Question 1

Multiple, bilateral, small angiomyolipomas are seen in patients with which of the following conditions?

Accepted Answer

Multiple, bilateral, small angiomyolipomas are a characteristic finding in patients with tuberous sclerosis. These lesions can cause renal dysfunction or bleeding and require monitoring. Sturge-Weber Syndrome is characterized by port-wine stains on the face and glaucoma. Von Hippel-Lindau disease is characterized by hemangioblastomas in the cerebellum and retina, as well as renal cell carcinoma. Multiple endocrine neoplasia is characterized by tumors in multiple endocrine glands, such as the parathyroid, pancreas, and pituitary.

Question 2

Renal cell carcinoma accounts for what percentage of primary malignant renal neoplasms?

Accepted Answer

Renal cell carcinoma accounts for approximately 80% to 90% of primary malignant renal neoplasms.

Question 3

Which of the following diagnostic imaging modalities is most appropriate as the initial imaging modality for evaluation of the adnexa?

Accepted Answer

Diagnostic ultrasonography is the most appropriate initial imaging modality for evaluation of the adnexa, as it is non-invasive, widely available, and able to provide detailed anatomical and functional information. Plan film radiographs are not useful for evaluating soft tissues, and computed tomography and magnetic resonance imaging may be reserved for further evaluation or when ultrasonography is inconclusive.

Question 4

Which of the following imaging findings is considered diagnostic for angiomyolipomas?

Accepted Answer

Angiomyolipomas contain fat, and thus have fat attenuation on computed tomography. This is considered diagnostic for angiomyolipomas. Marked echogenicity on diagnostic ultrasonography is a common finding in angiomyolipomas, but it is not specific. Calcification on plain film radiographs can be seen in angiomyolipomas but this is not a specific finding. Low signal intensity on T1-weighted MRI sequences is also a common finding in angiomyolipomas, but it is not specific.

Question 5

The largest percentage of renal stones in the United States is composed of __________.

Accepted Answer

Calcium oxalate is the most common type of renal stone in the United States, accounting for approximately 70-80% of all cases. Uric acid stones are the second most common, accounting for 5-10% of cases. Struvite and cysteine stones are much rarer, accounting for less than 5% of cases each.

Question 6

Which of the following groups of imaging findings is most suggestive of malignant ovarian lesion?

Accepted Answer

Malignant ovarian lesions typically present with irregular walls, thick septations, and complex architecture. This is in contrast to benign lesions that often have thin septations and simple architecture. The presence of large size and cystic lesions that resolve on serial ultrasounds can be seen in both benign and malignant lesions. However, the combination of irregular walls, thick septations, and complex architecture is most suggestive of a malignant ovarian lesion.

Question 7

Which of the following is associated with a cessation of growth of uterine leiomyomas?

Accepted Answer

Menopause marks the cessation of ovarian function and the resulting decrease in estrogen levels, which can lead to shrinkage of uterine leiomyomas. Pregnancy and certain hormonal therapies (such as oral contraceptives and postmenopausal hormone replacement therapy) can actually stimulate the growth of uterine leiomyomas.

Question 8

Foci of fat within mature cystic teratomas demonstrate __________ MRI pulse sequences.

Accepted Answer

Fat within mature cystic teratomas typically shows high signal intensity on T1-weighted MRI sequences due to its high lipid content.

Question 9

The most common location for a pheochromocytoma is the __________.

Accepted Answer

Pheochromocytomas are tumors that arise from chromaffin cells in the adrenal medulla and are the most common cause of endocrine hypertension. The tumors can also arise in extra-adrenal chromaffin tissue, which is part of the sympathetic nervous system, but this is less common. Adrenal cortex tumors may cause other endocrine disorders, but not pheochromocytoma. Pheochromocytomas are not typically found in the thorax.

Question 10

Which pattern of calcification is commonly observed with uterine leiomyomas on plain film radiographs?

Accepted Answer

The answer of Which pattern of calcification is commonly observed...

Question 11

Which of the following is not consistent with malignant transformation of dermoid cysts?

