Overview Of Renal Cell Carcinoma Assessment

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Cell Quizzes & Trivia

Questions and Answers
  • 1. 

    What is the kidney’s outer layer of fibrous tissue called?

    • A.

      Gerota’s fascia

    • B.

      Renal capsule

    • C.

      Renal cortex

    • D.

      Medulla

    • E.

      None of the responses are correct

    Correct Answer
    A. Gerota’s fascia
    Explanation
    Gerota's fascia is the correct answer because it is the outer layer of fibrous tissue that surrounds the kidney. It is named after the Romanian surgeon Dimitrie Gerota who first described it. The renal capsule is a different structure that covers the kidney directly, while the renal cortex and medulla are internal regions of the kidney. None of the responses are correct is not the correct answer because Gerota's fascia is indeed the outer layer of fibrous tissue.

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  • 2. 

    Which of the following is not a function of the kidneys?

    • A.

      Excretion of waste and foreign substances

    • B.

      Regulation of blood glucose

    • C.

      Regulation of blood volume

    • D.

      Regulation of blood pH

    • E.

      Regulation of protein synthesis

    Correct Answer
    E. Regulation of protein synthesis
    Explanation
    The kidneys are responsible for excreting waste and foreign substances, regulating blood glucose, regulating blood volume, and regulating blood pH. However, the kidneys do not have a direct role in the regulation of protein synthesis. This process primarily occurs in the cells of various organs and tissues, such as the liver, muscles, and glands. The kidneys primarily focus on maintaining fluid balance, removing waste products, and regulating electrolyte levels in the body.

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  • 3. 

    What is the median age of diagnosis for RCC in the US?

    • A.

      59 years

    • B.

      61 years

    • C.

      65 years

    • D.

      71 years

    • E.

      None of the responses are correct

    Correct Answer
    C. 65 years
    Explanation
    The median age of diagnosis for RCC in the US is 65 years. This means that half of the people diagnosed with RCC are younger than 65 years and half are older. It is important to note that this is the median age, so there may be individuals diagnosed at younger or older ages, but 65 years is the middle point.

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  • 4. 

    Which of the following is not a risk factor for RCC?

    • A.

      Hypertension

    • B.

      Race

    • C.

      Advanced renal cell disease

    • D.

      Age

    • E.

      All of the responses are correct

    Correct Answer
    D. Age
    Explanation
    Age is not a risk factor for RCC (Renal Cell Carcinoma). RCC is a type of kidney cancer, and although it is more commonly diagnosed in older adults, age itself is not considered a risk factor. Hypertension, race, and advanced renal cell disease are all recognized risk factors for RCC. However, it is important to note that while age may not be a direct risk factor, the incidence of RCC does increase with age due to other factors such as cumulative exposure to potential carcinogens and a decline in immune function.

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  • 5. 

    What percentage of kidney cancers is classified as RCC?

    • A.

      5-10%

    • B.

      75%

    • C.

      80%

    • D.

      90%

    • E.

      None of the responses are correct

    Correct Answer
    D. 90%
    Explanation
    Approximately 90% of kidney cancers are classified as renal cell carcinoma (RCC). This type of cancer originates in the cells lining the small tubes within the kidney. The remaining percentage includes other less common types of kidney cancer, such as transitional cell carcinoma and Wilms tumor. Therefore, 90% is the most accurate answer as it represents the majority of kidney cancer cases.

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  • 6. 

    What is the most predominant RCC histological type?

    • A.

      Papillary carcinoma

    • B.

      Chromophobe RCC

    • C.

      Collecting duct carcinoma

    • D.

      Clear cell

    • E.

      None of the responses are correct

    Correct Answer
    D. Clear cell
    Explanation
    Clear cell is the most predominant RCC histological type. This type of renal cell carcinoma is characterized by clear cytoplasm due to the accumulation of glycogen and lipids. It accounts for approximately 70-80% of all RCC cases. Clear cell RCC is typically aggressive and has a higher likelihood of metastasis compared to other histological types. It is important to identify the histological type of RCC as it can guide treatment decisions and prognosis.

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  • 7. 

    What percentage of patients with RCC present with metastatic disease?

    • A.

      15%

    • B.

      30%

    • C.

      45%

    • D.

      75%

    • E.

      None of the responses are correct

    Correct Answer
    B. 30%
    Explanation
    Approximately 30% of patients with renal cell carcinoma (RCC) present with metastatic disease. RCC is a type of kidney cancer that can spread to other parts of the body, such as the lungs, bones, or lymph nodes. This indicates that a significant portion of patients already have advanced-stage cancer at the time of diagnosis. The other percentages mentioned in the options are not accurate representations of the percentage of patients with RCC who present with metastatic disease.

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  • 8. 

