Urology

AFP & Embryomal cell carcinoma of Testis

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AFP in Pure Embryonal Cell Carcinoma MCQ | mcqsurgery.com
Q) Which of the following statements about alpha-fetoprotein (AFP) in pure embryonal cell carcinoma is most accurate?
✅ Answer: c) AFP is elevated in 50-80% of cases of pure embryonal cell carcinoma.

🔍 Explanation:
Alpha-fetoprotein (AFP) is a **tumor marker** commonly elevated in **non-seminomatous germ cell tumors** (NSGCTs), which includes **embryonal cell carcinoma**. AFP levels are elevated in approximately **50-80%** of cases of **pure embryonal carcinoma**, and this elevation is associated with the **yolk sac tumor component** that is often seen within these tumors.
  • AFP is a **glycoprotein** produced by the fetal liver and yolk sac, and its levels are typically **low in adults**.
  • It is elevated in conditions like **liver cancer**, **germ cell tumors**, and **yolk sac tumors** (which may be seen with embryonal carcinoma).
  • In **seminomas**, AFP is **usually normal**, and they are typically not associated with AFP elevation.
  • Correct interpretation of AFP levels is important for **diagnosis**, **monitoring treatment response**, and **detecting recurrence** in **germ cell tumors**.
Misinterpreting AFP levels can lead to **incorrect staging** or **diagnosis** of testicular cancers.
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Lymphatic Spread carcinoma Prostate

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MCQ on Most Common Lymph Node Involved in Prostate Carcinoma
Q) Most common lymph node involved in carcinoma prostate is
✅ Answer: A. Obturator

🔍 Explanation:
The most common lymph node involved in **prostate carcinoma** is the **obturator lymph node**.

Lymphatic spread may occur via lymphatic vessels that pass to the **obturator fossa**, along the sides of the rectum to the lymph nodes near the **internal iliac vein** and in the hollow of the sacrum.

Additionally, lymphatics pass over the **seminal vesicles** and follow the **vas deferens** for a short distance to drain into the **external iliac lymph nodes**.

From the retroperitoneal lymph nodes, the **mediastinal nodes** and occasionally the **supraclavicular nodes** may become implicated.

🧠 Key Point: **Obturator lymph nodes** are the first to be affected in prostate cancer due to the nature of lymphatic drainage from the prostate.

📘 Reference: NEET SS 2022 Paper

Testicular cancer

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Q) Which of following testicular cancer will increase Overall Survival  by Lymph Node  dissection?

a) Seminoma

b) Embryonal cell

c) Yolk Cell

d) Sertoli cell

Acute dilutional hyponatremia

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Q) 70 yr old male after TURP for BPH  develops un resoponsiveness, slurring of speech and  stroke like symptoms . Further management should be 

a ) Give 3% Nacl

b) Give 0.9% Nacl

c) IV fluid restriction

d) Desmopressin

PET CT In Urological Malignancies

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Q) PET CT in urological  malignancies most useful in? ( Questions as per NEW NEET SS Pattern) 

a) RCC

b) Testis

c) Urinary bladder

d) all

Ans B

Testis

In men with testis cancer, it is recommended in the follow-up of patients with seminoma with any residual mass

Promising in Urinary bladder ca

Not used in RCC 

BAiley page 1391

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