Wayground logo

Free Printable Worksheets

Font size

S
M
L
XL
Worksheets

Stevich - Renal Cell Carcinoma

Total questions: 64

Worksheet time: 1hrs 4mins

Name
Class
Date
1.

Most common type of malignancy of kidney and renal pelvis

a)

Renal Cell Carcinoma

b)

Melanoma

2.

Most common examples of hereditary Renal Cell Carcinoma

a)

von Hippel-Lindau (VHL) syndrome

b)

Birt-Hogg-Dubé syndrome

3.

Renal Cell Carcinoma ____ from epithelia which lines renal tubules

a)

Arises

b)

Shutdown

4.

Renal Cell Carcinoma: Clear Cell RCC

a)

Most common histological subtype of RCC (about 80% of all RCC cases)

b)

5% to 10% of RCC cases

c)

Occur in renal proximal tubules

5.

Renal Cell Carcinoma: Papillary Subtypes RRC

a)

Most common histological subtype of RCC (about 80% of all RCC cases)

b)

5% to 10% of RCC cases

c)

Occur in renal proximal tubules

6.

Renal Cell Carcinoma: Chromophore and Oncocytoma RCC subtypes

a)

5% to 10% of all RCC cases

b)

Occur in intercalated cells of the collecting system of kidney

c)

Associated with different chromosomal deletions and translocations

7.

Renal Cell Carcinoma: Sarcomatoid Dedifferentiation is _____ as a unique tumor subtype

a)

not classified

b)

classified

8.

Renal Cell Carcinoma: Sarcomatoid Features can occur across all histological subtypes A

a)

True

b)

False

9.

Renal Cell Carcinoma: Most commonly affects proximal tubule of kidney

a)

Clear Cell RCC

b)

Sarcomatoid Dedifferentiation

10.

Renal Cell Carcinoma: More likely to metastasize than other subtypes?

a)

Clear Cell RCC

b)

Sarcomatoid Dedifferentiation

11.

Renal Cell Carcinoma: Clear Cell RCC

a)

Association between tumors with clear cell histology and losses in the short arm of chromosome 3

b)

VHL was mapped to 3p24-25: gene responsible for clear cell RCC

12.

Inactivation of VHL tumor suppressor gene

a)

Hallmark of clear cell RCC

b)

Knudson and strong two-hit model

13.

Sequential inactivation of both copies of VHL can lead to the development of clear cell RCC

a)

Hallmark of clear cell RCC

b)

Knudson and strong two-hit model

14.

Clear Cell RCC: SPORADIC DISEASE

a)

Two copies of VHL present in healthy kidney inactivated via loss of chromosome 3p, epigenetic gee (eg: hypermethylation of VHL promoter), and genetic mutations (missensense mutations, none mutations)

b)

Additional mutations can lead to development of single, unilateral tumor

c)

One copy of VHL already had loss of function due to inherited gremlin mutations

d)

Fewer sporadic events needed for inactivation of remaining VHL copy

15.

Clear Cell RCC: HEREDITARY DISEASE

a)

Two copies of VHL present in healthy kidney inactivated via loss of chromosome 3p, epigenetic gee (eg: hypermethylation of VHL promoter), and genetic mutations (missensense mutations, none mutations)

b)

Additional mutations can lead to development of single, unilateral tumor

c)

One copy of VHL already had loss of function due to inherited gremlin mutations

d)

Fewer sporadic events needed for inactivation of remaining VHL copy

16.

General symptoms of RCC

a)

No symptoms often in early disease

b)

Flank pain

c)

Fatigue

17.

symptoms of disease progression/metastatic disease of RCC

a)

Bone pain

b)

Pulmonary symptoms: SOB and cough

c)

Cough

18.

Symptoms differ depending on location of disease spread?

a)

True

b)

False

19.

Signs of RCC

a)

Weight loss and anemia

b)

Hypertension and fever

c)

Lower extremity edema

d)

Hematuria and Palpable abdominal mass

e)

Adenopathy

20.