    Name the two most common sites of metastases associated with RCC

    • A.

      Skin, liver

    • B.

      Lung, soft tissue

    • C.

      Lung, CNS

    • D.

      Soft tissue, bone

    • E.

      Skin, CNS

    Correct Answer
    B. Lung, soft tissue
    Explanation
    The two most common sites of metastases associated with RCC (Renal Cell Carcinoma) are the lung and soft tissue. RCC commonly spreads to the lungs, where it can form new tumors. Soft tissue metastases can occur in various parts of the body, such as the muscles, tendons, or connective tissues. This spread of cancer to the lung and soft tissue is typical for RCC and can contribute to the progression and severity of the disease.

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  • 9. 

    Select the statement that best describes the relationship between the Von Hippel-Lindau (VHL) gene, the HIF pathway and its role in angiogenesis in patients with RCC.

    • A.

      The VHL mutation results in the downregulation of HIF and induces genes that promote angiogenesis.

    • B.

      The VHL mutation results in the upregulation of HIF and interferes with genes that promote angiogenesis.

    • C.

      The VHL mutation results in the upregulation of HIF and induces genes that promote angiogenesis.

    • D.

      The VHL mutation results in the downregulation of HIF and hinders genes that promote angiogenesis.

    • E.

      None of the responses are correct

    Correct Answer
    C. The VHL mutation results in the upregulation of HIF and induces genes that promote angiogenesis.
    Explanation
    The VHL mutation leads to an increase in the expression of HIF and triggers the activation of genes that stimulate angiogenesis.

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  • 10. 

    The PI3K/AKT/mTOR pathway is a key regulator of which cellular function (s)?

    • A.

      Angiogenesis

    • B.

      Cell growth

    • C.

      Survival

    • D.

      Angiogenesis and cell growth

    • E.

      Angiogenesis, cell growth and survival

    Correct Answer
    E. Angiogenesis, cell growth and survival
    Explanation
    The PI3K/AKT/mTOR pathway is a signaling pathway that plays a crucial role in regulating multiple cellular functions, including angiogenesis, cell growth, and survival. Angiogenesis refers to the formation of new blood vessels, which is important in various physiological and pathological processes. Cell growth involves the increase in cell size and number, which is essential for tissue development and maintenance. Survival refers to the ability of cells to avoid cell death and maintain their viability. The PI3K/AKT/mTOR pathway regulates these functions by activating various downstream signaling molecules and pathways.

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  • 11. 

    Which imaging study is the preferred means for viewing a renal mass?

    • A.

      X-Ray

    • B.

      CT with or without contrast

    • C.

      Abdominal MRI

    • D.

      Renal angiography

    • E.

      Abdominal ultrasound

    Correct Answer
    B. CT with or without contrast
    Explanation
    CT with or without contrast is the preferred means for viewing a renal mass because it provides detailed images of the kidney and surrounding structures. CT scans can help identify the size, location, and characteristics of the mass, which is important for making an accurate diagnosis and determining the appropriate treatment plan. The use of contrast dye can further enhance the visibility of the mass and help differentiate between solid tumors and cysts. X-rays, abdominal MRI, renal angiography, and abdominal ultrasound may also be used in certain cases, but CT with or without contrast is generally considered the most effective imaging study for evaluating renal masses.

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  • 12. 

    What is the stage of a RCC tumor classified as T2, N1, MO?

    • A.

      Stage I

    • B.

      Stage II

    • C.

      Stage III

    • D.

      Stage IV

    Correct Answer
    C. Stage III
    Explanation
    The stage of a RCC tumor classified as T2, N1, MO is Stage III. This classification indicates that the tumor is larger than 7 centimeters and has spread to nearby lymph nodes, but has not metastasized to other parts of the body. Stage III is a more advanced stage of kidney cancer, indicating a higher risk of the disease spreading and requiring more aggressive treatment options.

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  • 13. 

    The rate of RCC has _________ by __ each year for the last 65 years.

    • A.

      Increased, 2%

    • B.

      Increased, 7%

    • C.

      Increased, 12%

    • D.

      Decreased, 2%

    • E.

      Decreased, 7%

    Correct Answer
    A. Increased, 2%
    Explanation
    The correct answer is "increased, 2%". This means that the rate of RCC (whatever that may refer to) has been increasing by 2% each year for the past 65 years.

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  • 14. 

    Which is the most common type of hereditary RCC diagnosed?

    • A.

      Hereditary Papillary RCC

    • B.

      Hereditary leiomyoma-RCC

    • C.

      Birt-Hogg-Dube syndrome

    • D.

      VHL disease

    • E.

