Initial Evaluation Flashcards

1
Q

When doing imaging for a suspicious renal mass, which is best: abdominal CT/MRI or abdominopelvic CT/MRI? Is contrast preferred?

A

CONTRAST IS PREFERRED

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2
Q

What are the ancillary procedures to be done only when there is clinical indication?

A

BONE SCAN
BRAIN MRI
CHEST CT
CORE NEEDLE BIOPSY

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3
Q

If renal biopsy is to be done, what needle is to be used?

When will you suspect urothelial carcinoma?

A

CORE NEEDLE because FNA is not sufficient

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4
Q

If urothelial carcinoma is suspected, what other procedures can you do for workup?

A

Ureteroscopy
Urine Cytology
Percutaneous Biopsy

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5
Q

If metastatic disease is present or the patient cannot tolerate ureteroscopy for the initial workup, what can you do?

A

Percutaneous biopsy

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6
Q

When will you consider genetic evaluation?

A

If the patient is 46 years old or younger

and positive family history

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7
Q

Stage 1 (T1a) size and preferred primary treatment?

A

Tumor is 4cm or less

Partial nephrectomy is the preferred treatment

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8
Q

Stage 1 (T1a) size and 3 other primary treatment?

A

Tumor is 4cm or less

Ablative techniques

AS for 2cm or less

Radical nephrectomy if partial nephrectomy is not feasible

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9
Q

Stage 1 (T1b) size and primary treatment?

A

> 4-7cm

Partial nephrectomy
Radical nephrectomy
AS in selected patients

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10
Q

When is active surveillance indicated in renal masses?

A

2cm or less

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11
Q

Stage 2 (T2a and T2b) sizes and primary treatment?

A

T2a >7-10 cm
T2b >10cm

Partial nephrectomy
or Radical nephrectomy

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12
Q

Stage 2 (T2a and T2b) adjuvant treatment?

A

May undergo clinical trial or surveillance

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13
Q

Which structures are affected in T3a masses? (4)

A

T3a masses affect

Renal vein
Segmental branches
Pelvicalyceal system
Perirenal/renal sinus fat

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14
Q

Which structure is affected in T3b masses?

A

IVC BELOW the diaphragm

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15
Q

Which structure is affected in T3c masses?

A

IVC ABOVE the diaphragm

Wall of the vena cava

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16
Q

What structures is affected in T4 masses?

A

Beyond the Gerota’s

Adrenal gland

17
Q

Adjuvant treatment options for Stage II masses?

A

Clinical trial or surveillance

18
Q

Preferred adjuvant treatment option for Stage III clear cell histology masses.

A

Clinical trial

19
Q

Adjuvant option for non-clear cell histology patients?

Is surveillance an option in the adjuvant setting in clear cell histology Stage III masses?

A

Surveillance

20
Q

What category III adjuvant agent can you give Stage III patients with clear cell histology?

A

Sunitinib (Category 3)

21
Q

T1 N0 M0

22
Q

T2 N0 M0

23
Q

T1-T2 N1 M0

24
Q

T3, NX/N0/N1, M0

25
T4, ANY N, M0
STAGE IV
26
ANYT ANY N M1
STAGE IV
27
G1
Nucleoli absent or inconspicuous and basophilic at 400x magnification
28
G2
Nucleoli conspicuous and eosinophilic at 400x magnification, visible but not prominent at 100x magnification
29
G3
Nucleoli conspicuous and eosinophilic at 100x magnification
30
G4
Marked nuclear pleomorphism and/or multinucleate giant cells and/or rhabdoid and/or sarcomatoid differentiation