Signs of RCC: Sign of Advanced Disease

a)

Weight loss and anemia

b)

Hypertension and fever

c)

Lower extremity edema

d)

Hematuria and Palpable abdominal mass

e)

Adenopathy

21.

Diagnostic Test for RCC

a)

CBC and serum calcium

b)

SCr, LFTs, LDH

c)

Urinalysis

d)

Imaging: CT, MRI

e)

Biopsy

22.

TNM staging of RCC?

a)

True

b)

False

23.

Staging of RCC: Subdivisions in tumor classification includes kidney structures that are invaded by tumor

a)

Adrenal gland

b)

Gerota's fascia

c)

Perinephric fat which lies between fascia and renal capsule

24.

Staging of RCC: Subdivisions in tumor classification includes kidney structures that are invaded by tumor

-Layer of connective tissue surrounding kidneys

a)

Adrenal gland

b)

Gerota's fascia

c)

Perinephric fat which lies between fascia and renal capsule

25.

Treatment of RCC: Stages l, ll or lll disease

a)

Surgical excision

b)

Renal tumor

c)

Metastectomy (surgical removal of metastatic sites)

d)

Renal tumor and metastectomy

26.

Treatment of RCC: Metastatic disease; surgical resection of:

a)

Surgical excision

b)

Renal tumor

c)

Metastectomy (surgical removal of metastatic sites)

d)

Renal tumor and metastectomy

27.

Treatment of Advanced or Metastatic disease: First-line treatment options for patients with favorable prognostic risk

a)

Combination TKIs plus immune checkpoint inhibitors

b)

Combination immune checkpoint inhibitors

c)

Single-agent TKIs

28.

Treatment of Advanced or Metastatic disease: PROGNOSTIC RISK FACTORS

a)

Age, stage

b)

Histologic types/subtype

c)

Metastatic sites

d)

Performance status

29.

First-line treatment options for patients with intermediate or poor-risk disease:

a)

Combination TKI plus immune checkpoint inhibitors

b)

Combination immune checkpoint inhibitors

c)

Single-agent TKIs

d)

mTOR inhibitor (temsirolimues, for poor-risk only)

30.

Immunotherapy, cytokine-based treatments (IFN-alpha, IL-2)

a)

After nephrectomy different options: HISTORICALLY

b)

Novel multi targeted TKIs

c)

mTOR inhibitors

d)

Immune checkpoint inhibitors

e)

VEGFA inhibitor

31.

Axitinib, cabozantinib, lenvatinib, pazopanib, sorafenib, sunitinib

a)

After nephrectomy different options: HISTORICALLY

b)

Novel multi targeted TKIs

c)

mTOR inhibitors

d)

Immune checkpoint inhibitors

e)

VEGFA inhibitor

32.

Everolimus and Temsirolimues

a)

After nephrectomy different options: HISTORICALLY

b)

Novel multi targeted TKIs

c)

mTOR inhibitors

d)

Immune checkpoint inhibitors

e)

VEGFA inhibitor

33.

Bevacizumab

a)

After nephrectomy different options: HISTORICALLY

b)

Novel multi targeted TKIs

c)

mTOR inhibitors

d)

Immune checkpoint inhibitors

e)

VEGFA inhibitor

34.

Avelumab, Ipilimumab, Nivolumab, Pembrolizumab

a)

After nephrectomy different options: HISTORICALLY

b)

Novel multi targeted TKIs

c)

mTOR inhibitors

d)

Immune checkpoint inhibitors

e)

VEGFA inhibitor

35.

Cytotoxic chemotherapy has minimal activity in treatment of RCC?

a)

True

b)

False

36.

Different cytotoxic agents investigated

a)

Gemcitabine

b)

Vinblastine

c)

5-Fluorouracil

37.

Intrinsic resistance to chemotherapy:

-Due to expression MDR1

a)

Encodes P-glycoprotein (Pgp) transmembrane pump which is involved in drug influx

b)

Encodes P-glycoprotein (Pgp) transmembrane pump which is involved in drug eflux

38.

Immunotherapy: RCC --> occasional spontaneous regression

a)

Hypothesize that RCC evokes host immune response

b)

Rationale for studying immunotherapy in RCC

39.

