MCQ Book Questions

Q60602. A 20-year-old intersex woman presents with questions regard- ing her sexual differentiation. Physical examination reveals ambiguous female external genital organs with signs of viril- ization. Cytogenetic studies show a normal 46,XY karyotype. Which of the following is the most likely diagnosis for this patient’s medical condition?

Q60603. An 8-year-old boy is brought to the physician because his parents noticed a mass on his left testicle. Physical exami- nation reveals a solid mass that cannot be transilluminated, and biopsy shows a haphazard arrangement of benign differ- entiated tissues, including squamous epithelium, glandular epithelium, cartilage, and neural tissue. The left testicle was removed surgically, and the patient is symptom free 5 years later. Which of the following is the most likely diagnosis?

Q60604. A 2-year-old boy is brought to the physician because his par- ents noticed a mass on his right testicle. Physical examina- tion confi rms the parents’ observation. An orchiectomy is performed. Microscopic examination of the surgical specimen shows neoplastic cells forming glomeruloid Schiller-Duval bodies. Which of the following serum markers is most useful for monitoring the recurrence of tumor in this patient?

Q60605. A 32-year-old man presents with a testicular mass that he fi rst noticed 2 weeks ago. The mass cannot be transilluminated and appears solid and homogeneous on ultrasound examination. No tumor markers are detected on serologic testing. An orchiec- tomy is performed, and the surgical specimen is shown in the image. Which of the following is the most likely diagnosis?

Q60606. A 67-year-old man complains of increased urgency to void. He could not completely empty his bladder and felt “distended” and “irritated” all the time. Rectal digital examination reveals an enlarged nodular prostate. A biopsy discloses hyperplastic prostatic glands (shown in the image). If this patient’s pros- tate continues to enlarge, which of the following is a possible complication?

Q60607. A 60-year-old man with a history of nodular prostatic hyper- plasia and recurrent cystitis presents with pain in the scrotum. His temperature is 38°C (101°F). Physical examination reveals a small, tender nodule attached to the testis. Which of the following is the most likely diagnosis?

Q60608. A 20-year-old woman presents for questions regarding fertil- ity. Laboratory studies previously identifi ed a 21-hydroxylase defi ciency and adrenogenital syndrome. Physical examination reveals virilization of the vulva and an enlarged clitoris. What is the most likely karyotype of this patient?

Q60609. A 65-year-old man presents with a 4-month history of a scro- tal mass. Which of the following is the most likely diagnosis?

Q60610. An 8-year-old boy is brought to the physician by his parents who have begun to notice the onset of puberty in their child. Physical examination reveals enlargement of the external male genitalia and facial hair. Which of the following neoplasms is the most likely cause of precocious puberty in this patient?

Q60611. A 16-year-old boy from Africa presents with a 5-day history of fever and testicular pain. Physical examination shows swollen, tender parotid glands and testes. Which of the following is the most likely responsible pathogen?

Q60612. A tall and slender 16-year-old boy presents with breast enlargement. Cytogenetic studies reveal a 47,XXY karyotype. Which of the following urogenital disorders is anticipated in this patient?

Q60613. A 78-year-old man was admitted to the hospital due to acute urinary tract obstruction. For the past few years, he has had recurrent bouts of cystitis. Two days before being admitted to the hospital, he could not urinate at all. What is the probable cause of bladder outlet obstruction in this patient?

Q60614. A 68-year-old man is found to have an elevated serum PSA level (9.5 ng/mL, normal = 0 to 4 ng/mL). Biopsy of the pros- tate gland reveals a poorly differentiated adenocarcinoma.

Q60615. A 38-year-old man presents with a 10-month history of a painless testicular mass. Physical examination reveals a small nodule of the left testis. The mass cannot be transilluminated and appears to be solid on ultrasound examination. A testicu- lar biopsy is shown in the image. The multinucleated giant cells in this neoplasm are derived from which of the following cell types?

Q60616. A left orchiectomy is performed in the patient described in Question 27. Which of the following serum markers would be most useful for monitoring tumor recurrence of this neoplasm following surgery?

Q60617. A 3-month-old boy is brought to the physician because his parents cannot fi nd one of his testicles. Physical examination confi rms the parents’ observation. Which of the following is the most likely diagnosis?

Q60618. A 60-year-old woman with a history of chronic cystitis is referred to a urologist because of hematuria. Cystoscopy reveals a mass in the dome of the bladder. Biopsy shows tumor cells arranged as gland-like structures. Special stains demon- strate mucin in the cytoplasm of the tumor cells. What is the appropriate diagnosis?

Q60619. A 65-year-old woman suffers a massive stroke and expires. At autopsy, the bladder appears edematous with a prominent central ulcer (shown in the image). Histologic examination reveals lymphocytes and mast cells, as well as extensive fi bro- sis within the bladder mucosa and muscularis. Which of the following is the most likely diagnosis?

Q60620. During the physical examination of a newborn boy, the pedia- trician notices that the urethral meatus is positioned on the lower side of the penile shaft. What is the appropriate diagno- sis for this congenital birth defect?

Q60621. A 55-year-old man presents with urinary symptoms of urgency and frequency. Rectal examination reveals an enlarged pros- tate. Laboratory studies show an elevated serum PSA level of 4.9 ng/mL. The patient subsequently undergoes a prostate needle biopsy series, which demonstrates two cancer-positive needle cores: Gleason grades 2+2(4) and 3+2(5). Which of the following is the appropriate diagnosis?