Renal: 12.7: Chronic Renal Failure 12.8: Renal Neoplasia

Question 1

What is uremia?

Answer 1

symptoms caused by increased nitrogenous waste products in the blood (azotemia)

Question 2

What are some s/s of uremia?

Answer 2

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

Question 3

What produces EPO?

Answer 3

renal peritubular interstitial cells

Question 4

What is osteitis fibrosa cystica?

Answer 4

decreased Ca++ –> increased PTH –> Ca++ resorbed –> bones destroyed –> fibrosis, cyst formation

Question 5

What is osteomalacia?

Answer 5

inability to mineralize osteoid made by osteoblasts

Question 6

What is osteoporosis?

Answer 6

leeching of Ca++ over time due to metabolic acidosis

Question 7

What happens to a shrunken kidney in dialysis?

Answer 7

cyst formation

Question 8

Dialysis increases the risk for what cancer?

Answer 8

renal cell carcinoma

Question 9

What is an angiomyolipoma of the kidney?

Answer 9

a hamartoma of BVs, smooth muscle and adipose tissue

Question 10

What kidney tumor is associated with tuberous sclerosis?

Answer 10

angiomyolipoma

Question 11

What is the triad of RCC?

Answer 11

hematuria, palpable mass, and flank pain

Question 12

What are the s/s of RCC?

Answer 12

fever, weight loss, paraneoplastic syndromes, L-sided varicocele

Question 13

What does increased ACTH cause?

Answer 13

Cushing syndrome

Question 14

The spermatic vein drains into the ____ on the left side.

Answer 14

renal vein

Question 15

The spermatic vein drains into the ____ on the right side.

Answer 15

IVC

Question 16

What are the gross findings of RCC?

Answer 16

a yellow mass

Question 17

What are the path findings in RCC?

Answer 17

clear cytoplasm

Question 18

What gene mutation causes RCC?

Answer 18

loss of VHL on Ch. 3

Question 19

What is the VHL gene’s job?

Answer 19

tumor suppression

Question 20

What is the key risk factor for sporadic RCC?

Answer 20

smoking

Question 21

What is Von Hippel-Lindau disease? What is its inheritance?

Answer 21

inactivation of VHL gene; auto dominant

Question 22

Along with RCC, pts with Von Hippel-Lindau disease are at an increased risk of what other tumor?

Answer 22

hemangioblastoma of the cerebellum

Question 23

Where does RCC metastasize to?

Answer 23

retroperitoneal lymph nodes and the renal vein

Question 24

What is a Wilms tumor?

Answer 24

a malignant kidney tumor in children

Question 25

What comprises a Wilms Tumor?

Answer 25

blastema, primitive glomeruli and tubules, and stromal cells

Question 26

How does a Wilms Tumor present?

Answer 26

large, unilateral flank mass with hematuria and HTN (from increased renin)

Question 27

What is WAGR syndrome?

Answer 27

W= wilms tumor
A = anuiridia
G = genital abn
R = mental and motor Retardation

Question 28

What mutation causes Wilms Tumors?

Answer 28

WT1

Question 29

What are the findings in Beckwith-Wiedemann Syndrome?

Answer 29

Wilms tumor
neonatal hypoglycemia
muscular hemidystrophy
organomegaly (tongue)