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Clin Med Renal > Renal Cancers and Transitional CA > Flashcards

Renal Cancers and Transitional CA Flashcards

1
Q

What is the most common tumor of childhood?

A

Wilms tumor (nephroblastoma)

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2
Q

Which type of descent has the highest rate of Wilms tumor?

A

African descent

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3
Q

What is a Wilms tumor?

A

Malignancy derived from the primitive cells of the renal cortex

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4
Q

What are some genetic anomalies that may be associated with a patient with a Wilms tumor?

A

Abesence of iris- aniridia
Enlargement of one side of face
Genitourinary complications

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5
Q

What is the most common presentation of a Wilms tumor?

A

Often asymptomatic - large abdomen

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6
Q

What are some clinical manifestations associated with an advanced Wilms tumor?

A

Pain w/ vomiting
Hematuria
HTN

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7
Q

Why should you not biopsy a Wilms tumor?

A

Risk of spreading it to other tissue, significantly increases staging if ruptured

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8
Q

What is the imaging method of choice for a Wilms tumor?

A

CT scan

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9
Q

How do you manage a Wilms tumor?

A

Surgery
Chemotherapy
Sometimes radiatiom

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10
Q

What is the prognosis of a Wilms tumor?

A

Good if caught early before METs or rupture

90% survival over 5 years if caught before

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11
Q

Which type of ancestry is renal cell carcinoma most common in?

A

Northern European ancestry

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12
Q

What are the 3 symptoms associated with renal cell carcinoma?

A

flank pain, palpable flank mass, and painless hematuria

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13
Q

What are some other symptoms associated with renal cell carcinoma?

A

weight loss, malaise, anemia, hypertension, hypercalcemia, recurrent fevers

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14
Q

What age/gender is renal cell carcinoma common in?

A

50-70 usually male

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15
Q

What are the three synthetic substances that can increase the risk for renal cell carcinoma with prolonged exposure?

A

Asbestos, cadmium, petroleum products

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16
Q

What disorders/diseases put a patient at risk for renal cell carcinoma?

A 
Tuberos sclerosis (Genetic benign tumors)
Von Hippel-Lindau disease (CNS, kidneys MC)
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17
Q

Long term dialysis puts a patient at risk for ??

A

Renal cell carcinoma

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18
Q

Usually grows shperical , well circumscribed mass in the cortex of the kidney

A

Renal cell carcinoma

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19
Q

Where does renal cell carcinoma arise from?

A

Epithelial lining of the proximal tubule

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20
Q

Where does renal cell carcinoma grow into?

A

Renal vein
Inferior vena cava
Can occlude R side of the heart

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21
Q

What will you find on a UA of a patient with renal cell carcinoma?

A

Microscopic hemturia - always retest if you are suspicious!

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22
Q

What is the best initial diagnosis of renal cell carcinoma?

A

CT scan (91% accuracy in staging)

23
Q

What is the DEFINITIVE diagnosis of renal cell carcinoma?

A

Biopsy

24
Q

When should you use an MRI in a patient with renal cell carcinoma?

A

To look for METS once diagnosed

25
Q

When would you use a CXR or CT of lungs in a patient with renal cell carcinoma?

A

METS concern once diagnosed

26
Q

When does renal cell carcinoma usually present?

A

When it is advanced

27
Q

Most common sites of METS with renal cell carcinoma?

A

Lung, Lymph nodes, Bone, Liver, Brain

28
Q

What is the only cure of renal cell carcinoma?

A

Surgical eradication (resection, ablation with cryotherapy, embolization of arteries)

29
Q

What type of staging is used in renal cell carcinoma?

A

TNM and Robson staging

30
Q

Which stages of renal cell carcinoma do you treat with resection and which do you treat with palliative care?

A 
I-III = resection
IV = palliative care
31
Q

What are the two most common types of renal cell cancer?

A

Clear cell and papillary

32
Q

Papillary renal cell carcinoma looks like ____-____ projections on the tumor

A

Finger-like

33
Q

Type of kidney cancer that begins in the blood vessels or connective tissue of the kidneys

A

Renal sarcomas

34
Q

Where does transitional cell cancer typically reside?

A

Bladder

35
Q

Most common study for bladder, kidney abnormalities

A

Intravenous pyelogram

36
Q

What is one major risk factor for transitional cell cancer?

A

SMOKERS! Half of the cases

37
Q

Which chemical exposure puts a patient at a risk for transitional cell cancer?

A

Aniline dyes (leather woodwork)

38
Q

Symptoms of urothelial carcinoma

A

PAINLESS hematuria- typical
Similar to Renal Cell presentation - may have more back pain
If involving the ureters/bladder may have dysuria

39
Q

How do you diagnose urothelial carcinoma?

A

Cystoscopy and Biopsy

40
Q

Cancer of the mucosal lining of the bladder

A

Urothelial carcinoma (Renal pelvis, Ureters , Urethra)

Urothelial carcinoma = Transition cell cancer

41
Q

What can lead to invasive urothelial carcinoma without warning?

A

Urothelial Carcinoma in situ (CIS)

42
Q

CIS and low-grade papillary urothelial carcinoma can be treated with?

A

Bacillus Calmette –Guerin (BCG)

This is the TB vaccine!

43
Q

Recurrent CIS or invasive urothelial carcinoma must be treated with?

A

Resection of all or part of the bladder with/without chemotherapy

44
Q

Monitoring the cytology of a patients urine who has or had urothelial carcinoma frequently gives an almost ____% survival rate

A

100%

45
Q

Common spots of METS for urothelial cancer?

A

Lungs, liver, bones

46
Q

Tumor occupying the renal pelvis and into upper and mid pole calyces

A

Transitional cell CA - renal pelvis

47
Q

Transitional cell carcinoma is most commonly associated with?

A

The bladder

48
Q

Most common neoplasm arising from the kidney in 9/10 cases?

A

Renal cell cancer

49
Q

What are the two major groups of malignant tumors int he kidneys?

A

Wilms tumor and renal cell carcinoma

50
Q

What type of pattern would you describe a renal cell cancer that has proliferation along fibrovascular core?

A

Papillary

51
Q

What is the first line treatment for RCC?

A

Resection

52
Q

Does transitional cancer have a high chance of recurrence?

A

Yes

53
Q

1 risk factor for bladder cancer??

A

Smoking!

Clin Med Renal (4 decks)

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