This page is dedicated to organizing various examples of standardized exam questions whose answer is Wilms tumor/nephroblastoma. While this may seem a odd practice, it is useful to see multiple examples of how Wilms tumor/nephroblastoma will be characterized on standardized exams (namely the boards and the shelf exams). This page is not meant to be used as a tradition question bank (as all of the answers will be the same), however seeing the classic “test” characterization for a disease is quite valuable.
Question # 1
A previously healthy 28 month old girl is brought to the clinic because she has a firm mass in her left flank. She is constipated but does not have any other symptoms. She appears to be healthy, but is pale. A discrete mass can be palpated in her left flank. An ultrasound shows a normal right kidney and a left kidney with a mass distorting the collecting system. Bone marrow analysis is unremarkable. A urinalysis shows no WBC/hpf, and 20-30 RBC/hpf. What is a possible diagnosis for this patient?
Question # 2
A 4 year old boy is brought to he clinic for evaluation of abdominal swelling that was noticed by his father. The child does not seem to be in any pain, and has had no changes to his appetite, sleeping schedule, bathroom habits, or activity level. This child was recently treated for a case of bacteria pharyngitis, however his past medical history is unremarkable. His weight and height have consistently always been in the 70th percentile. His vital signs are all within reference range. A physical exam shows a well-appearing well-nourished boy. On the abdominal exam a contender from abdominal mass is palpated on the left side. A urinalysis is conducted and shows the presence of blood in the urine. What diagnosis should be considered in this child?
Question # 3
A 3 year male is brought to the pediatrician for a routine checkup. His mother explains that she believes that he is doing well. He has no medical concerns and has been eating and growing without issue. His vital sings are normal. A physical exam reveals the presence of a palpable right flank mass. The patient has no urgency or frequency, however a urinalysis shows hematuria, and there are 35 RBC/hpf. What is the likely diagnosis in this patient?
Explanation: young child + flank mass + hematuria = Wilms tumor
Page Updated: 11.08.2016