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senior clerkship lectures > renal tumors > Flashcards

renal tumors Flashcards

1
Q

hematuria nephritic wala nephrotic

A

nephritic

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2
Q

which type of renal cell carcinoma is the most aggressive ?

A

medullary carcinoma

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3
Q

which RCC is associated with ESRD ?

A

papillary RCC

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4
Q

what is the most common type of renal cell carcinoma ?

A

clear cell (conventional) , associated with alteration in 3p

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5
Q

what grading system is used for clear cell RCC ?

A

fuhrman’s system

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6
Q

what is the clinical manifestation of hereditary papillary RCC ?

A

type 1 papillary RCC

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7
Q

what is the clinical manifestation of hereditary leiomyoma RCC ?

A

type II papillary RCC

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8
Q

what is the TNM staging in RCC ?

A

T1- confined to the kidney and is less than 7 cm
T2 - confined to thee kidney and more than 7 cm
T3a - locally advanced into renal vein adrenal or perirenal fat
T3b- IVC below diaphragm
T3c- IVC above diaphragm
T4- beyond gerota

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9
Q

what are the paraneoplastic syndromes associated with RCC ?

A

HTN
hypercalcemia
polycythemia or anemia
non-met hepatic dysfunction (stauffer syndrome)

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10
Q

what is stauffer syndrome ?

A

a paraneoplastic disorder associated with RCC , hepatic dysfunction without metastasis

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11
Q

when do we use MRI in renal investigations ?

A

if there is any suspected venous involvement

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12
Q

what is the management of RCC ?

A

surgery is the mainstay of treatment

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13
Q

what is the treatment of localized disease ?

A

T1and T2
radical nephrectomy
nephron sparing surgery

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14
Q

what are the alternatives to surgery in RCC ?

A

ablation ( radiofrequency/ cryoablation)

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15
Q

when is ablation indicated ?

A

1- for patients with significant comorbidities and small lesions which are
2- below 4 cm
3- peripheral
4- solid exophytic lesions

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16
Q

when is active surveillance indicated ?

A

elderly patients with significant comorbidities and small lesions ( which is less than 3 cm) with a slow growth rate

17
Q

what is the management of T3 tumors ?

A

surgical resection with vascular control

17
Q

is chemotherapy indicated in RCC ?

A

RCC is a chemoresistant tumor

17
Q

what is the management of metastatic disease ?

A

systemic therapy - immunological therapy , targeted therapy. with tyrosine kinase inhibitor

surgical resection : cytoreductive nephrectomy , metastatectomy

18
Q

what are the differential diagnosis for RCC ?

A

AML - Angiomyolipomas
Oncocytoma

19
Q

what is the hereditary association with upper tract TCC ?

A

lynch syndrome

20
Q

what type of nephropathy is associated with upper tract TCC ?

A

balkan nephropathy

21
Q

what is the genetic inheritance associated with upper tract tcc ?

A

autosomal dominant

22
Q

what are the differential diagnosis of filling defect in upper tract TCC ?

A

radiolucent stone
clot
fungus ball
TB

23
Q

what is the management of upper tract TCC ?

A

radical nephroureterectomy with excision of bladder cuff
endosccopicc resection

24
Q

what topical treatment can be used for upper tract TCC ?

A

BCG

25
Q

at what age is wilm’s tumor most common at ?

A

1-4 year old

26
Q

what is the predisposition of wilms tumor ?

A

deletion of the short arm of chromosome 11

27
Q

what are thee associated syndromes with wilms tumor ?

A

WAGR syndrome
wilms
anirridia
GU abnormalities and mental retardation
beckwith-wiedemann syndrome

28
Q

what is the presentation of wilms tumor ?

A

painless firm mass on examination
hematuria
fever
associated syndromes

29
Q

what is the best mode of investigation for screening for wilms tumor ?

A

abddominal US

30
Q

what imaging modality is best for diagnosis and staging of wilms tumor ?

A

abdominal CT/MRI

31
Q

what is the gold standard for treatment of wilms tumor ?

A

radical nephrectomy

32
Q

what are thee other treatment modalities for wilms tumor?

A

very radio and chemo sensitive

33
Q

what is the prognosis of wilms tumor ?

A

generally favorable and stage dependent

senior clerkship lectures (25 decks)

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