RENAL and Reproductive

Systems – Q & A
 Question 1
A 34-year-old woman complains of a firm lump in her
breast. She mentions that the lump enlarges and is tender
when she has her periods. On examination, the lump
measured 2x3cm and was mobile. Which of the following
is the most likely diagnosis?

A. Benign duct papilloma

B. Benign fibroadenosis
C. Invasive ductal carcinoma
D. Benign phyllodes tumour
E. Ductal carcinoma-in-situ.
Ans: B
 Question 2
Which of the following is the most important
prognostic factor when assessing a woman with
breast cancer?

A. Presence of BRCA1 mutation

B. Obesity
C. Family history of breast cancer
D. Presence or absence of estrogen receptor
E. Presence or absence of axillary lymph node metastasis
Ans: E
 Question 3
A 45-year-old woman saw her doctor for a lump in her
breast. Excision biopsy of the lump showed a tumour
composed of discohesive neoplastic cells infiltrating in
single files and in a targetoid fashion around breast ducts
and acini. What is the most likely diagnosis?

A. Infiltrating lobular carcinoma

B. Infiltrating ductal carcinoma
C. Infiltrating tubular carcinoma
D. Medullary carcinoma
E. Lymphoma

Ans: A
 Question 4
A 25-year-old woman saw her doctor for a lump in her breast. The lump
was smooth, non-tender and mobile, measuring 1 cm in diameter. She
was worried about breast cancer and enquired about the use of
mammography. Which of the following statements is true?

A. All women with breast cancer die of their disease

B. All women who have a relative with breast cancer will develop breast
cancer
C. Mammography is a useful screening tool for women under 50years
of age.
D. Fibroadenomas will not transform into breast carcinoma
E. Men do not develop breast carcinoma

Ans: D.
 Question 5
An 11-year-old girl is brought to see her doctor
because of acute onset of orbital swelling,
haematuria, malaise and headaches. She has a
history of pharyngitis 2 weeks before. Which of the
following findings is expected?

A. Hypertension
B. Marked hypoalbuminaemia
C. Marked proteinuria
D. Polyuria
E. Positive urine cultures for beta haemolytic streptococcus
Ans: A
 Question 6
A 5-year-old boy is admitted for massive oedema and
proteinuria. He responds dramatically to a short course of
corticosteroid therapy. Electron microscopy of the
glomeruli in this patient will most likely reveal which of the
following?

A. Subendothelial deposition of electron-dense immune complex in the

basement membrane.
B. Deposition of immune complex in the mesangium
C. Electron-dense ‘humps’ in the subepithelial location
D. No change except for fusion of foot processes
E. Mild thickening of the basement membrane and an
increase in mesangial matrix.
Ans: D
 Question 7
A 2-year-old boy is seen for increasing distension
of his abdomen. Palpation reveals a massive right
flank mass arising from the left kidney. The most
likely diagnosis is:

A. Renal cell carcinoma

B. Wilm’s tumour
C. Transitional cell carcinoma
D. Polycystic kidney
E. Leiomyoma

Ans: B
 Question 8
A 60 year-old man with a history of colonic cancer
was found to have generalized oedema and
proteinuria. Which of the following is the most
likely explanation?

A. Hypoalbuminemia
B. IgA nephropathy
C. Membranous glomerulopathy
D. Acute nephritic syndrome
E. Cardiac failure.
Ans: C
 Question 9
A 5-year-old boy was brought to the clinic because his
mother noticed that he was swollen and his urine was
frothy. His renal function tests were normal. Which of the
following statements is not true?

A. The diagnosis is minimal change glomerulopathy

B. Hypertension is always an accompanying feature.
C. The proteinuria will be massive
D. Response to steroid treatment is usually dramatic.
E. Progression to chronic renal failure is unlikely.
Ans: B
 Question 10
A 65-year-old man presents with nephrotic syndrome and
hypertension. A renal biopsy reveals hyaline, nodular
glomerular deposits regarded as Kimmelstiel-Wilson
lesions. Which of the following laboratory finding is likely to
be associated?

A. Increased serum sodium

B. Decreased serum creatinine
C. Hyperglycaemia
D. Hypocalcaemia
E. Decreased urine specific gravity

Ans: C
 Question 11
A 4-year-old girl presented with severe oedema
and massive proteinuria. She responded well to
a course of corticosteroid. Which of the following
is the most likely diagnosis?

A. Minimal Change glomerulopathy

B. Membranous change glomerulopathy
C. Diabetic nephrosclerosis
D. Lupus nephropathy
E. Crescentic glomerulonephritis.
Ans: A
 Question 12
• A 50-year-old patient was referred to the
hospital with a diagnosis of azotemia. Which of
the following conditions is unlikely to be a
cause?
A. Acute renal failure
B. Dehydration
C. Severe blood loss after a road traffic accident
D. Acute myocardial infarction
E. Acute tubular necrosis
Ans: D