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UROLOGY > KIDNEY: TUMOURS > Flashcards

KIDNEY: TUMOURS Flashcards

1
Q

🩺 IOC for RENAL CYST

A

CECT

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2
Q

BOSNIAK CLASSIFICATION is used for

A

RENAL CYSTS

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3
Q

BOSNIAK CLASSIFICATION

A
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4
Q

Benign tumours of KIDNEY

A
  1. Angiomyolipoma
  2. Papillary Adenoma
  3. Oncocytoma
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5
Q

Angiomyolipoma is ASSOCIATED with

A

Tuberous SCLEROSIS

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6
Q

Tuberous SCLEROSIS
🧠⚡ ASH⚡

A
  1. Ashleaf spots
  2. Shagreen Patch
  3. Macules
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7
Q

Angiomyolipoma arises from

A

Perivascular epitheloid cells

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8
Q

🧑🏻‍⚕️ Clinical Features of ANGIOMYOLIPOMA

🧠⚡50-60 yrs⚡

A
  1. Asymptomatic
  2. Pain
  3. Massive RETROPERITONEAL Hemorrhage
  4. Lenk’s triad
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9
Q

Wunderlich Syndrome
⭐ ASSOCIATED with

A

Acute onset of spontaneous, nontraumatic renal hemorrhage into the subcapsular and perirenal spaces.

⭐ LENK’S TRIAD

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10
Q

Lenk’s TRIAD
🧠⚡MPS⚡

A
  1. Mass Flank
  2. Pain
  3. Shock (HYPOTENSION)
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11
Q

🩺 IOC of ANGIOMYOLIPOMA

A

CECT
⬇️
Shows: LOW DENSITY FAT

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12
Q

💊💉 MANAGEMENT of ANGIOMYOLIPOMA

⭐ < 4cm & Asymptomatic
⭐ Bleeding ➕
⭐ > 4cm & Symptomatic

A

⭐ < 4cm & Asymptomatic
🎯 OBSERVATION with SERIAL CT Scan

⭐ Bleeding ➕
🎯 Angioembolization ➡️ Partial NEPHRECTOMY

⭐ > 4cm & Symptomatic
🎯 PARTIAL NEPHRECTOMY

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13
Q

Renal Papillary Adenoma presents as

A

Yellow Plaques (CORTICAL)

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14
Q

Benign Tumour of KIDNEY with HIGH RISK OF SPONTANEOUS HEMORRHAGE

A

ANGIOMYOLIPOMA

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15
Q

⚡⚡ MOST COMMON BENIGN TUMOUR OF KIDNEY

A

Oncocytoma

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16
Q

Oncocytes are SEEN in:

A
  1. Parotid Gland
  2. Kidney
  3. Thyroid
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17
Q

Oncocytes specific to THYROID Gland is known as

A

Hurthle cell (OR) ASHKENAZY cells

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18
Q

Familial Form of ONCOCYTOMA

A

Birt Hogg Dube Syndrome

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19
Q

Birt Hogg Dube Syndrome is ASSOCIATED with which gene

A

⭐ BHD gene
⭐ Chromosome 17

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20
Q

Birt Hogg Dube Syndrome

🧠⚡CHIPs FAT⚡

A
  1. Cancers: GI, RCC Thyroid
  2. Hidradenoma
  3. Intestinal POLYPOSIS
  4. Fibrofolliculomas
  5. Acrocordons
  6. Trichodiscomas

KIDNEY:
7. ONCOCYTOMA
8. Chromphobe RCC

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21
Q

🩺 IOC for ONCOCYTOMA

⭐ FINDING

A

CECT
⬇️
Central STELLATE SCAR ➕

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22
Q

Central STELLATE SCAR is seen in

🧠⚡SOF CR⚡

A
  1. Serous Cystadenoma of Pancreas
  2. ONCOCYTOMA
  3. Focal NODULAR HYPERPLASIA of Liver
  4. Chromophobe RCC
    Fibrolamellar variant of bcc
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23
Q

💊💉 MANAGEMENT of ONCOCYTOMA

A

Bosniak 3 ➕: Partial NEPHRECTOMY

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24
Q

Synonyms of RENAL CELL CARCINOMA

A
  1. Grawitz Tumour
  2. Hypernephroma
  3. Internist’s Tumour
  4. Renal ADENOCARCINOMA
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25
Q

⚒️ RISK FACTOR for RCC

🧠⚡PHOTo of C&D ⚡

A
  1. Petroleum Products / Protein intake ⬆️
  2. HYPERTENSION
  3. Obesity
  4. Tuberous Sclerosis / Thorotrast Exposure
  5. O: Diabetes mellitus
  6. Smoking
  7. CKD & DIALYSIS
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26
Q

