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Wilms' Tumor (Nephroblastoma) โ most common renal malignancy in children (peak age 3โ4 years).
Classic presentation:
- Asymptomatic abdominal mass (discovered by parent/during bath)
- Painless gross hematuria
- Hypertension (renin secretion)
- Child appears well (unlike neuroblastoma โ ill-appearing)
Important physical examination note: DO NOT palpate the abdominal mass repeatedly โ risk of tumor capsule rupture and metastatic seeding.
Associations:
- WAGR syndrome: Wilms' + Aniridia + Genitourinary anomalies + mental Retardation (WT1 gene mutation)
- Beckwith-Wiedemann syndrome
- Hemihypertrophy
Staging and Treatment:
| Stage | Description | Survival |
|---|---|---|
| I | Confined to kidney, completely resected | ~95% |
| IIโIII | Regional extension | ~85โ90% |
| IV | Hematogenous mets (lung, liver) | ~75% |
Treatment: Nephrectomy + chemotherapy (actinomycin D, vincristine) ยฑ radiotherapy. Wilms' has excellent prognosis โ one of most curable solid tumors.
A missile is fired for maximum range with initial velocity $20\text{ m/s}$ ($g = 10\text{ m/s}^2$). The range of the missile is:
Maximum range occurs at $\theta = 45ยฐ$:
$R_{\max} = \dfrac{u^2}{g} = \dfrac{(20)^2}{10} = \mathbf{40\text{ m}}$
Size decreases as nuclear charge increases (more protons pull same electrons closer):
- \(\text{Ca}^{2+}\): Z=20
- \(\text{Ar}\): Z=18
- \(\text{K}^+\): Z=19
- \(\text{Cl}^-\): Z=17
- \(\text{S}^{2-}\): Z=16
The thermal stress required to keep the length constant is given by the formula:
- $\text{Stress} = Y \alpha \Delta T$
- Substituting the values: $\text{Stress} = (2 \times 10^{11}) \times (1.1 \times 10^{-5}) \times 100$
- $\text{Stress} = 2.2 \times 10^{8}\text{ Pa}$
Pressure is equivalent to the stress applied at the ends.
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