Immunotherapy: IFN-alpha high dose IL-2

a)

Combinations of these two agents were standard of care for mRCC before approval of target therapies

b)

Low response rates

c)

Few durable responses

d)

High rates of severe toxicities

40.

Immune checkpoint inhibitors and PD-L1:

a)

Improved responses compared to previous therapy

b)

Utilized in frontline setting for mRCC: PD-L1/PD-1 inhibitors and Cytotoxic T lymphocyte-associated antigen-4 (CTLA-4) inhibitors

41.

Immune checkpoint inhibitors and PD-L1:

a)

Improved responses compared to previous therapy

b)

Utilized in frontline setting for mRCC: PD-L1/PD-1 inhibitors and Cytotoxic T lymphocyte-associated antigen-4 (CTLA-4) inhibitors

42.

Immune checkpoint inhibitors and PD-L1:

PD-L1/PD-1 inhibitors

a)

Ipilimumab

b)

Avelumab (PD-L1), Nivolumab (PD-1), Pembrolizumab (PD-1)

43.

Immune checkpoint inhibitors and PD-L1:

Cytotoxic T lymphocyte-associated antigen-4 (CTLA-4)

a)

Ipilimumab

b)

Avelumab (PD-L1), Nivolumab (PD-1), Pembrolizumab (PD-1)

44.

Immune checkpoint inhibitors and PD-L1:

PD-L1/PD-1 inhibitors:

Which are PD-L1

a)

Pembrolizumab

b)

Avelumab

c)

Nivolumab

45.

Immune checkpoint inhibitors and PD-L1:

PD-L1/PD-1 inhibitors:

Which are PD-1

a)

Pembrolizumab

b)

Avelumab

c)

Nivolumab

46.

Treatment of RCC -Immunotherapy

PD-L1/PD-1 inhibitors:

a)

PD-1 expressed on activated T-cells

b)

PD-L1 ligand expressed on immune and tumor cells

c)

When PD-L1 binds to PD-1 activity of T-cells is down regulated

d)

By blocking the interaction, PD-L1 or PD-1 inhibitors allow T-cells to remain activated

e)

Autoimmune toxicites

47.

Treatment of RCC -Immunotherapy

Immunotherapy (PD-1, PD-L1, and CTLA-4 inhibitors) --> integral component of the management of patients with advanced MRCC as:

a)

Single agents

b)

In combinations

c)

Never combinations

48.

PD-L1 expression _____ predictive value in mRCC

a)

does not have

b)

does have

49.

Immunotherapy for RCC - Treatment selection depends on

a)

Patient characteristics

b)

Goal of therapy

c)

Adverse event profile

d)

Expected tolerability of these immunotherapy combinations can inform treatment selection

50.

a)

True

b)

False

51.

Target therapies: mTOR inhibitors

a)

Bevacizumab

b)

Everolimus

c)

Temsirolimus

52.

Target therapies: VEGF inhibitor monoclonal antibodies

a)

Bevacizumab

b)

Everolimus

c)

Temsirolimus

53.

a)

True

b)

False

54.

a)

True

b)

False

55.

a)

True

b)

False

56.

a)

True

b)

False

57.

a)

True

b)

False

58.

a)

True

b)

False

59.

a)

True

b)

False

60.

a)

True

b)

False

61.

a)

True

b)

False

62.

Which of the following is not considered a risk factor for renal cell carcinoma?

a)

Hypotension

b)

Hypertension

63.

Which of the following is the most common type of renal cell carcinoma?

a)

Clear cell renal cell carcinoma

b)

Papillary renal cell carcinoma

64.

In Renal Cell Carcinoma (RCC) disease there is occasional spontaneous regression observed which hypothesizes that RCC evokes host immune response and that is also a rationale for studying immunotherapy in RCC

a)

True

b)

False

Similar Resources on Wayground

Cardio Q6

59 questions

Cardio Q6

quiz

Worksheet

•

Professional Development

CBT nyok

60 questions

CBT nyok

quiz

Worksheet

•

Professional Development