Renal Neoplasms & Failure Flashcards
What is the most common abdominal solid tumor in children?
Nephroblastoma/Wilms tumor
What population is likely to have nephroblastoma?
Children
Most often, diagnosis of nephroblastoma is made after…
recognition of an abdominal mass
What are some symptoms of nephroblastoma?
- Abdominal pain
- Intestinal obstruction
- Hypertension
- Hematuria
- Symptoms of traumatic tumor rupture
A child presents with abdominal pain and blood in their urine. Upon taking vitals, the child is hypertensive. Upon palpation, an abdominal mass is recognized.
What is the likely diagnosis?
Nephroblastoma/Wilms tumor
What is the most common primary cancer of the kidney?
Renal cell carcinoma
When in life does renal cell carcinoma incidence peak?
In the sixth decade
Which sex is more often affected by renal cell carcinoma?
Twice as often in men as women
What is the clinical triad of renal cell carcinoma?
- Hematuria
- Flank pain
- A palpable abdominal mass
A 56-year-old male patient complains of flank pain. Upon palpation, you find an abdominal mass. With further questioning, the patient reveals he has had what appears to be blood in his urine.
What is the likely diagnosis?
Renal cell carcinoma
A patient presents with sudden hematuria. During history, they say they have a history of smoking cigarettes and has worked in the textile industry for a long time (azo dyes present). Patient does not report any dysuria or recent infections.
What is the likely diagnosis?
Urinary bladder carcinoma (transitional)
Urinary bladder carcinoma is most commonly which type of cancer?
Transitional cell carcinoma
What is the less common type of bladder carcinoma?
Squamous cell carcinoma
A patient reports he has a history of prostate cancer which he received radiation therapy for. He admits that he has been smoking for 10 pack years as well. Suddenly, he is finding blood in his urine and is worried he may have prostate cancer again.
What is the likely diagnosis?
Urinary bladder cell carcinoma (tansitional)
What are the most important etiologies of urinary bladder carcinoma?
- Cigarette smoking
- Industrial exposure to azo dyes
- Infection with S. haematobium (in endemic regions)
- Drugs, such as cyclophosphamide and analgesics
- Radiation therapy (following cervical, prostate, or rectal cancer)
What is the typically clinical manifestation of urinary bladder carcinoma?
Sudden hematuria and, less often, dysuria
At the time of urinary bladder carcinoma presentation, ___% of tumors are confined to the urinary bladder
85%
At the time of urinary bladder carcinoma presentation, is it more likely that tumors are confined to the bladder or that they have spread?
More likely confined (85% of the time)
Etiologies of renal failure may be classified in terms of…
prerenal, renal, or postrenal
What are some prerenal causes of kidney failure?
- Hypovolemia (ie. hemorrhage, congestive heart failure)
- Hypotension
Are these etiologies of kidney failure prerenal, renal, or postrenal?
- Hypovolemia
- Hypotension
Prerenal
Hypovolemia and hypotension both lead to…
acute kidney injury and necrosis
How might a kidney appear if it has been injured by hypovolemia or hypotension?
Swollen, with a pale cortex and a congested medulla
What are some renal causes of kidney failure?
- Glomerulonephritis
- APCK
- Diabetic nephropathy
- Acute tubular necrosis
(Any primary kidney pathology)
What is the leading cause of acute kidney injury?
Ischemia
Ischemia has caused acute kidney injury
This will cause rapidly rising ___, usually with decreased ___
rising serum creatinine, usually with decreased urine output (oliguria)
What are some postrenal causes of kidney failure?
- BPH (benign prostatic hyperplasia)
- Nephrolithiasis
Are these etiologies of kidney failure prerenal, renal, or postrenal?
- Glomerulonephritis
- APCK
- Diabetic nephropathy
- Acute tubular necrosis
Renal
Are these etiologies of kidney failure prerenal, renal, or postrenal?
- Benign prostatic hyperplasia (BPH)
- Nephrolithiasis
Postrenal
What is the etiology of nephroblastoma?
Mutation in WT gene (tumor suppressor)
