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ROSH REVIEW Genitourinary Practice Questions and Answers

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ROSH REVIEW Genitourinary Practice Questions and Answers Which of the following is the most common solid renal tumor of childhood? Adenocarcinoma Leiomyoma Nephroblastoma Renal lipoma - Answer️️ -Correct Answer ( C ) Explanation: Nephroblastoma, or Wilms tumor, is the most common solid ...

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  • September 15, 2024
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ROSH REVIEW Genitourinary Practice
Questions and Answers


Which of the following is the most common solid renal tumor of childhood?




Adenocarcinoma

Leiomyoma

Nephroblastoma

Renal lipoma - Answer✔️✔️-Correct Answer ( C )

Explanation:

Nephroblastoma, or Wilms tumor, is the most common solid renal tumor of childhood. It

accounts for approximately 5% of all childhood cancers and in 5% of those cases the

cancer occurs bilaterally. There is a sporadic form that arises from two postzygotic

mutations and a familial form that arises after one pre-zygotic mutation and one

postzygotic mutation. Signs and symptoms range from the discovery of an

asymptomatic abdominal mass to abdominal pain, anorexia, abdominal distention,

vomiting, and hematuria. Urinalysis will demonstrate hematuria and a complete blood

count (CBC) may show anemia. Diagnosis can be made by obtaining abdominal

ultrasound or CT scans of the abdomen, although chest X-ray is used to evaluate for

metastatic lung disease. Treatment includes surgical resection of the kidney and is

usually accomplished through a radical nephrectomy through a transabdominal incision.

Chemotherapy and radiation therapy are also used as adjuncts to surgical resection. If

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, ©SOPHIABENNETT EXAM SOLUTIONS_2024/2025 Tuesday, September 3, 2024 10:30 AM


the histology of the tumor is favorable, the prognosis is good with a 4-year-survival rate

around 90%.

One Step Further

Question: What is the peak age for presentation with a Wilms tumor? - Answer✔️✔️-

Answer: The third year of life.

A previously healthy, asymptomatic 21-year-old woman presents to your office with

questions about screening for sexually transmitted infections. She is sexually active and

would like to know what screening tests she should have done. Which of the following is

the next best step in management?



Annual testing for human papillomavirus

Annual testing for Neisseria gonorrheae and Chlamydia trachomatis

One time screening for hepatitis B

One time screening for herpes simplex virus - Answer✔️✔️-Correct Answer ( B )

Explanation:

Sexually transmitted infections (STIs) are a serious public health problem in the United

States and worldwide. Sequelae of untreated STIs include infertility, cervical cancer,

infections, and transmission to uninfected individuals. Many patients with STIs are

asymptomatic, and assessment of risk factors is an important aspect of determining

who and when to screen. STI counseling and an assessment of risk factors begins with

a thorough sexual history including questions about new partners, frequency of condom

use, history of multiple sexual partners, intercourse with trauma, and types of sexual

exposures. Risk factors for STIs include new and multiple sexual partners, age younger


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, ©SOPHIABENNETT EXAM SOLUTIONS_2024/2025 Tuesday, September 3, 2024 10:30 AM


than 25 years, previous STIs, illegal drug use, incarceration at a correctional facility or

juvenile detention facility, intercourse with sex workers, and meeting sexual partners on

the internet. The United States Preventive Services Task Force (USPSTF) recommends

annual screening for Neisseria gonorrheae and Chlamydia trachomatis infection in

sexually active women under the age of 25 years.

A 67-year-old man presents to his primary care provider with dyspnea and fatigue. He

has a past medical history of hypertension, diabetes mellitus, and stage 3 chronic

kidney disease. A CBC shows a hemoglobin of 9 g/dL, hematocrit of 28%, total iron-

binding capacity of 220 mcg/dL, mean corpuscular volume of 80 fL, mean corpuscular

hemoglobin concentration of 31 g/dL, and ferritin of 310 ng/dL. A peripheral blood

smear shows normocytic, normochromic red blood cells with few reticulocytes. Which of

the following is the most appropriate management?



Cyanocobalamin

Darbepoetin

Ferrous gluconate and darbepoetin

Red blood cell transfusion - Answer✔️✔️-Correct Answer ( B )

Explanation:

The man in this case has anemia of chronic disease and should be managed with

darbepoetin. Anemia in chronic kidney disease (CKD) is primarily due to decreased

production of erythropoietin by the diseased kidney. Almost all of patients with

glomerular filtration rate less than 30 mL/min have some degree of anemia.

Erythropoietin is produced by the kidney in response to decreased blood oxygen levels.


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