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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
Q

Certain electrolyte abnormalities that are related to tissue damage/necrosis w/ subsequent release of intracellular contents

A

tumor lysis syndrome

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26
Q

tumor lysis syndrome 4 main electrolyte abnormalities

A

hyperkalemia
hyperphosphatemia
hypocalcemia
hyperuricemia

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27
Q

AKI is also seen in ______ syndrome

A

tumor lysis syndrome

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28
Q

most commonly occurs after treatment of hematologic malignancies (BURKITT LYMPHOMA)

A

tumor lysis syndrome

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29
Q

main determinant of osmolality in ECF

A

serum [Na+]

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30
Q

main determinant of osmolality in ICF

A

K+

31
Q

lab diagnosis of tumor lysis syndrome

A

more than 2/4 lab criteria

(uric acid, K+, phosphate, calcium)

32
Q

how to diagnose tumor lysis syndrome clinically

A

AKI (Cr level)
cardiac arrythmia (hyperkalemia)
seizures

33
Q

massive ischemia injury to neoplastic cells release what

A

K+

34
Q

main cause of AKI in tumor lysis syndrome

A

too much uric acid

35
Q

why does too much uric acid cause AKI

A

acidic urine won’t dissolve uric acid; crystal nephropathy

36
Q

crystal independent mechanism of uric acid causing AKI in tumor lysis syndrome

A

low NO (vasoconstriction); worsens ischemia of PCT

37
Q

2 ways to prevent tumor lysis syndrome:

A

HYDRATION
reduce uric acid formation (allopurinol)

38
Q

MoA of allopurinol

A

xanthine oxidase inhibitor

39
Q

3 ways to treat tumor lysis syndrome:

A
  1. urinary alkalization
  2. rasburicase
  3. dialysis
40
Q

drug used to treat tumor lysis syndrome that converts uric acid to soluble form

A

Rasburicase

41
Q

one electrolyte disorder of malignancy

A

hypercalcemia

42
Q

2 main things tumors can produce to cause hypercalcemia

A

active Vitamin D
PTH

43
Q

active vitamin D and PTH will do what to calcium

A

cause more reabsorption

44
Q

typical tumor causing hypercalcemia

A

squamous cell lung carcinoma

45
Q

osteolytic metastasis from what tumor cytokine release (releasing calcium)

A

breast
multiple myeloma

46
Q

normal serum Ca2+ level

A

8-10

47
Q

AKI from hypercalcemia at what serum level of Ca2+

A

above 12

48
Q

what can hypercalcemic patient develop

A

nephrogenic diabetes insipidus

49
Q

tubular atrophy, interstitial fibrosis and calcification

A

long standing hypercalcemia

50
Q

to treat hypercalcemia:

A

IV isotonic saline
calcitonin
bisphosphonates

51
Q

short term inhibitors of osteoclast release of Ca2+

A

Calcitonin

52
Q

long term inhibitor release of Ca2+

A

bisphosphonates

53
Q

this electrolyte disorder can also be a/w cancer

A

hyponatremia

54
Q

hyponatremia a/w SIADH is a/w what cancer

A

small cell lung carcinoma

55
Q

small cell lung carcinoma produces what

A

AVP/ADH

56
Q

too much water

A

hyponatremia

57
Q

patient has low osmolality, but is euvolemic

A

SIADH

58
Q

to diagnose SIADH, what has to be normal and what drug can patient not be on

A

thyroid, adrenal, and kidney fx and no use of diuretics

59
Q

3 main cancer drugs that can cause thrombotic microangiopathy of glomeruli

A

Mitomycin C
Gemcitabine
Anti-VEGF

60
Q

drugs that cause this

A

Mitomycin C
Gemcitabine
Anti-VEGF

61
Q

cancer drug that gets into PCT by OCT-2 and causes AKI

A

Cisplatin

62
Q

_____ causes oxidative injury to tubules

A

Cisplatin

63
Q

how to avoid AKI from Cisplatin

A

reduce dose and see if GFR goes up

64
Q

if GFR does not increase, what to do with Cisplatin

A

take patient off

65
Q

testicular cancer drug that gets into PCT by OCT-2 and leads to acute tubular necrosis

A

IFOSFAMIDE

66
Q

causes hemorrhagic cystitis and ATN

A

IFOSFAMIDE

67
Q

to treat hemorrhagic cystitis caused by Ifosfamide

A

MESNA

68
Q

this cancer drug has no cellular uptake and causes hemorrhagic cystitis and nephrogenic DI

A

Cyclophoshamide

69
Q

to treat hemorrhagic cystitis caused by cyclophosphamide

A

MESNA

70
Q

to prevent side effect of methotrexate

A

IV fluid and urine alkalization

71
Q

SE of methotrexate

A

crystal induced nephropathy

72
Q

how to treat crystal nephropathy caused by methotrexate

A

Glucarpidase

73
Q

drug that will rapidly metabolize methotrexate and treat crystal nephropathy

A

Glucarpidase

URN Biweekly 2 (15 decks)

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