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URN Biweekly 2 > Onco-Nephrology- Al Jaber > Flashcards

Onco-Nephrology- Al Jaber Flashcards

1
Q

the study of kidney diseases in cancer patients

A

onco-nephrology

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2
Q

higher rates of mortality in ____ patients who develop AKI

A

cancer

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3
Q

cause of AKI that deals with volume loss

A

prerenal AKI

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4
Q

cause of AKI that deals with glomerular, tubulointerstitial, and vascular segments of kidney

A

renal AKI

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5
Q

cause of AKI that deals with plumbing problem of kidney

A

postrenal AKI

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6
Q

____% of patients w/ multiple myeloma develop renal disease

A

50%

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7
Q

______+ kidney impairment= higher rate of early mortality

A

multiple myeloma

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8
Q

main renal disease (AKI) in patients w/ multiple myeloma

A

cast nephropathy

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9
Q

Toxic and obstructive effects on Proximal Tubule cells
Precipitation of light chain/Tamm-Horsfall protein distally

A

cast nephropathy

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10
Q

deals with toxic effects when proteins pass through PCT

A

cast nephropathy

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11
Q
A

cast nephropathy in MM patients

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12
Q

one present
one absent

A

kappa/lambda light chains (MM)

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13
Q

____% of cases of membranous nephropathy are due to secondary causes

A

20%

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14
Q

what to do if pt has membranous nephropathy

A

screen for cancers

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15
Q

what are derived from tumors that contribute to membranous nephropathy

A

circulating immune complexes

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16
Q

proteinuria
hyperlipidemia
hypoalbuminemia
spikes
subepithelial deposits
effacement of podocytes

A

Membranous Nephropathy

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17
Q

treat the cancer, what improves

A

proteinuria

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18
Q

_____ will relapse w/ cancer recurrence

A

membranous nephropathy

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19
Q

________is associated with minimal change disease seen in children

A

Hodgkin’s lymphoma

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20
Q

______ also associated with minimal change disease and deals with T cell dysfunction

A

thymoma

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21
Q

tram track seen; lobular glomerular lobes; subendothelial deposits

A

membranoproliferative glomerulonephritis

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22
Q

chronic lymphocytic leukemia is associated with what

A

MPGN

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23
Q

______ may be diagnosed on imaging (a/w MPGN)

A

infiltrative nephropathy

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24
Q

a/w lymphomas and leukemias

A

infiltrative nephropathy

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25
Certain electrolyte abnormalities that are related to tissue damage/necrosis w/ subsequent release of intracellular contents
tumor lysis syndrome
26
tumor lysis syndrome 4 main electrolyte abnormalities
hyperkalemia hyperphosphatemia hypocalcemia hyperuricemia
27
AKI is also seen in ______ syndrome
tumor lysis syndrome
28
most commonly occurs after treatment of hematologic malignancies (BURKITT LYMPHOMA)
tumor lysis syndrome
29
main determinant of osmolality in ECF
serum [Na+]
30
main determinant of osmolality in ICF
K+
31
lab diagnosis of tumor lysis syndrome
more than 2/4 lab criteria (uric acid, K+, phosphate, calcium)
32
how to diagnose tumor lysis syndrome clinically
AKI (Cr level) cardiac arrythmia (hyperkalemia) seizures
33
massive ischemia injury to neoplastic cells release what
K+
34
main cause of AKI in tumor lysis syndrome
too much uric acid
35
why does too much uric acid cause AKI
acidic urine won't dissolve uric acid; crystal nephropathy
36
crystal independent mechanism of uric acid causing AKI in tumor lysis syndrome
low NO (vasoconstriction); worsens ischemia of PCT
37
2 ways to prevent tumor lysis syndrome:
HYDRATION reduce uric acid formation (allopurinol)
38
MoA of allopurinol
xanthine oxidase inhibitor
39
3 ways to treat tumor lysis syndrome:
1. urinary alkalization 2. rasburicase 3. dialysis
40
drug used to treat tumor lysis syndrome that converts uric acid to soluble form
Rasburicase
41
one electrolyte disorder of malignancy
hypercalcemia
42
2 main things tumors can produce to cause hypercalcemia
active Vitamin D PTH
43
active vitamin D and PTH will do what to calcium
cause more reabsorption
44
typical tumor causing hypercalcemia
squamous cell lung carcinoma
45
osteolytic metastasis from what tumor cytokine release (releasing calcium)
breast multiple myeloma
46
normal serum Ca2+ level
8-10
47
AKI from hypercalcemia at what serum level of Ca2+
above 12
48
what can hypercalcemic patient develop
nephrogenic diabetes insipidus
49
tubular atrophy, interstitial fibrosis and calcification
long standing hypercalcemia
50
to treat hypercalcemia:
IV isotonic saline calcitonin bisphosphonates
51
short term inhibitors of osteoclast release of Ca2+
Calcitonin
52
long term inhibitor release of Ca2+
bisphosphonates
53
this electrolyte disorder can also be a/w cancer
hyponatremia
54
hyponatremia a/w SIADH is a/w what cancer
small cell lung carcinoma
55
small cell lung carcinoma produces what
AVP/ADH
56
too much water
hyponatremia
57
patient has low osmolality, but is euvolemic
SIADH
58
to diagnose SIADH, what has to be normal and what drug can patient not be on
thyroid, adrenal, and kidney fx and no use of diuretics
59
3 main cancer drugs that can cause thrombotic microangiopathy of glomeruli
Mitomycin C Gemcitabine Anti-VEGF
60
drugs that cause this
Mitomycin C Gemcitabine Anti-VEGF
61
cancer drug that gets into PCT by OCT-2 and causes AKI
Cisplatin
62
_____ causes oxidative injury to tubules
Cisplatin
63
how to avoid AKI from Cisplatin
reduce dose and see if GFR goes up
64
if GFR does not increase, what to do with Cisplatin
take patient off
65
testicular cancer drug that gets into PCT by OCT-2 and leads to acute tubular necrosis
IFOSFAMIDE
66
causes hemorrhagic cystitis and ATN
IFOSFAMIDE
67
to treat hemorrhagic cystitis caused by Ifosfamide
MESNA
68
this cancer drug has no cellular uptake and causes hemorrhagic cystitis and nephrogenic DI
Cyclophoshamide
69
to treat hemorrhagic cystitis caused by cyclophosphamide
MESNA
70
to prevent side effect of methotrexate
IV fluid and urine alkalization
71
SE of methotrexate
crystal induced nephropathy
72
how to treat crystal nephropathy caused by methotrexate
Glucarpidase
73
drug that will rapidly metabolize methotrexate and treat crystal nephropathy
Glucarpidase

URN Biweekly 2 (15 decks)

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