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1 A 1-year-old female is admitted to the hospital with a
palpable mass within one of her labia majora.
Radiographic examination reveals that a loop of intestine
has herniated into the visibly enlarged labium majus. This
condition is due to failure of the processus vaginalis to
close off. From which of the following tissue layers is the
A. Parietal peritoneum
B. Extraperitoneal tissue
C. Transversalis fascia
D. Dartos fascia
E. Internal abdominal oblique aponeurosis
1 A. The processus vaginalis (meaning sheathlike process)
- is composed of parietal peritoneum that precedes the
- testis as it “migrates” from a position in the upper lumbar
- wall to a position outside the abdomen. This process
- usually obliterates, leaving only a distal portion that
- surrounds most of the testis as the tunica vaginalis.
- Whereas these features are typical of development in the
- male, females also have a processus vaginalis that extends
- into the labia majus, although congenital inguinal hernias
- are more common in males than females. The other listed
- structures are not involved in congenital inguinal hernias.
2 A 3-year-old boy is admitted to the hospital with signs of
acute renal failure. Radiologic studies reveal that the boy
has bilateral masses involving both kidneys. Examination of
biopsy material confirms the diagnosis of Wilms tumor.
Which of the following gene mutations is the most common
in Wilms tumor?
A. The gene responsible for WT1
B. The gene responsible for HGF
C. The gene responsible for VEGF
D. The gene responsible for GDNF
E. The gene responsible for FGF-2
A. Wilms tumor is a kidney malignancy that usually occurs
- in children. It has recently been shown that it can be caused
- by mutations in the WT1 gene, behaving according to
- Knudson’s two-hit model for tumor suppressor genes.
- GAS 355; GA 147