Pathology CPC: Flank Pain & Haematuria

A 65-year-old male presents with left flank pain for 4 months and a palpable left-sided abdominal mass. Which of the following is the MOST likely differential diagnosis to exclude first?

A 65-year-old male presents with left flank pain for 4 months and a palpable left-sided abdominal mass. His lab results show elevated hemoglobin (Hb) at 17 g/dL and C-reactive protein (CRP) at 40. White cell count (WCC) is normal. What does an elevated CRP indicate?

Following an ultrasound that reveals an 8cm mass on the left kidney of a 65 year old male, which of the following would be the MOST appropriate next step in diagnosis?

A CT scan reveals a hypodense mass in the left kidney. In which of the following scenarios would a biopsy be MOST necessary to help direct management?

Which of the following is LEAST likely in the differential diagnosis of a renal mass?

Which of the following is the MOST common type of renal parenchymal carcinoma?

A patient is diagnosed with clear cell renal carcinoma. Which genetic syndrome is MOST closely associated with an increased risk of developing this cancer?

What is the typical first-line treatment for localized renal parenchymal cell carcinoma?

From which cells does renal parenchymal cell carcinoma arise?

Which finding would indicate a POOR prognosis in renal cell carcinoma?

Polycythemia is a paraneoplastic syndrome sometimes caused by renal carcinoma. What is the underlying mechanism?

A 56-year-old male presents with hematuria on two occasions. Which of the following classifications is used to categorize potential causes of hematuria?

A 56-year-old male presents with hematuria. Which of the following renal conditions should be included in the differential diagnosis?

Which non-renal cause is LEAST likely to be associated with hematuria?

A 56-year-old male presents with hematuria. Initial investigations should follow a logical classification. What is the correct logical order for hematuria investigations?

A cystoscopy reveals a papillary tumor in the bladder. When comparing malignant and benign bladder tumours, which statement is CORRECT?

Which of the following is the MOST common type of bladder carcinoma?

A patient is diagnosed with squamous cell carcinoma of the bladder. Which of the following risk factors is MOST strongly associated with this type of bladder cancer?

Which of the following is NOT a typical symptom of bladder carcinoma?

What is the MOST important factor in determining the prognosis of bladder carcinoma?

A patient is diagnosed with high-grade urothelial carcinoma in situ of the bladder. What is the MOST appropriate initial management?

Which occupational exposure is a well-known risk factor for bladder cancer?

A patient presents with macroscopic hematuria. Which of the following statements regarding hematuria is MOST accurate?

A 43-year-old male presents with severe colicky left loin pain of sudden onset. Which of the following initial differential diagnoses is the MOST probable?

What is the BEST single initial test to confirm a case of renal colic?

Calcium oxalate stones are the most common type of urinary stone. Which of the following is the LEAST likely cause of them?

Proteus mirabilis increases the risk of triple stones (struvite) due to its production of urease. What effect does this have on urine?

Uric acid stones are radiolucent. What can cause them?

A patient with a history of recurrent kidney stones and UTIs presents with a new kidney stone. Which is the MOST likely complication if left untreated?

Stricture of the ureter is a serious complication of untreated kidney stones. What is the MOST concerning consequence of ureteral stricture?

Which of the following is the MOST important learning outcome related to renal cell carcinoma?

A 65-year-old male with a history of smoking presents with left flank pain and hematuria for the past month. An abdominal CT scan reveals a 7 cm solid mass in the left kidney. Lab results show hypercalcemia. What is the MOST likely cause of hypercalcemia in this patient?

A 60-year-old male presents with painless hematuria. Cystoscopy reveals a high-grade urothelial carcinoma of the bladder that has invaded into the muscle layer. What is the MOST appropriate next step in the management of this patient?

A 35-year-old male presents with left flank pain radiating to the groin, along with nausea and vomiting. A urinalysis shows microscopic hematuria. A non-contrast CT scan reveals a 6 mm stone in the left ureter. What is the BEST initial approach to manage this patient?

A 50-year-old male presents with hematuria and is found to have a bladder mass. Biopsy confirms urothelial carcinoma. Further staging reveals the tumor has spread to the perivesical fat, indicating it is at least stage T3. What does the 'T' in the TNM bladder cancer staging system refer to?

A 45-year-old female presents with sudden onset of severe right flank pain, hematuria, and nausea. She has no prior medical history. Urinalysis shows red blood cells and a few white blood cells. What is the MOST likely underlying cause?

Following a diagnosis of high-grade bladder cancer, a patient undergoes radical cystectomy. Post-operatively, which of the following long-term complications is MOST likely?

A 60-year-old with schistosomiasis presents with haematuria. What kind of bladder cancer is MOST likely?

When would a partial nephrectomy be considered for the removal of a renal cortical tumour?

Which of these is not an example of presentation or paraneoplastic effect of renal cell carcinoma?

