Renal: 12.7: Chronic Renal Failure 12.8: Renal Neoplasia Flashcards
What is uremia?
symptoms caused by increased nitrogenous waste products in the blood (azotemia)
What are some s/s of uremia?
nausea, anorexia, pericarditis, platelet dysfunction, encephalopathy with asterixis, deposition of urea crystals in the skin, salt and water retention –> HTN, hyperkalemia, anion gap metabolic acidosis, anemia, hypocalcemia, renal osteodystrophy
What produces EPO?
renal peritubular interstitial cells
What is osteitis fibrosa cystica?
decreased Ca++ –> increased PTH –> Ca++ resorbed –> bones destroyed –> fibrosis, cyst formation
What is osteomalacia?
inability to mineralize osteoid made by osteoblasts
What is osteoporosis?
leeching of Ca++ over time due to metabolic acidosis
What happens to a shrunken kidney in dialysis?
cyst formation
Dialysis increases the risk for what cancer?
renal cell carcinoma
What is an angiomyolipoma of the kidney?
a hamartoma of BVs, smooth muscle and adipose tissue
What kidney tumor is associated with tuberous sclerosis?
angiomyolipoma
What is the triad of RCC?
hematuria, palpable mass, and flank pain
What are the s/s of RCC?
fever, weight loss, paraneoplastic syndromes, L-sided varicocele
What does increased ACTH cause?
Cushing syndrome
The spermatic vein drains into the ____ on the left side.
renal vein
The spermatic vein drains into the ____ on the right side.
IVC
What are the gross findings of RCC?
a yellow mass
What are the path findings in RCC?
clear cytoplasm
What gene mutation causes RCC?
loss of VHL on Ch. 3
What is the VHL gene’s job?
tumor suppression
What is the key risk factor for sporadic RCC?
smoking
What is Von Hippel-Lindau disease? What is its inheritance?
inactivation of VHL gene; auto dominant
Along with RCC, pts with Von Hippel-Lindau disease are at an increased risk of what other tumor?
hemangioblastoma of the cerebellum
Where does RCC metastasize to?
retroperitoneal lymph nodes and the renal vein
What is a Wilms tumor?
a malignant kidney tumor in children
What comprises a Wilms Tumor?
blastema, primitive glomeruli and tubules, and stromal cells
How does a Wilms Tumor present?
large, unilateral flank mass with hematuria and HTN (from increased renin)
What is WAGR syndrome?
W= wilms tumor A = anuiridia G = genital abn R = mental and motor Retardation
What mutation causes Wilms Tumors?
WT1
What are the findings in Beckwith-Wiedemann Syndrome?
Wilms tumor
neonatal hypoglycemia
muscular hemidystrophy
organomegaly (tongue)
