b. Strict follow up for tumor recurrence for 5 years
c. Do meticulous family screening
d. No follow up is required
12. In case of autosomal dominant polycystic kidney disease (ADPKD), the main
issue should be discussed to the patient is:
a. Strict BPs control and regular follow up for fear of renal failure
b. High possibility of malignant transformation
c. Risk of life-threating hematuria
d. Risk of cyst rupture with subsequent anaphylaxis
13. Large hydronephrotic non-functioning left kidney due to obstructing large upper
1/3 ureteral stone is managed by:
a. Push the stone to the kidney and do PCNL
b. Do ureteroscopic stone extraction
c. Just place JJ stent for annual exchange
d. Left simple nephrectomy
14. The correct order of such renal tumor pathological patterns (From good to
worse) is:
a. Chromophobe RCC >> Medullary renal carcinoma >> Papillary RCC
b. Papillary RCC >> Chromophobe RCC >> Clear cell RCC
c. Chromophobe RCC >> Clear cell RCC >> Collecting duct carcinoma
d. Chromophobe RCC >> Clear cell RCC >> Papillary RCC
15. The gold standard radiological tool to clarify anatomy of RCC-associated tumor
thrombus is:
a. Renal doppler US
b. MR venography
c. CT urography
d. PET-CT
16. Non-metastatic hepatic dysfunction with malignant renal tumor “Stauffer
syndrome”:
a. Also called hepato-renal syndrome
b. Reversible after radical treatment
c. Refers to dismal prognosis
d. Only occurs if the tumor on the right side
17. The proper management of 25-year-old male patient who visits ER with acute
retention of urine and radiologically evident posterior urethral stone is:
a. Suprapubic catheter fixation
b. Bilateral nephrostomy tube fixation
c. Urgent endoscopic stone extraction
d. Medical expulsive therapy
18. Elevation of serum creatine in cases of urosepsis without bilateral obstruction
could be explained by:
a. Severe dehydration
b. Toxic acute tubular necrosis
c. Nephrotoxic antibiotic
d. Medical expulsive therapy
19. Deterioration of kidney function in long standing cases of benign prostatic
hyperplasia is attributed to:
a. 2ry stone formation
b. High pressure chronic retention
c. Malignant transformation
d. Infiltration of ureteral orifices
20. The main concern in management of bilateral renal calcular obstruction with
high serum creatinine is:
a. Stone retrieval at one side
b. Stone retrieval at both side
c. Fluid adjustment by nephrology team
d. Optimization of patient’s general condition by proper drainage

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MCQ (Loin masses)

By Dr. Mohamed Attya

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