⚡⚡ MOST Significant ⚒️ RISK FACTOR For RCC

A

Smoking

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27
Q

⚡⚡ MOST COMMON MODE OF INHERITENCE 💉 of RCC

A

SPORADIC

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28
Q

VARIENT of RCC

A
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29
Q

⚡⚡ MOST COMMON VARIENT of RCC

⚡⚡ 2nd MOST COMMON VARIENT of RCC

A

⚡⚡ MOST COMMON VARIENT of RCC
🎯 CLEAR CELL RCC

⚡⚡ 2nd MOST COMMON VARIENT of RCC
🎯 Papillary RCC

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30
Q

⚡⚡ MOST COMMON SYNDROME ASSOCIATED WITH FAMILIAL RCC

A

Von Hippel Lindau

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31
Q

🧬 MODE OF INHERITENCE 💉 of VHL
⭐ Chromosome

A

AD
⭐ TUMOUR SUPPRESSOR GENE
⭐ Chromosome 3

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32
Q

VHL gene encodes for

A

UBIQUITIN LIGASE COMPLEX

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33
Q

VHL is ASSOCIATED with which VARIENT of RCC

A
  1. Clear Cell RCC
  2. Hereditary Papillary RCC
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34
Q

Which Syndrome is ASSOCIATED with ⬆️ Risk of CHROMOPHOBE RCC

A

Birt Hogg Dube Syndrome

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35
Q

HLRCC
🧬 MODE OF INHERITENCE 💉
⭐ Gene mutation

A

Hereditary LEIOMYOMATOSIS & RCC
⭐ AD
⭐ FUMERATE HYDRATASE 4

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36
Q

Papillary RCC
➕
UTERINE LEIOMYOMATOSIS (Fibroid)

A

HLRCC

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37
Q

HPRCC
⭐ GENE
🧬 MODE OF INHERITENCE 💉

A

⭐ MET Proto-oncogene
⭐ AD

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38
Q

Other Mutations ASSOCIATED with RCC

A
  1. Loss of CHROMOSOME 4
  2. HYPOPLOIDY
  3. TRISOMY 7 & 17
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39
Q

VON HIPPEL LINDAU Syndrome
🧠⚡ VHL⚡
🧠⚡CAR PEEP⚡

A

⭐ VHL gene
⭐ Hemangioblastoma / HIF 1 alpha
⭐ Lots of CATECHOLAMINES: Pheochromocytoma

C-Cerebellar Hemangioma
A- Retinal Angioblastoma
R - Renal Cell Carcinoma

P-Pheochromocytoma
E - Epidydymal nodule and tumour
E-Endolymphatic sac tumour
P-Pancreatic endocrine tumour and cyst

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40
Q

Deletion of Chromosome 3p & 6p is ASSOCIATED with

A

Clear cell RCC

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41
Q

RCC ASSOCIATED with LONG TERM DIALYSIS

A

Micropapillary VARIENT of PAPILLARY RCC

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42
Q

Psammoma bodies are ASSOCIATED with which RCC

A

Papillary RCC

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43
Q

Psamomma Bodies

Also known as:
🧠⚡P³SM² ⚡

A

P = Papillary Carcinoma Thyroid, Papillary RCC, Prolactinoma
S = Serous Cystadenocarcinoma Ovary
M = Meningioma / Mesothelioma

Note: They are characteristic spherules of calcification seen in the above tumors. They are also know as Calcosperites.

44
Q

Microscopy of CLEAR CELL RCC

A
  1. Polygonal cell with CLEAR CYTOPLASM (PAS ➕)
  2. Oil RED O ➕ ( means LIPIDS are ➕)
45
Q

