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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
Q

What is the most common type of renal cell carcinoma?

A

Clear Cell Carcinoma

26
Q

Papillary renal cell carcinoma is characterized genetically by what?

A
  • trisomy involving chromosome 7 or 17

- loss of Y chromosome

27
Q

What are the symptoms of renal cell carcinoma? (hint: triad)

A
  • pain
  • palpable mass
  • haematuria
28
Q

Renal cell carcinoma is associated with paraneoplastic syndromes. List some effects of the paraneoplastic syndromes

A
  • polycythaemia
  • iron deficiency anaemia
  • hypertension
  • pyrexia
  • elevated ESR
  • Cushing’s syndrome (secretion of ACTH)
  • Stauffer’s syndrome
29
Q

What is the first-line treatment for renal cell carcinoma? Why?

A

Surgery - Radical Nephrectomy/Nephron-Sparing Surgery

  • RCC unresponsive to chemotherapy and radiotherapy
30
Q

What is the treatment for RCC metastatic disease?

A

Immunotherapy

  • Interferon Alpha
  • Interleukin 2
  • Both
31
Q

List the risk factors for bladder cancer

A
  • industrial carcinogens
  • smoking
  • schistosomiasis (a/w SCC)
  • cyclophosphamide
32
Q

What type of drug is cylophosphamide?

A

chemotherapy drug

33
Q

What are the 3 predominant types of bladder cancer?

A
  1. Transitional Cell Carcinoma (Urothelial Carcinoma)
  2. Squamous Cell Carcinoma
  3. Adenocarcinoma
34
Q

What is the most common type of bladder cancer? (be specific!)

A

Transitional Cell Carcinoma - Non-Muscle Invasive (superficial)

35
Q

Most of bladder carcinomas in-situ will become which type of cancer?

A

muscle invasive transitional cell carcinoma (aggressive!)

36
Q

What are the symptoms of bladder cancer?

A
  • painless haematuria (or microscopic haematuria)
  • irritative voiding symptoms
  • clot in bladder
37
Q

What is the treatment for a bladder tumour if it is a primary lesion and is NOT low-grade?

A

transurethral resection of bladder tumour (TURBT)

38
Q

What is the treatment for invasive or high-grade bladder tumour?

A
  • radical cystoprostatectomy
  • neoadjuvant chemotherapy
  • radiation therapy
39
Q

What are the main symptoms of bladder carcinoma in situ?

A
  • irritative voiding symptoms

- microscopic haematuria

40
Q

What are the possible treatment options for bladder carcinoma in-situ? [2]

A
  1. Intra-Vesical Chemotherapy w/ BCG [6 cycles]**

2. Radical Cysto-Prostatectomy

41
Q

What are squamous cell carcinomas of the bladder associated with?

A
  • schistosomiasis*
  • chronic indwelling catheters
  • bladder stones
  • UTI
42
Q

What are adenocarcinomas of the bladder associated with?

A
  • fistulas

- bladder exstrophy

43
Q

What is exstrophy of the bladder? What cancer is associated with this condition?

A
  • birth defect
  • bladder develops outside of fetus
  • a/w adenocarcinoma of bladder
44
Q

What is the type of carcinoma/name of the carcinoma that appears in the renal pelvis and ureters?

A

Urothelial Carcinoma/Transitional Cell Carcinoma

45
Q

What is Stauffer’s Syndrome? List 3 characteristics

A

hepatic dysfunction
fever
anorexia

pareneoplastic syndrome a/w renal cell cancer

REGUB (22 decks)

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