      Hereditary renal oncocytoma

    Correct Answer
    D. VHL disease
    Explanation
    VHL disease is the most common type of hereditary RCC diagnosed. VHL stands for Von Hippel-Lindau disease, which is an autosomal dominant disorder characterized by the development of various tumors, including RCC. Individuals with VHL disease have a mutation in the VHL gene, which leads to a higher risk of developing RCC. This type of RCC is often bilateral and multifocal, meaning it affects both kidneys and can have multiple tumor nodules. Other features of VHL disease include the development of other tumors like hemangioblastomas in the central nervous system and pheochromocytomas in the adrenal glands.

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  • 15. 

    Which of the following is not a predictor of short survival?

    • A.

      Hgb < LLN

    • B.

      < 1 year from diagnosis to start of systemic treatment

    • C.

      Karnofsky PFS ≤ 70

    • D.

      LDH > 1.5X ULN

    • E.

      ≥ 1 site organ metastasis

    Correct Answer
    E. ≥ 1 site organ metastasis
    Explanation
    The presence of at least one site organ metastasis is a predictor of short survival. This means that if a patient has metastasis in one or more organs, their survival prognosis is likely to be poor. Therefore, it is incorrect to say that ≥ 1 site organ metastasis is not a predictor of short survival.

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  • 16. 

    What is the average 5-year survival rate for a Stage IV RCC patient?

    • A.

      23%

    • B.

      64%

    • C.

      82%

    • D.

      96%

    • E.

      None of the responses are correct

    Correct Answer
    A. 23%
    Explanation
    The correct answer is 23%. This means that, on average, only 23% of Stage IV RCC patients survive for 5 years after diagnosis. Stage IV RCC refers to advanced kidney cancer that has spread to other parts of the body, making it more difficult to treat and resulting in a lower survival rate.

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  • 17. 

    In what part of the kidney does clear cell RCC originate?

    • A.

      Collecting duct

    • B.

      Distal convoluted tubule

    • C.

      Proximal convoluted tubule

    • D.

      Glomerulus

    • E.

      None of the responses are correct

    Correct Answer
    C. Proximal convoluted tubule
    Explanation
    Clear cell renal cell carcinoma (RCC) is a type of kidney cancer that originates in the proximal convoluted tubule. The proximal convoluted tubule is a part of the nephron, which is the functional unit of the kidney responsible for filtering and processing blood to produce urine. Clear cell RCC is characterized by the presence of clear cells, which are filled with lipids and glycogen. This type of cancer is the most common form of RCC and typically presents with symptoms such as blood in the urine, flank pain, and a palpable mass in the abdomen.

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  • 18. 

    Which statistic best characterizes RCC?

    • A.

      It has a higher incidence in men

    • B.

      It has a higher incidence in women

    • C.

      Its incidence is equally distributed among men and women

    • D.

      The overall 5-year relative survival for all stages is 48.3%

    • E.

      It is the 11th most common cancer diagnosed in the US

    Correct Answer
    A. It has a higher incidence in men
    Explanation
    The correct answer is "It has a higher incidence in men." This means that renal cell carcinoma (RCC) is more commonly diagnosed in men compared to women. This statistic helps to characterize the disease by highlighting its gender distribution and prevalence.

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  • 19. 

    Within what period of time do tumor recurrences primarily recur?

    • A.

      1-3 years

    • B.

      3-5 years

    • C.

      5-7 years

    • D.

      7-10 years

    • E.

      10-15 years

    Correct Answer
    B. 3-5 years
    Explanation
    Tumor recurrences primarily recur within a period of 3-5 years. This means that after the initial treatment and removal of a tumor, there is a higher likelihood of the tumor coming back within this time frame. It is important for patients and healthcare providers to be vigilant during this period and closely monitor for any signs or symptoms of recurrence. After 5 years, the risk of recurrence decreases, although it is still possible for tumors to recur after this time.

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  • 20. 

    Recurrence of RCC in the local tumor bed and the contralateral kidney is ___________

    • A.

      Rare

    • B.

      Unheard of

    • C.

      Common

    • D.

      Likely

    • E.

      Normal

    Correct Answer
    A. Rare
    Explanation
    The recurrence of RCC in the local tumor bed and the contralateral kidney is rare, meaning it does not occur frequently. This suggests that the chances of RCC reoccurring in the same area or spreading to the opposite kidney are low.

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  • 21. 

    What percentage of RCCs are detected incidentally by abdominal imaging?

    • A.

      3-5%

    • B.

      10-15%

    • C.

      20-25%

    • D.

      35-50%

    • E.

      >50%

    Correct Answer
    E. >50%
    Explanation
    More than 50% of renal cell carcinomas (RCCs) are detected incidentally by abdominal imaging. This means that over half of these types of cancers are found unintentionally while performing imaging tests for other reasons. This highlights the importance of regular abdominal imaging for early detection and treatment of RCCs.

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