CMET mutation is ASSOCIATED with

A

Papillary RCC

46
Q

RCC VARIENT presenting as

⭐ SOLITARY & U/L & UPPER POLE
⭐ MULTIFOCAL & B/L

A

⭐ SOLITARY & U/L & UPPER POLE
🎯 Clear Cell RCC

⭐ MULTIFOCAL & B/L
🎯 Papillary RCC

47
Q

⭐ Most ANGIO-INVASIVE VARIENT OF RCC

⭐ Most ANGIO-INVASIVE TUMOUR OF BODY

A

⭐ Most ANGIO-INVASIVE VARIENT OF RCC
🎯 PAPILLARY RCC

⭐ Most ANGIO-INVASIVE TUMOUR OF BODY
🎯 RCC

48
Q

RCC ASSOCIATED with DIALYSIS

A

Papillary RCC

49
Q

CHROMOPHILIC RCC is also known as

A

Papillary RCC

50
Q

IHC Markers of

⭐ PAPILLARY RCC
⭐ CLEAR CELL RCC

A

⭐ PAPILLARY RCC
🎯 VIMENTIN
🎯 CYTOKERATIN

⭐ CLEAR CELL RCC
🎯 CYTOKERATIN 7

51
Q

⭐ BEST PROGNOSIS with which RCC

⭐ WORST PROGNOSIS with which RCC

A

⭐ BEST PROGNOSIS with which RCC
🎯 Chromophobe RCC

⭐ WORST PROGNOSIS with which RCC
🎯 COLLECTING DUCT (OR) BELLINI DUCT RCC

52
Q

Tan Brown GROSS appearance is seen with which RCC

A

Chromophobe RCC

53
Q

Plant like Cells & Resin like Nucleus os Characteristic feature of

A

Chromophobe RCC

54
Q

HALE’S COLLOIDAL IRON is used to stain which RCC

A

Chromophobe RCC

55
Q

Loss of MULTIPLE CHROMOSOMES (1, 2, 6, 10 & 13) ASSOCIATED with

A

Chromophobe RCC

56
Q

Electron MICROSCOPY showing NUMEROUS MICROVESICLES (150-300nm) is Characteristic feature of which RCC

A

Chromophobe RCC

57
Q

H&E of COLLECTING DUCT (OR) BELLINI DUCT RCC

A
  1. Hobnail cells
  2. Extensive DESMOPLASIA
58
Q

Hobnail cells are Characteristic FEATURE of

A

Collecting DUCT RCC

59
Q

RCC ASSOCIATED with SICKLE CELL TRAIT

A

MEDULLARY RCC

60
Q

Childhood RCC is ASSOCIATED with

A

TFE3 gene mutation in Chromosome Xp11.2

61
Q

REED Syndrome
🧠⚡Feels Like Renal⚡

A

Feels: Fumerate Hydratase 4 gene mutation
Like: LEIOMYOMATOSIS
Renal: RCC (Chromophobe)

62
Q

Triad of RCC

A
  1. Mass
  2. Pain
  3. Hematuria
63
Q

Pulsatile BONY METASTASIS is seen in

64
Q

⚡⚡ MOST COMMON presentation OF RCC

65
Q

⚡⚡ MOST COMMON SITE OF DISTANT METASTASIS IN RCC

A

Lung: Canon Ball METASTASIS

66
Q

⚡⚡ MOST COMMON PARANEOPLASTIC SYNDROME OF RCC

A

Increased ESR

67
Q

STAUFFER SYNDROME

A

PARANEOPLASTIC syndrome in RCC

⭐ NON-METASTATIC HEPATIC DYSFUNCTION

✨ ⬆️ IL6
✨ ⬆️ Bilirubin
✨ ⬆️ ALP
✨ ⬆️ Liver Enzymes

68
Q

PARANEOPLASTIC SYNDROME of RCC

🧠⚡SH²A²P²E² C² ⚡

69
Q

🩺 IOC for RCC

🩺 IOC for staging RCC

70
Q

Indications of BIOPSY in RCC

A
  1. Non-operative TUMOUR
  2. Metastatic TUMOUR
71
Q

Indications of CT ANGIOGRAM in RCC

A

Involvement along RENAL VEIN in RCC

72
Q

⭐ STAGING of RCC done by

⭐ PATHOLOGICAL STAGING of RCC done by

⭐ GRADING SYSTEM of RCC

🧠⚡ GF⚡

A

⭐ STAGING of RCC done by
🎯 TNM

⭐ PATHOLOGICAL STAGING of RCC done by
🎯 ROBSON STAGING

⭐ GRADING SYSTEM of RCC
🎯 FUHRMANN GRAFING SYSTEM

73
Q

TNM STAGING OF RCC
🧠⚡ 4 & 7⚡

74
Q

⚡⚡ RCC: Radiotherapy & Chemotherapy senstivity

⚡⚡ Wilm’s: Radiotherapy & Chemotherapy senstivity

A

⚡⚡ RCC: Radiotherapy & Chemotherapy senstivity
🎯 RADIORESISTANT & CHEMORESISTANT

⚡⚡ Wilm’s: Radiotherapy & Chemotherapy senstivity
🎯 RADIOSENSITIVE & CHEMOSENSITIVE

75
Q

💊💉 MANAGEMENT of RCC

🧠⚡Surgery ⚡

76
Q

💊💉 MANAGEMENT of METASTATIC RCC

A
  1. Debulking surgery
  2. mTOR ⛔: Sirolimus, Everolimus
  3. Sunitinib & Sorafenib
  4. IL-2
77
Q

