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Question 1 of 22
1. Question1 point(s)
What is the most common type of renal cell carcinoma in adults?CorrectIncorrect
Question 2 of 22
2. Question1 point(s)
A 67 year old patient presents with painless haematuria.
She has a normal cystoscopy, but is found to have a mass on her left kidney on ultrasound.
She undergoes a staging CT scan and ultrasound guided biopsy and is diagnosed with a T1N0M0 Renal Cell Carcinoma.
What lifestyle factor is most likely to have made a significant contribution to her diagnosis?CorrectIncorrect
Question 3 of 22
3. Question1 point(s)
Which of the following findings is found almost exclusively in renal cell carcinomas?CorrectIncorrect
Question 4 of 22
4. Question1 point(s)
What is the most common type of bladder cancer?CorrectIncorrect
Question 5 of 22
5. Question1 point(s)
A 56 year old Egyptian patient presents with painless haematuria.
He remembers having schistosomiasis several times when he was younger and living in Egypt, however this was treated prior to coming to the UK 10 years ago and he hasn’t been back to Egypt or been swimming in fresh water since treatment.
He has a cystoscopy, and a lesion suspicious of a bladder cancer is biopsied.
What is the most likely finding on the histology?CorrectIncorrect
Question 6 of 22
6. Question1 point(s)
A patient is diagnosed with an isolated transitional cell carcinoma of the bladder that is not invading the muscle.
What is the definitive treatment in this patient?CorrectIncorrect
Question 7 of 22
7. Question1 point(s)
A 78 year old male patient presents to his GP complaining of some difficulty passing urine. He finds that he takes a long time to start passing urine, and has a weak stream, intermittently starting and stopping during urination and then tends to dribble urine for a few minutes after emptying his bladder. He has had no systemic symptoms.
He is otherwise fit and well, and only takes medication for hypertension which is well controlled.
This is causing him significant frustration.
Examination of his genitals is normal. Digital rectal examination reveals a smooth, enlarged prostate with a central sulcus.
Prostate specific antigen is normal.
What is the most appropriate initial management?CorrectIncorrect
Question 8 of 22
8. Question1 point(s)
Match the risk factor to the cancer:
- Being tall
- Chronic Dehydration
Question 9 of 22
9. Question1 point(s)
Match the risk factor to the diagnosis
- Anabolic Steriod Use
- Exposure to Aromatic Amines
- Long-Term Dialysis
Question 10 of 22
10. Question1 point(s)
What is the name of the grading system used in prostate cancer?CorrectIncorrect
Question 11 of 22
11. Question1 point(s)
A urologist decides to start an LHRH agonist in a patient with metastatic prostate cancer.
Which of the following medications is an example of an LHRH agonist?CorrectIncorrect
Question 12 of 22
12. Question1 point(s)
A 43 year old man presents with a painful swollen left testicle that has progressed gradually over the last 5 days. He has also been experiencing fevers and feeling generally unwell. He has had no urethral discharge. He is otherwise fit and well and has a single long term partner for the past 8 years.
On examination his left testicle is swollen and acutely tender, particularly over the epididymis. The scrotum is mildly tender, particularly over the left side. There is no tracking cellulitis. The testicle is in a normal lie.
Given the likely diagnosis of epididymo-orchitis, what is the most likely causative organism?CorrectIncorrect
Question 13 of 22
13. Question1 point(s)
A 35 year old man presents to A&E with a painful swollen right testicle. It has got progressively more painful and tender over the last 36 hours, and he is not sure the exact moment it started. He also feels the testicle is larger and feels like it is dragging. Lifting the testicle helps to relieve the pain. He has not had any urethral discharge or urinary symptoms. He is unsure whether he has had any fevers. He has a regular partner and has recently been tested negative for sexually transmitted infections.
On examination his scrotum is mildly erythematous. His right is swollen, firm but not hard, and acutely tender, particularly over the superior pole and posteriorly. The testicle is too tender to examine thoroughly. Cremasteric reflex is present.
The patient has been given some analgesia and the pain has settled slightly with this.
What would be the most appropriate next step in management.CorrectIncorrect
Question 14 of 22
14. Question1 point(s)
A 16 year old boy presents with an acutely painful left testicle.
This started as he was playing rugby 2 hours ago, and came on suddenly.
His left testicle is retracted and in a horizontal position. There is an absent cremasteric reflex. It is hard and extremely tender.
Given the most likely diagnosis, what is the most appropriate next step in management?CorrectIncorrect
Question 15 of 22
15. Question1 point(s)
What is the name of the congenital abnormality that predisposes a patient to testicular torsion due to the absence of the normal posterior attachment of the testicle to the tunica vaginalis?CorrectIncorrect
Question 16 of 22
16. Question1 point(s)
Match the typical presentation to the likely diagnosis.
- Non-tender, hard, irregular lump
- Non-tender, soft, fluctuant lump around the testicle that transilluminates with light
- Mildly tender, soft and irregular lump separate from the testicle
- Non-tender, soft, fluctuant lump at the superior pole of the testicle that is separate from the testicle itself. It transilluminates with light.
- Very tender, hot, swollen testicular swelling most prominent at the superior pole and at the back of the testicle
- Large soft mass in the scrotum, separate from the testicle that disappears when the patient lies flat and becomes more prominent on standing
Question 17 of 22
17. Question1 point(s)
Select the common types of testicular cancer from the list belowCorrectIncorrect
Question 18 of 22
18. Question1 point(s)
A 21 year old man presents with a painless, hard, irregular left testicular lump.
Tumour markers are as follows:
Alpha-fetoprotein: 430 ng/mL (normally <10)
Beta-hCG: 32 U/L (normally <5)
Lactate dehydrogenase: 1400 IU/L (normally 50-115)
What is the most likely diagnosis?CorrectIncorrect
Question 19 of 22
19. Question1 point(s)
A 32 year old presents to her accident and emergency department with fevers and a dully, achey pain in her left loin. She started having dysuria and some low grade temperatures 3 days ago that has progressively worsened. She is normally fit and well but prone to urinary tract infections.
On examination she has a temperature of 38.6C, blood pressure 94/67, heart rate 102, respiratory rate 17 and saturations 99% on room air. She is tender over left renal angle on bimanual palpation.
What is the most likely diagnosis?CorrectIncorrect
Question 20 of 22
20. Question1 point(s)
What is the most common composition of renal stones?CorrectIncorrect
Question 21 of 22
21. Question1 point(s)
What is the most appropriate imaging for establishing a diagnosis in a patient presenting with renal colic?CorrectIncorrect
Question 22 of 22
22. Question1 point(s)
A 46 year old lady presents with fluctuating loin to groin pain. When you arrive she is moving around on the bed with pain, and states she is unable to get comfortable and is in severe pain (10/10). She says it is similar to a previous episode, during which she was told she had stones in her kidneys and that they would pass without doing anything. She has a penicillin allergy but is not aware of any other allergies. She is normally fit and well.
She asks if she can have something to take the pain away.
What is the most appropriate choice given the severity of her pain?CorrectIncorrect