OnlineMedEd: Nephrology - "Cysts and Cancer"

Question 1

Review simple cysts.

Answer 1

• Discovered incidentally (so asymptomatic)
• Small
• No loculations or septations
• No treatment or further workup required

Question 2

Review complex cysts.

Answer 2

• Symptomatic: hematuria, flank pain, fever
• Large
• Loculations or septations
• Workup with UA; CT/US; and/or biopsy

Question 3

What is the “classic triad” or renal cell carcinoma?

Answer 3

• Flank pain
• Flank mass
• Hematuria

Question 4

Suspected RCC (based on symptoms and imaging) should be diagnosed with _____________.

Answer 4

resection

Question 5

RCC can present with what paraneoplastic syndrome?

Answer 5

Erythrocytosis due to EPO-production

Question 6

Describe the presentation and management of autosomal recessive polycystic kidney disease.

Answer 6

• Inheritance: AR
• Presentation: anuric renal failure with bilateral masses at birth; radially oriented cysts
• Diagnose with US and biopsy
• Treat with supportive care

Question 7

Describe the presentation and management of autosomal dominant polycystic kidney disease.

Answer 7

• Inheritance: AD
• Presentation follows this sequence: 
- Asymptomatic
- HTN
- ESRD 
- Other than the above sequence, those with ADPCKD can present with palpable masses (not radially oriented!), infection, or bleeding. 
• Diagnose with biopsy and US or CT
• Treat with HD or transplant 

Don’t forget the liver/pancreatic cysts and Berry aneurysms!