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Pelvis and Abdomen: R&O > Kidney > Flashcards

Kidney Flashcards

1
Q

epidemiology

A

7th most common in the UK
1.7:1 M:F ratio
50-89 years

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2
Q

aetiology

A

smoking
obesity
cadmium exposure
phenacetin abuse
small family link
Von Hoppel- Lindau syndrome
coffee

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3
Q

investigations

A

haematology: FBC, U&E, LFT
radiography: MRI, angiography, IVO, plain film, chest x-ray
CT, US
urine cytology: malignant cells

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4
Q

pathology types

A

renal cell carcinoma
transitional cell carcinoma of renal pelvis
wilms tumour (nephroblastoma)

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5
Q

treatment types

A

RT, surgery, chemo and immunotherapy

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6
Q

T1

A

<7cm limited to kidney

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7
Q

T2

A

> 7cm limited to kidney

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8
Q

T3a

A

invades adrenal gland or perinephric fat doesn’t extend beyond the renal capsule

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9
Q

T3b

A

extension into the renal vein or IVC below the diaphragm

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10
Q

T3c

A

extension into the IVC above the diaphragm

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11
Q

T4

A

beyond the renal capsule

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12
Q

N1

A

single regional LN

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13
Q

N2

A

more than one

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14
Q

M0

A

no distant mets

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15
Q

M1

A

evidence of distant mets

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16
Q

is RCC resistant or sensitive

A

resistent (for Palliative)

17
Q

what types of surgery are there

A

radical nephrectomy
partial nephrectomy
nephrourectomy
cryotherapy

18
Q

chemo

A

limited use
vinblastine: single agent <10% response rate
hormonal drug: medroxyprogesterone

19
Q

immunotherapy

A

interferon and interleukin 2 have been used
15% response rate to interferon
20-30% rate with interleukin 2
combo with 5FU showed enhances activity but its very toxic

20
Q

advanced disease trials

A

tyrosine kinase inhibitors, sunitab and sorafenib appear beneficial
SE: fatigue, diarrhoea, nausea, stomatitis

21
Q

what is prognosis dependent on

A

stage and grade

22
Q

stage 1 prognosis

A

65%, five year survival drops to 30% if LN are involved

23
Q

stage 4 prognosis

A

very few survivors

24
Q

what is the five year survival if confined to kidney

A

50-80%

25
Q

when is the most loss of life?

A

in the first two years after diagnosis

Pelvis and Abdomen: R&O (22 decks)

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