⚡⚡ MOST IMPORTANT PROGNOSTIC FACTOR OF RCC

⚡⚡ MOST IMPORTANT PROGNOSTIC FACTOR OF WILMS TUMOUR

A

⚡⚡ MOST IMPORTANT PROGNOSTIC FACTOR OF RCC
🎯 Tumour Grading

⚡⚡ MOST IMPORTANT PROGNOSTIC FACTOR OF WILMS TUMOUR
🎯 HISTOLOGY (BLASTEMAL Component)

78
Q

Cryoablation for RENAL TUMOURS
Done in:

A
  1. T1a
  2. Metastatic Tumours
79
Q

⚡⚡ MOST COMMON PEDIATRIC RENAL MALIGNANCY

A

WILMS TUMOUR

80
Q

⚡⚡ MOST COMMON ABDOMINAL MALIGNANCY IN CHILDREN

⚡⚡ 2nd MOST COMMON ABDOMINAL MALIGNANCY IN CHILDREN

A

⚡⚡ MOST COMMON ABDOMINAL MALIGNANCY IN CHILDREN
🎯 NEUROBLASTOMA

⚡⚡ 2nd MOST COMMON ABDOMINAL MALIGNANCY IN CHILDREN
🎯 WILMS TUMOUR

81
Q

Synonyms of WILMS TUMOUR

A

Nephroblastoma

82
Q

Syndromes ASSOCIATED with WILMS TUMOUR

🧠⚡By D Way ⚡

A
  1. Beckwidth Wiedmann Syndrome
  2. Denys Darsh Syndrome
  3. WAGR SYNDROME
83
Q

Beckwidth Wiedmann Syndrome

84
Q

Denys Darsh Syndrome

85
Q

WAGR SYNDROME

A
  1. WILMS TUMOUR
  2. Aniridia
  3. Genitourinary Malformation
  4. Retardation Mental
86
Q

Two HIT HYPOTHESIS is applicable on

A
  1. Retinoblastoma
  2. WAGR
  3. Denys Darsh Syndrome
87
Q

BECKWIDTH WIEDMANN SYNDROME
⭐ Genetic Cause

A

Genomic Imprinting

⭐ IGF1 over expression on WT2 Region

88
Q

Classical Triad of WILMS TUMOUR

A

Abdominal Mass
➕
Fever
➕
Hematuria

89
Q

How will you DISTINGUISH RCC & WILMS TUMOUR based on PAIN

A

Painful is RCC
Painless WILMS

90
Q

How will you DISTINGUISH RCC & WILMS TUMOUR based on FEVER

A

Fever is ➕ only in WILMS

91
Q

DISTINGUISH between RCC vs WILMS vs RVT
🧠⚡HuMP⚡

92
Q

Precursor lesion of WILMS TUMOUR

A

Nephrogenic Cell Rest

93
Q

WILMS TUMOUR is ASSOCIATED with MUTATION OF

🧠⚡ TUMOUR SUPPRESSOR GENE⚡

A

WT1: chromosome 11p13
WT2: chromosome 11p15

94
Q

🩺 IOC for WILMS TUMOUR

95
Q

Staging of WILMS TUMOUR

96
Q

Differentiate BETWEEN WILMS & NEUROBLASTOMA

97
Q

💊💉 MANAGEMENT of WILMS TUMOUR

🧠⚡NWTSG: SCRipt & SIOP⚡

98
Q

Chemotherapy in WILMS

🧠⚡CVD ⚡

A
  1. Cyclophosphamide
  2. Vincristine
  3. Dactinomycin
99
Q

TRIPHASIC PATTERN is characteristic of

A

WILMS TUMOUR

100
Q

WILMS TUMOUR
🧠⚡BEST⚡

101
Q

H&E of WILMS TUMOUR

A

Homerwright Pseudo-rossettes

102
Q

⚡⚡ MOST COMMON SITE OF NEUROBLASTOMA

A

Adrenal Gland

103
Q

BEST INVESTIGATION for NEUROBLASTOMA

A

Nuclear SCAN with I-123 MIBG detects TUMOUR & METASTASIS accurately

104
Q

PROGNOSTIC Factors for NEUROBLASTOMA

105
Q

Difference BETWEEN Psammoma bodies & Keratin Pearls

106
Q

Tumours undergoing SPONTANEOUS REGRESSION
🧠💡MR NCR💡

A
  1. Medulloblastoma
  2. RCC
  3. Neuroblastoma
  4. Choriocarcinoma
  5. Retinoblastoma

UROLOGY (12 decks)

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