RCC

Question 1

Q2. What is lining epithelium of urinary tract?

Answer 1

Stratified transitional epithelium

Question 2

A young lady KCO chronic renal failure developed secondary. Now she developed renal stones. Blood results available.

Q1. How is hyperparathyroidism caused in renal failure?

Answer 2

Less serum calcium due to decreased absorption as a result of low Vit D13 in case of renal failure with increase in Ca excreation and phosphate absorption leading to hypocalcemia and hyperphosphatemia which stimulates ParaThyroid gland to produce PTH (2ry HPT)

Question 3

Q3. What’re the types of stones?

Answer 3

Ca Oxalate – Ca Phosphate – Cystein – Struvite – Uric acid

Question 4

Q4: What are the genitourinary complications of stones?

Answer 4

Inf. / HTN / bleeding / Incr Risk of Malignancy / Fistula formation

Question 5

Q5. What’re the different modalities for management of renal stones ?

Answer 5

Acc to size – Less than 0.8 (No obstr/ No single )  Conservative
Less 2cm – > ESWL (CI; in AAA and pregnancy)
more than 2  nephrostomy

Question 6

Q6. What are the risk factors for RCC & How can stone cause cancer?

Answer 6

Dye and Petroleum substance exposure / Smoking / Acquired type of PCKD
,,
Chronic irritation leading to hyperplasia and dysplasia which will lead to cancer

Question 7

Q7.What is the most common type of renal cell carcinoma?

Q8. What is the second most common type of renal cell carcinoma?

Q9. What is the most common type of renal cell carcinoma in PCKD or dialysis patients?

Answer 7

7. Clear cell carcinoma /
   8.Papillary renal cell carcinoma
   9.Papillary renal cell carcinoma

Question 8

Q10: What are the macroscopic finding in renal carcinoma (In refence to pathology report)?

Answer 8

Clear CC; .
Arises from PCT /
Solitary mass & unilateral/
Cut surface is solid, yellowish greywhite & variegated appearance due to accumulation of lipids with areas of hemorrhage, necrosis and cystic degeneration.
Tumor invades renal vein & grows as a solid column extends to IVC
**Papillary CC; **
Arises from DCT
Multiple masses & bilateral
Cut surface is less vibrantly because of their lower lipid content with areas of hemorrhage, necrosis and cystic degeneration.

Question 9

Q11. What are the microscopic finding in renal carcinoma(in reference to pathology report)?

Answer 9

**Clear CC; **
. Cellular structure: Clear or granular cytoplasm containing lipid & glycogen
· Cellular arrangement: Round to polygonal cells arranged in tubules or cords
Stroma: scanty but vascular
**Papillary CC; **
. Cellular structure: Interstitial foam cells Psammoma bodies may be present
· Cellular arrangement: Cuboidal or low columnar cells arranged in papillary formations with fibrovascular cores
· Stroma: scanty but highly vascular

Question 10

Q12. What docs R1 mean?

Answer 10

Microscopic residual tumor