Which of the following are learning outcomes related to renal calculi?

A 65-year-old male presents with left flank pain and an abdominal mass. If an adrenal mass is suspected, which of the following features would be MOST suggestive of a malignant etiology rather than a benign one?

A 65 year old male has a hypodense mass in his left kidney. If a biopsy is performed, which of the following is the MOST significant risk associated with renal mass biopsy that clinicians must consider?

A 65-year-old male is diagnosed with a renal mass. Which of the following inherent limitations of imaging modalities makes a definitive diagnosis challenging without tissue sampling?

What is the underlying genetic mechanism MOST commonly associated with the development of clear cell renal carcinoma?

Which of the following molecular mechanisms is implicated in the pathogenesis of papillary renal cell carcinoma?

After nephrectomy for localized renal cell carcinoma, a patient develops a solitary brain metastasis 3 years later. Which of the following is the MOST appropriate management strategy?

What is the MOST likely cell type of origin for renal cell carcinoma?

Which pathological feature is MOST indicative of aggressive behavior in clear cell renal cell carcinoma?

A patient with renal cell carcinoma develops hypercalcemia. Which of the following is the MOST likely mechanism contributing to this paraneoplastic syndrome?

Aside from malignancy, what other renal cause is most commonly associated with haematuria?

A 56-year-old male presents with hematuria and a history of smoking. After initial investigations, a bladder mass is suspected. Which of the following is MOST crucial in determining the stage and guiding the management of bladder cancer?

A patient undergoes transurethral resection of a bladder tumor (TURBT) and is found to have high-grade urothelial carcinoma. What adjunctive treatment strategy is MOST commonly employed to reduce the risk of recurrence and progression?

A patient with bladder cancer is being considered for radical cystectomy. Which of the following factors would be MOST influential in deciding whether to construct an orthotopic neobladder versus an ileal conduit urinary diversion?

A 56-year-old male presents with gross hematuria. Which finding on cystoscopy would MOST strongly suggest a urothelial carcinoma in situ rather than an invasive papillary tumor?

Which of the following genetic mutations is MOST closely associated with urothelial carcinoma?

Which of the following is MOST important when considering the aetiology of bladder cancer?

A 43-year-old male presents with acute renal colic secondary to a 6mm distal ureteral stone. He has moderate pain despite oral analgesics and is unable to tolerate oral fluids. What is the MOST appropriate next step in management?

Following initial management of a ureteric stone, what is the MOST appropriate imaging modality to monitor stone passage and assess for complications such as hydronephrosis?

A patient with a history of recurrent calcium oxalate stones is found to have hypercalciuria with normal serum calcium levels. Which of the following is thought to be the MOST likely underlying cause of this condition?

What distinguishes the mechanism of formation in triple stones (struvite) from other urinary stones?

A patient is diagnosed with uric acid stones. Which dietary modification would be MOST appropriate in preventing recurrence?

A patient with recurrent urinary tract infections (UTIs) and a large staghorn calculus is MOST at risk of developing which of the following long-term complications if the stone is left untreated?

A patient develops a ureteral stricture secondary to chronic impaction from a large kidney stone. What is the MOST significant long-term consequence of an untreated ureteral stricture?

A 65-year-old smoker presents with hematuria and weight loss. CT imaging reveals a 6 cm renal mass with regional lymph node involvement. What is the MOST likely stage of the renal cell carcinoma based on the TNM staging system?

A 60-year-old patient with a history of chronic analgesic abuse presents with painless hematuria. Cystoscopy reveals a bladder tumor. Biopsy confirms squamous cell carcinoma. Which of the following predisposing factors is MOST directly associated with this specific type of bladder cancer?

When considering a partial nephrectomy for a renal cortical tumor, which of the following factors is MOST critical in determining patient selection?

Following radical cystectomy and ileal conduit diversion, which of the following long-term metabolic complications is MOST likely to occur and require ongoing management?

A 45-year-old female with a history of recurrent UTIs presents with a large staghorn calculus. She undergoes percutaneous nephrolithotomy (PCNL) for stone removal. Postoperatively, which complication is MOST concerning and requires immediate intervention ?

A 40-year-old male presents with hematuria and is found to have a 3 cm papillary bladder tumor. Transurethral resection confirms high-grade urothelial carcinoma that invades the lamina propria (T1). Molecular analysis reveals overexpression of FGFR3. What is the MOST relevant implication of this finding?

A 55-year-old male presents with hematuria and is diagnosed with invasive bladder cancer. Staging indicates the tumor has extended through the bladder wall and into the perivesical fat (T3N0M0). Which adjuvant therapy is MOST likely to improve overall survival following radical cystectomy?

A 30-year-old male presents with a renal mass discovered incidentally on imaging for unrelated symptoms. The mass is small (2 cm), well-defined, and located in the lower pole of the kidney. He has a strong family history of renal cell carcinoma. Which approach is the MOST appropriate?