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REGUB > L8 + L28: Renal + Bladder Cancer > Flashcards

L8 + L28: Renal + Bladder Cancer Flashcards

1
Q

In chronic renal failure, there is increased glomerular pressure which can lead to…

A

progressive glomerulosclerosis

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2
Q

What is chronic kidney disease? (definition)

A
  • is the result of progressive scarring
    resulting from any type of kidney disease
  • alterations in the function of remaining intact nephrons are maladaptive and cause further scarring
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3
Q

What is uraemia? Why does it occur in chronic renal failure/chronic kidney disease?

A

Uraemia: raised blood urea

  • occurs because kidneys unable to get rid of urea in body
  • waste product builds up in body
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4
Q

What is a treatment/medication given to treat chronic renal failure?

A

ACE Inhibitors - to lower blood pressure and essentially glomerular pressure

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5
Q

SLE can cause glomerulonephritis in the kidney. According to WHO, what does Type 1 entail?

A
  • normal glomeruli

- positive on fluorescence microscopy

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6
Q

SLE can cause glomerulonephritis in the kidney. According to WHO, what does Type 2 entail?

A
  • mesangial proliferation
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7
Q

SLE can cause glomerulonephritis in the kidney. According to WHO, what does Type 3 entail?

A
  • segmental lesions <50% of glomeruli
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8
Q

SLE can cause glomerulonephritis in the kidney. According to WHO, what does Type 4 entail?

A
  • segmental lesions > 50% of glomeruli
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9
Q

SLE can cause glomerulonephritis in the kidney. According to WHO, what does Type 5 entail?

A
  • membranous type pattern (similar to membranous glomerulonephritis)
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10
Q

List the 4 types of benign renal tumours

A
  1. Adenoma
  2. Angioma
  3. Angiomyolipoma
  4. Oncocytoma
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11
Q

What is an oncocytoma?

A
  • benign renal tumour
  • begin in collecting ducts
  • pink cells + encapsulated
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12
Q

What is Wilm’s tumour?

A

nephroblastoma in children (malignant renal tumour)

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13
Q

What is a nephroblastoma? What is another name for this?

A
  • malignant renal tumour in children

- Wilm’s Tumour

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14
Q

There are multiple different names for renal cell carcinoma. List some of these names

A
  • Grawitz Tumour
  • Adenocarcinoma
  • Hypernephroma
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15
Q

List the 4 types of malignant tumours of the kidney

A
  1. Nephroblastoma
  2. Renal Cell Carcinoma (adenocarcinoma)
  3. Transitional Cell Carcinoma (renal pelvis + collecting system)
  4. Squamous Carcinoma (of renal pelvis)
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16
Q

Hereditary papillary renal cell carcinoma is a hereditary form of RCC. What gene is associated with this condition?

A

7q34

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17
Q

Hereditary leiomyoma renal cell carcinoma increases the risk of RCC. What gene is associated with this condition?

A

1q42

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18
Q

Which gene is renal cell carcinoma associated with? Why is this significant?

A
  • chromosome 3

- von hippel lindau is on chromosome 3 too so that’s why this genetic condition can lead to RCC

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19
Q

List some of the risk factors for renal cell carcinoma

A
  • smoking
  • acquired renal cystic disease
  • nutrition
  • obesity
  • hypertension
20
Q

Explain the pathology behind how Von Hippel Lindau syndrome can lead to renal cell carcinoma

A
  • loss of both copies of VHL gene (a tumour suppressor)
  • VHL suppresses HIF-1
  • HIF-1 upregulates VEGF
21
Q

What is the function of VEGF in cancer?

A

promotes the growth of new blood vessels (angiogenesis)

22
Q

Which organs/tissues do kidney cancers usually metastasize to? [2]

A
  1. lungs
  2. bone

*appear with cannonball/coin mets

23
Q

What are the gross characteristic features of renal cell carcinoma?

A
  • yellow or orange
  • haemorrhage
  • necrosis
24
Q

What are the 5 different types of renal cell carcinoma?

A
  1. Clear Cell
  2. Papillary
  3. Chromophobe
  4. Collecting Duct (Bellini)
  5. Medullary Cell
25
What is the most common type of renal cell carcinoma?
Clear Cell Carcinoma
26
Papillary renal cell carcinoma is characterized genetically by what?
- trisomy involving chromosome 7 or 17 | - loss of Y chromosome
27
What are the symptoms of renal cell carcinoma? (hint: triad)
- pain - palpable mass - haematuria
28
Renal cell carcinoma is associated with paraneoplastic syndromes. List some effects of the paraneoplastic syndromes
- polycythaemia - iron deficiency anaemia - hypertension - pyrexia - elevated ESR - Cushing's syndrome (secretion of ACTH) - Stauffer's syndrome
29
What is the first-line treatment for renal cell carcinoma? Why?
Surgery - Radical Nephrectomy/Nephron-Sparing Surgery - RCC unresponsive to chemotherapy and radiotherapy
30
What is the treatment for RCC metastatic disease?
Immunotherapy - Interferon Alpha - Interleukin 2 - Both
31
List the risk factors for bladder cancer
- industrial carcinogens - smoking - schistosomiasis (a/w SCC) - cyclophosphamide
32
What type of drug is cylophosphamide?
chemotherapy drug
33
What are the 3 predominant types of bladder cancer?
1. Transitional Cell Carcinoma (Urothelial Carcinoma) 2. Squamous Cell Carcinoma 3. Adenocarcinoma
34
What is the most common type of bladder cancer? (be specific!)
Transitional Cell Carcinoma - Non-Muscle Invasive (superficial)
35
Most of bladder carcinomas in-situ will become which type of cancer?
muscle invasive transitional cell carcinoma (aggressive!)
36
What are the symptoms of bladder cancer?
- painless haematuria (or microscopic haematuria) - irritative voiding symptoms - clot in bladder
37
What is the treatment for a bladder tumour if it is a primary lesion and is NOT low-grade?
transurethral resection of bladder tumour (TURBT)
38
What is the treatment for invasive or high-grade bladder tumour?
- radical cystoprostatectomy - neoadjuvant chemotherapy - radiation therapy
39
What are the main symptoms of bladder carcinoma in situ?
- irritative voiding symptoms | - microscopic haematuria
40
What are the possible treatment options for bladder carcinoma in-situ? [2]
1. Intra-Vesical Chemotherapy w/ BCG [6 cycles]** | 2. Radical Cysto-Prostatectomy
41
What are squamous cell carcinomas of the bladder associated with?
- schistosomiasis* - chronic indwelling catheters - bladder stones - UTI
42
What are adenocarcinomas of the bladder associated with?
- fistulas | - bladder exstrophy
43
What is exstrophy of the bladder? What cancer is associated with this condition?
- birth defect - bladder develops outside of fetus - a/w adenocarcinoma of bladder
44
What is the type of carcinoma/name of the carcinoma that appears in the renal pelvis and ureters?
Urothelial Carcinoma/Transitional Cell Carcinoma
45
What is Stauffer's Syndrome? List 3 characteristics
hepatic dysfunction fever anorexia pareneoplastic syndrome a/w renal cell cancer

REGUB (22 decks)

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