Cysts and Cancer Flashcards

1
Q

What is a simple cyst?

A

A small fluid filled sac, usually asx and found incidentally. Fluid = ultrafiltrate.

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2
Q

How does a simple cyst look on ultrasound?

A

anechoic (black)

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3
Q

What is a complex cysts?

A

Cysts that are large, septated, w/ loculations, or have solid components.

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4
Q

Treatment of simple cysts vs. complex cysts?

A

Simple - nothing.

Complex - resect or drain.

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5
Q

In what age group does autosomal recessive polycystic kidney disease present?

A

In infancy.

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6
Q

Patient presentation of ARPKD?

A

Anuric, b/l palpable flank masses.

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7
Q

ARPKD diagnosis?

A

U/S and biopsy.

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8
Q

What do the cysts in ARPKD look like?

A

radially oriented.

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9
Q

What is ARPKD associated with?

A

congenital hepatic fibrosis, potter sequence.

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10
Q

What is potter sequence?

A

Olighydramnios –> compression of developing fetus –> limb deformities, facial anomalies such as low set ears, retrognathia.
Compression of chest and lack of amniotic aspiration into lungs leads to pulmonary hypoplasia (cause of death).

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11
Q

If patients with ARPKD live, what are some concerns beyond the neonatal period?

A

systemic HTN, progressive renal insufficiency, and portal hypertension from congenital hepatic fibrosis.

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12
Q

What is autosomal dominant polycystic kidney disease?

A

Numerous cysts causing b/l enlarged kidneys that ultimately destroy kidney parenchyma.

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13
Q

What is the presentation of ADPKD?

A

flank pain, hematuria, HTN, UTIs, progressive renal failure.

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14
Q

What is ADPKD associated with?

A
HTN (increased renin production)
Benign hepatic cysts
Cysts in the pancreas
Mitral Valve Prolapse
Berry Aneurysms
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15
Q

What is medullary cystic disease?

A

Inherited disease causing tubulointerstitial fibrosis and progressive renal insufficiency with inability to concentrate urine.

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16
Q

What does medullary cystic disease look like on ultrasound?

A

Shrunken kidneys.

17
Q

In what age range does renal cell carcinoma present?

A

Men 50-70

18
Q

Risk factors for renal cell carcinoma?

A

Smoking, obesity

19
Q

Clinical sx of renal cell carcinoma?

A

hematuria, flank mass/pain. 2ndry polycythemia (too much EPO), fever, weight loss.

20
Q

How does RCC spread and where?

A

Hematogenously. Invades IVC via renal vein, then spreads to lungs and bone.

21
Q

What paraneoplastic syndromes is RCC associated with?

A

EPO, ACTH, PTHrP.

22
Q

What genetic syndrome is RCC associated with?

A

von-Hippel Lindau. Cerebellar hemangiomas, clear cell renal, pheos.

23
Q

Where in the kidney does RCC manifest?

A

PCT cells - polygonal clear cells.

24
Q

Treatment for RCC?

A

resection if local, immunotherapy or targeted therapy for advanced/metastatic disease. Not great for chemo/rads.

25
Q

What is renal oncocytoma?

A

Benign epithelial cell tumor. Often resected to r/o RCC.

26
Q

What is Wilms Tumor?

A

Nephroblastoma. Most common renal malignancy of early childhood (ages 2-4).

27
Q

Presentation of wilms tumor?

A

Large palpable, unilateral flank mass +/- hematuria.

28
Q

What syndromes may Wilms be a part of?

A

Beckwidth Wiedmann - Wilms, macroglossia, organomegaly, hemi-hypertrophy.
WAGR complex - Wilms Tumor, Aniridia, Genitourinary malformation, mental Retardation.