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  • Question 1 - A 25-year old man presented to the clinic with swelling of the penis....

    Correct

    • A 25-year old man presented to the clinic with swelling of the penis. His uncircumcised penis was erythematous and oedematous. The foreskin could not be retracted over the glans. Which of the following agents is the likely cause of his condition?

      Your Answer: Staphylococcus aureus

      Explanation:

      Inflammation of the glans penis is known as balanitis. Associated involvement of the foreskin is then known as balanoposthitis. More likely to occur in men who have a tight foreskin that is difficult to pull back, or poor hygiene.

    • This question is part of the following fields:

      • Pathology
      • Urology
      13.5
      Seconds

  • Question 2 - When a penile tumour invades the subepithelial connective tissue of the penis, what...

    Incorrect

    • When a penile tumour invades the subepithelial connective tissue of the penis, what is its stage?

      Your Answer: T2

      Correct Answer: T1

      Explanation:

      The TNM staging used for penile cancer is as follows:

      TX: primary tumour cannot be assessed

      T0: primary tumour is not evident

      Tis: carcinoma in situ is present

      Ta: non-invasive verrucous carcinoma is present

      T1: tumour is invading subepithelial connective tissue

      T2: tumour is invading the corpora spongiosum or cavernosum

      T3: tumour invading the urethra or prostate

      T4: tumour invading other adjacent structures.

      In this case, the patient has a T1 tumour.

    • This question is part of the following fields:

      • Pathology
      • Urology
      4.2
      Seconds

  • Question 3 - A 7-year-old boys undergoes a testicular biopsy after a tumour is found in...

    Correct

    • A 7-year-old boys undergoes a testicular biopsy after a tumour is found in his right testis. Elements similar to hair and teeth are found in it. What kind of tumour is this?

      Your Answer: Teratoma

      Explanation:

      A teratoma is a tumour containing tissue elements that are similar to normal derivatives of more than one germ layer. They usually contain skin, hair, teeth and bone tissue and are more common in children, behaving as a benign tumour. After puberty, they are regarded as malignant and can metastasise.

    • This question is part of the following fields:

      • Pathology
      • Urology
      6.2
      Seconds

  • Question 4 - Difficulty in retracting the foreskin of the penis in an uncircumcised male is...

    Correct

    • Difficulty in retracting the foreskin of the penis in an uncircumcised male is known as:

      Your Answer: Phimosis

      Explanation:

      Phimosis is the inability to fully retract the foreskin of the penis in an uncircumcised male. It can be physiological in infancy, in which it could be referred to as ‘developmental non-retractility of the foreskin. However, it is almost always pathological in older children and men. Causes include chronic inflammation (e.g. balanoposthitis), multiple catheterisations, or forceful foreskin retraction. One of the causes is chronic balanitis xerotica obliterans. It leads to development of a ring of indurated tissue near the tip of the prepuce, which prevents retraction. Contributory factors include infections, hormonal and inflammatory factors. The recommended treatment includes circumcision.

    • This question is part of the following fields:

      • Pathology
      • Urology
      2.3
      Seconds

  • Question 5 - A patient with testicular seminoma has the following tumour markers: LDH 1.3 times...

    Correct

    • A patient with testicular seminoma has the following tumour markers: LDH 1.3 times the reference levels, β-hCG 4500 mIU/ml and AFP 875 ng/ml. What's the serum tumour marker stage in this case?

      Your Answer: S1

      Explanation:

      According to AJCC guidelines, the serum tumour marker staging is the following:

      S0: marker studies within normal limits

      S1: lactate dehydrogenase (LDH) less than 1.5 times the reference range, beta-human chorionic gonadotrophin (β-hCG) <5000 mIU/ml, and alpha-fetoprotein (AFP) <1000 ng/ml S2: LDH 1.5–10 times the reference range, β-hCG 5000–50,000 mIU/ml or AFP 1000–10,000 ng/ml S3: LDH greater than 10 times the reference range, β-hCG >50,000 mIU/ml or AFP >10,000 ng/ml.

      According to this, the patient’s tumour belongs to the S1 stage.

    • This question is part of the following fields:

      • Pathology
      • Urology
      5.9
      Seconds

  • Question 6 - Out of the given options, which of the following is the most likely...

    Correct

    • Out of the given options, which of the following is the most likely diagnosis in a 25-year old gentleman presenting with a testicular germ cell tumour?

      Your Answer: Embryonal carcinoma

      Explanation:

      Embryonal carcinoma is a non-seminomatous germ cell tumour of the testis, accounting for 25% testicular tumours. Other germ cell tumours include seminoma, teratoma and choriocarcinoma. Embryonal carcinomas are known to occur in men aged 25-35 years, and occasionally in teens. They are rarely seen in ovaries of females. It can spread to the vas deferens and also to the aortic lymph nodes. Embryonal carcinomas are known to have elements of fetal origin such as cartilage. Usually, the main tumour is about 2.5cm long, with an extension of 8-9cm along the testicular cord. Contiguous spread to the testicle is seen in less than 1% cases.