Accepted Answer

Malignant transformation of dermoid cysts is rare and occurs in less than 2% of cases. Therefore, choice C which states that malignant transformation is common is not consistent with the facts about dermoid cysts. Choices A, B, and D are consistent with malignant transformation, as older age, larger tumor size, and rapid growth can be associated with malignancy.

Question 12

Which of the following is the most common clinical presentation for women with dermoid cysts?

Accepted Answer

The most common clinical presentation for women with dermoid cysts is an incidental finding on imaging or physical exam. While some women may experience pelvic pain or ovarian torsion, this is not as common as an incidental finding. Chemical peritonitis and shock are not commonly associated with dermoid cysts.

Question 13

Which of the following represents the most common benign renal neoplasm presenting as a small renal mass?

Accepted Answer

Angiomyolipoma is the most common benign renal neoplasm presenting as a small renal mass. Pheochromocytoma is a rare tumor typically found in the adrenal gland, not the kidney. Oncocytoma is a benign tumor of the kidney, but it is less common than angiomyolipoma. Lymphoma is a malignant tumor, not a benign tumor, and it is not typically found as a solitary mass in the kidney.

Question 14

An adult male patient presents with clinical findings of headache, sweating, and palpitations. Laboratory evaluation reveals urinary catecholamines and their metabolites. Which of the following specialized imaging studies is recommended if noncontrast abdominal CT is negative?

Accepted Answer

Urinary catecholamines and their metabolites are suggestive of pheochromocytoma or paraganglioma. MIBG (metaiodobenzylguanidine) scan is a specialized imaging study recommended for patients with suspected or confirmed pheochromocytoma or paraganglioma when noncontrast abdominal CT is negative. This scan can detect and localize primary and metastatic lesions. SPECT (single photon emission computed tomography) and PET (positron emission tomography) are other imaging studies that can be used for evaluation, but MIBG is the preferred first-line study. Contrast-enhanced CT can be used in selected cases, but MIBG scan is more sensitive and specific.

Question 15

Which of the following diagnostic imaging modalities provides the greatest imaging sensitivity in detecting nephrolithiasis?

Accepted Answer

Computed tomography (CT) provides the greatest imaging sensitivity in detecting nephrolithiasis compared to the other modalities listed. CT can detect stones as small as 1-2 mm and provide detailed information on the size, location, and number of stones. Plain film radiographs and intravenous pyelography have lower sensitivity and are more useful for monitoring stone progression. Diagnostic ultrasonography is less sensitive than CT but can be useful in certain cases, such as in pregnant patients or those with allergies to contrast agents.

Question 16

Leiomyomas are the most common benign uterine tumors, occurring in approximately __________ percent of women over __________ years of age.

Accepted Answer

Leiomyomas, also known as fibroids, are indeed the most common benign tumors of the uterus, and they are found in up to 40% of women over the age of 35.

Question 17

Which the following is considered the most lethal of all genitourinary cancers?

Accepted Answer

The answer of Which the following is considered the most...

Question 18

Contrast-enhanced computed tomography examination of the abdomen of a 57-year-old patient reveals an asymptomatic, enhancing 3.5 cm mass within the kidney. Which of the following diagnoses must be excluded through further work-up?

Accepted Answer

The most important differential diagnosis that must be excluded in this clinical scenario is renal cell carcinoma, which is the most common primary malignant tumor of the kidney. Pheochromocytoma can also be a differential diagnosis, but it usually presents with symptoms such as hypertension, headache, palpitations, and sweating. Renal cysts are usually benign and non-enhancing on contrast-enhanced CT. Metastases can also present as enhancing masses, but they typically have a different appearance and distribution pattern than primary renal tumors.

Question 19

__________ percent of ovarian tumors are benign.

Accepted Answer

According to medical studies, approximately 80% of ovarian tumors are benign.

Question 20

Which of the following radiographic densities is most helpful in diagnosing mature cystic teratomas?

Accepted Answer

Teeth are the most helpful radiographic density in diagnosing mature cystic teratomas.

Quiz 29: Genitourinary Diseases