MCQ-Uro

FRCPath Part1 Course

Uropathology EMQ 1 Select the appropriate pathological tumour stage from the options for each of the renal tumours described. Each option may be used once, more than once or not at all.

A. B. C. D. E. F. G. H. I. J.

pT0 pT1a pT1b pT2a pT2b pT3a pT3b pT3c pTx pT4

1. Tumour 3 cm confined to the kidney.

2. Tumour 5cm, invasion into perinephric fat.

3. Tumour 4 cm with direct extension into the renal sinus fat. The major tributaries of the renal vein show macroscopic tumour invasion.

4. Tumour 7cm with invasion of the adrenal gland.

5. Tumour 6 cm with invasion beyond Gerota’s fascia.

MCQ 2 A renal tumour on histology shows solid sheets of clear cells with a prominent vascular network. The majority of the tumour cells have slightly irregular nuclei with nucleoli visible at X400 magnification.

A focal area with spindled, highly pleomorphic cells is also noted. What is the ISUP grade of the tumour?

A. Grade 1 B. Grade 2 C. Grade 3 D. Grade 4 E. Grade2 and Grade 3 MCQ 3 A 30 year old male presents with bilateral renal clear cell carcinoma. Investigations also reveal a posterior fossa CNS tumour with histological appearances of a haemangioblastoma. Abnormalities of which of the following chromosomes leads to this condition?

A. 7q31 B. 3p25 C. 17p11.2 D. 9q34 E. 1q42

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FRCPath Part1 Course MCQ 4 A 56 year old female undergoes cystoscopy for investigation of haematuria. Multiple nodular thickenings of the mucosa are seen near the trigone, which are biopsied. Histology reveals sheets of CD 68 positive cells with intracytoplasmic concentrically layered inclusions. Which of the following histochemical stains demonstrates these inclusions?

A. Alcian blue B. Rubeonic acid C. Orcein D. Von Kossa E. PTAH EMQ 5 A. pT1a B. pT1b C. pT1C D. pT2a E. pT2b F. pT2C G. pT3a H. pT3b I. pT4 Classify: 1. A 73 year old male with PSA levels of 8.4. Histology shows adenocarcinoma invading into the right seminal vesicle.

2. A 62 year old male undergoes radical prostatectomy for cancer. On histology, the carcinoma extends beyond the prostate into the periprostatic fat.

3. A 68 year old male with elevated PSA levels has a normal prostate on clinical and radiological examination. Needle core biopsies from both lobes however, reveal an adenocarcinoma.

4. A 52 year old male with obstructive symptoms undergoes radical prostatectomy. On histology, an adenocarcinoma involving both lobes, but confined to the prostate is seen.

5. A 58 year old male with obstructive symptoms and a PSA of 38, undergoes a CT scan of the pelvis, which reveals a prostatic tumour extending into the levator muscles.

MCQ 6 A 66 year old man undergoes radical prostatectomy for a needle core detected adenocarcinoma.

The tumour predominantly shows raggedly infiltrating single and separate glands of varying sizes.

Approximately 5% of the carcinoma also shows rounded tumour masses with central necrosis.

Which of the following best represents the grade of the tumour?

A. Gleason’s 3 + 3 = 6 B. Gleason’s 3 + 4 = 7 C. Gleason’s 4 + 3 = 7 D. Gleason’s 3 + 5 = 8 E. Gleason’s 4 + 5 = 9

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FRCPath Part1 Course EMQ 7 Choose the BTTP classification category from the options for each of the testicular tumours described below. Each option may be used once, more than once or not at all.

A. B. C. D. E. F. G. H. I.

Embryonal carcinoma Seminoma Teratoma with somatic transformation Spermatocytic tumour Mixed germ cell tumour Dermoid cyst Mature teratoma Yolk sac tumour Choriocarcinoma

1. Nests of tumour cells separated by fibrous septae, infiltrated by lymphocytes. A few syncitiotrophoblast like cells are seen.

2. Diffuse sheets of anaplastic cells, positive for CD30 3. A child with a cystic lesion containing keratin and lined by squamous epithelium. The wall contains cutaneous adnexal structures.

4. Haemorrhagic tumour showing admixture of atypical syncitio and cytotrophoblastic cells.

5. Diffuse sheets of CD30 + anaplastic cells admixed with areas showing well differentiated glandular structures and islands of mature cartilage MCQ 8 A biopsy of a cryptorchid testis shows atrophy with a few seminiferous tubules containing atypical germ cells with clear cytoplasm. These cells are positive for PLAP. Which other immunostain is routinely used to confirm the diagnosis?

A. B. C. D. E.

EMA CD30 C-Kit AFP Inhibin

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