    • This question is part of the following fields:

      • Pathology
      • Urology
      7.2
      Seconds

  • Question 7 - If a tumour is found in both lobes of the prostate, without nodal...

    Incorrect

    • If a tumour is found in both lobes of the prostate, without nodal involvement or metastases, a histological grade of G2 and elevated PSA, what is the overall prostatic cancer stage?

      Your Answer: Stage I

      Correct Answer: Stage II

      Explanation:

      The AJCC uses the TNM, Gleason score and PSA levels to determine the overall stage of prostatic cancer. This staging is as follows:

      Stage I: T1, N0, M0, Gleason score 6 or less, PSA less than 10; or T2a, N0, M0, Gleason score 6 or less, PSA less than 10

      Stage IIa: T1, N0, M0, Gleason score of 7, PSA less than 20; or T1, N0, M0, Gleason score of 6 or less, PSA at least 10 but less than 20; or T2a or T2b, N0, M0, Gleason score of 7 or less, PSA less than 20

      Stage IIb: T2c, N0, M0, any Gleason score, any PSA; or T1 or T2, N0, M0, any Gleason score PSA of 20 or more; or T1 or T2, N0, M0, Gleason score of 8 or higher, any PSA

      Stage III: T3, N0, M0, any Gleason score, any PSA Stage IV: T4, N0, M0,any Gleason score, any PSA; or any T, N1, M0,any Gleason score, any PSA; or Any T, any N, M1, any Gleason score, any PSA.

      The patient in this case has a T2 N0 M0 G2 tumour, meaning it belongs in stage II

    • This question is part of the following fields:

      • Pathology
      • Urology
      10
      Seconds

  • Question 8 - A 30 year old male has a painless and transilluminant swelling at the...

    Correct

    • A 30 year old male has a painless and transilluminant swelling at the upper pole of his left testi. There is a negative cough test. Which of the following is the likely diagnosis?

      Your Answer: Spermatocoele

      Explanation:

      Spermatocele, also known as a spermatic cyst is a cystic mass usually occurring at the upper pole of the testis. Differential diagnosis included hydrocele as both are cystic, painless and transilluminant. Ultrasound is a useful modality. If symptomatic or large, surgical excision can be done.

    • This question is part of the following fields:

      • Pathology
      • Urology
      8.6
      Seconds

  • Question 9 - Painful erections along with deviation of the penis to one side when erect...

    Correct

    • Painful erections along with deviation of the penis to one side when erect are seen in which of the following conditions?

      Your Answer: Peyronie’s disease

      Explanation:

      Peyronie’s disease leads to development of fibrous plaques in the penile soft tissue and occurs in 1% of men, most commonly affecting white males above 40 years age. It is a connective tissue disorder named after a French surgeon, François de la Peyronie who first described it. Symptoms include pain, hard lesions on the penis, abnormal curvature of erect penis, narrowing/shortening, painful sexual intercourse and in later stages, erectile dysfunction. 30% cases report fibrosis in other elastic tissues such as Dupuytren’s contractures of the hand. There is likely a genetic predisposition as increased incidence is noted among the male relatives of an affected individual.

    • This question is part of the following fields:

      • Pathology
      • Urology
      15.8
      Seconds

  • Question 10 - If a 68-year-old man is diagnosed with a testicular seminoma that reaches the...

    Incorrect

    • If a 68-year-old man is diagnosed with a testicular seminoma that reaches the tunica albuginea and involves the tunica vaginalis, with retroperitoneal lymph nodes greater than 5cm, LDH 1.4 times the reference levels, β-hCG 4250 mIU/ml and AFP 780 ng/ml, what's the clinical stage in this case?

      Your Answer: Stage IA

      Correct Answer: Stage IIC

      Explanation:

      According to the AJCC, the clinical staging for testicular seminoma is:
      Stage IA: T1 N0 M0 S0
      Stage IB: T2/3/4 N0 M0 S0
      Stage IC: any T N0 M0 S1/2/3
      Stage IIA: any T N1 M0 S0/1
      Stage IIB: any T N2 M0 S0/1
      Stage IIC: any T N3 M0 S0/1
      Stage IIIA: any T any N M1a S0/1
      Stage IIIB: any T any N M0/1a S2
      Stage IIIC: any T any N M1a/1b S3.
      The patient in this case has IIC stage

    • This question is part of the following fields:

      • Pathology
      • Urology
      15
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Pathology (7/10) 70%
Urology (7/10) 70%
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