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Oncology > 05b: Urinary tract/Kidney > Flashcards

05b: Urinary tract/Kidney Flashcards

1
Q

Most common presenting feature of genitourinary tract cancer

A

Hematuria

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2
Q

The vast majority of renal tumors in adults prove to be (X), (benign/malignant) tumors.

A

X = clear cell renal tumors (80%)

Malignant

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3
Q

T/F: Autosomal dominant polycystic kidney disease (ADPKD) does not increase risk of renal cancer.

A

True

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4
Q

T/F: Renal cancer accounts for under 3% of all malignancies in adults.

A

True (2.6%)

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5
Q

T/F: Cancer of renal pelvis arises from renal epithelium and accounts for 40% of renal cancers.

A

False - considered urothelial (transitional cell) cancer and accounts for 5% of renal cancers

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6
Q

Genetic disorders that increase irsk of CCRC carcinoma:

A
  1. von Hippel-Lindau disease
  2. Familial chromosome 3 translocations
  3. Tuberous sclerosis
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7
Q

Non-genetic diseases/factors that increase irsk of CCRC carcinoma:

A
  1. ESRD (acquired cystic kidney disease)
  2. Smoking (2-4x risk)
  3. Heavy metal exposure (2-4x risk)
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8
Q

CCRC carcinoma: cells of origin?

A

Prob proximal tubule

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9
Q

CCRC carcinoma: cells are filled with (X) and express high levels of (Y) growth factor.

A 
X = lipid (high glycogen content)
Y = VEGF (highly vascular)
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10
Q

Classic triad of CCRC:

A
  1. Flank pain
  2. Hematuria
  3. Abdominal mass

**found in less than 10% of cases! So many various Sx presentation

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11
Q

The “internist’s tumor”

A

CCRC (due to wide breadth of paraneoplastic features/Sx)

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12
Q

CCRC carcinoma: most effective therapy

A

Nephrectomy

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13
Q

CCRC carcinoma: 5y survival if disease confined in renal capsule is (X)%.

A

X = 90

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14
Q

CCRC carcinoma: 5y survival if disease invades renal capsule but has not spread past (X) is (Y)%.

A 
X = Gerota's fascia
Y = 60

Stage III

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15
Q

CCRC carcinoma: 5y survival if disease spreads beyond Gerota’s fascia is (X)%

A

X = 10%

Locally invasive - Stage IV

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16
Q

(X) renal cell cancers may undergo spontaneous remission. Which characteristic of this cancer may account for this?

A

X = CCRC carcinoma

This carcinoma may be relatively responsive to chances in host immunity

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17
Q

T/F: Renal cancer responds poorly to conventional cytotoxic chemotherapy and radiation therapy.

A

True

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18
Q

T/F: Renal cancer that responds to chemo “completely” implies the patient has been cured.

A

False! Indicates disappearance of radiographic evidence of tumor, but relapses may occur

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19
Q

CCRC carcinoma: 5y survival if disease spread to renal vein is (Y)%.

A

Y = 60%

Stage IIIA

20
Q

CCRC carcinoma: 5y survival if disease spread to one lymph node is (Y)%.

A

X = 20%

Stage IIIB

21
Q

Von Hippel-Lindau (VHL) disease: most common cause of death

A

CCRC carcinoma

22
Q

Major renal cancer cell gene in adults:

A

VHL (tumor suppressor)

23
Q

Von Hippel-Lindau (VHL) disease: inheritance pattern

A

AD

24
Q

VHL protein function

A

Down-regulates hypoxia-induced genes by targeting HIF-alpha (TF) for destruction

25
Q

Renal cancer: VHL loss results in overexpression of which key factors?

A
  1. VEGF
  2. PDGF-beta
  3. TGF-beta

Angiogenic factors!

26
Q

Renal cancer: VHL loss allows cancer cell to form cooperative relationship with (X)

A

X = neighboring endothelial cell (gives it oxygen, nutrients via neovascularization)

27
Q

T/F: loss of second VHL allele results in renal cancer

A

False -forms cyst that (with additional mutations)can become cancer

28
Q

(X) renal tumors are small (<5mm), present in (cortex/medulla) as pale yellow nodule with papillary growth pattern. If larger than (Y) size, they’re re-classified as…

A

X = renal papillary adenoma
Cortex
Y = 3 cm
RCC (due to malignant potential)

29
Q

List some tyrosine kinase inhibitor targets for RCC

A

VEGF-R

PDGF-R

30
Q

List the urothelial tumor cell types and star the most common

A
  1. Transitional cell* (95%)
  2. Squamous Cell
  3. Adenocarcinoma
31
Q

Bladder cancer: (X) is the major risk factor and is responsible for (Y)% of cases

A 
X = smoking (4x risk)
Y = 50
32
Q

Chronic inflammation, such as in (X) conditions, increases risk of which urothelial cancers?

A

X = catheter or schistosomiasis

Squamous and transitional cell carcinomas of bladder

33
Q

Which drug causes 9x increased risk of bladder cancer?

A

Cyclophosphamide

34
Q

Bladder cancer: T1 involves (X) layer. T2 involves (Y) layer. T3 involves (Z) layer.

A 
X = mucosa
Y = mucosa and muscularis
Z = mucosa, muscularis, and fat
35
Q

Bladder cancer: Rx and prognosis for stage T1

A

TUR (Transurethral resection)

Good prognosis, but can recur

36
Q

Bladder cancer: Rx and prognosis for stage T2

A

Cystectomy

60% 5y survival

37
Q

Bladder cancer: prognosis for stage T3

A

10% 5y survival

38
Q

Bladder cancer can be identified early with thorough work-up of (X) patients that present with (Y)

A 
x = >40 years old
Y = hematuria (evaluate by cytoscopy)
39
Q

Bladder cancer: Deletion of (X) is an early event. Deletion of (Y) happens later and has been linked to poorer prognosis.

A 
X = chromosome 9q
Y = Rb and p53
40
Q

List the two main benign tumors of the kidney

A
  1. Renal papillary adenoma

2. Oncocytoma

41
Q

(X) renal tumors are small (<5mm), present in (cortex/medulla) as pale yellow nodule with papillary growth pattern. If larger than (Y) size, they’re re-classified as…

A

X = renal papillary adenoma
Cortex
Y = 3 cm
RCC (due to malignant potential)

42
Q

Oncocytoma: composed of (small/large) (eosinophilic/basophilic) cells thought to arise from the (X) cells.

A

Large; eosinophilic

X = interacalated cells of collecting duct

43
Q

Oncocytoma: (X) color and can grow up to (Y).

A 
X = mahogany-brown
Y = 12 cm
44
Q

Pt has renal mass resected that shows numerous mitochondria on EM. Which type of tumor is this a characteristic of?

A

Oncocytoma

45
Q

Aside from the most common malignant renal tumor, (X), which other malignant tumors can arise in kidney? Star the one with the best prognosis.

A

X = CCRC carcinoma (80%)

  1. Papillary carcinoma
  2. Chromophobe renal carcinoma*
46
Q

Characteristic chromosomal abnormalities of CCRC largely involve chromosome (X).

A

X = 3

loss of the short arm of chromosome 3 or translocations involving chromosome 3

Oncology (10 decks)

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