Carcinomas

Question 1

In hydronephrosis, serum creatinine becomes elevated only if obstruction is?

Answer 1

bilateral or if patient has only one kidney

Question 2

PCT cells=>􏰁polygonal clear cells A filled with accumulated lipids and carbohydrates. Where is this found?

Answer 2

RCC

Question 3

MC symptoms of RCC?

Answer 3

Hematuria, palpable mass and flank pain

Question 4

MC renal malignancy?

Answer 4

RCC

Question 5

RCC pathogenesis?

Answer 5

Loss of VHL=>RCC (3 letters=Chrom. 3)=>increased IGF-1 and HIF=>Increased VEGF and PDGF

Question 6

RCC is associated with what kind of Syndromes?

Answer 6

Paraneoplastic (ectopic EPO, ACTH, PTHrP)

Question 7

RCC can present with?

Answer 7

Left sided Varicoele

Question 8

Where does RCC love to go?

Answer 8

Renal Vein and Retroperitoneal Node

Question 9

RCC sporadic form is found more in the _______ pole as a ________ tumor and it is most often found in patients that are __________?

Answer 9

Upper Pole, Single tumor, Smokers

Question 10

Compared to Sporadic, Hereditary is _________ and _______?

Answer 10

Multiple and Bilateral

Question 11

Renal Oncocytomas have same presentation as RCC, what is different?

Answer 11

The Cells: Large eosinophilic cells with abundant mitochondria without perinuclear clearing

Question 12

With VHL, where are the tumors?

Answer 12

Hemangioblastomas in cerebellum/brain, B/L RCC and Pheochromocytoma

Question 13

What does the VHL gene do?

Answer 13

Inhibits hypoxia inducible factor 1a

Question 14

MC type of RCC?

Answer 14

Clear Cell Type

Question 15

MC Renal Early Childhood (age 2-4)

Answer 15

Wilms Tumor

Question 16

Wilms tumor presentation?

Answer 16

large, palpable, unilateral flank mass

Question 17

What is the Beckwith-Wiedemann syndrome? Describe

Answer 17

Hypertrophy
Wilms tumor, macroglossia, organomegaly,
hemihypertrophy

Question 18

WAGR complex? Describe

Answer 18

Absence

Wilms tumor, Aniridia, Genitourinary malformation, mental Retardation (intellectual disability).

Question 19

Both VHL and WNT1/2 are what kind of genes?

Answer 19

Tumor Suppressor Genes

Question 20

VHL inheritance?

Answer 20

AD

Question 21

VHL is on Chromosome? WNT1 and 2 is on?

Answer 21

3

There are two 1’s=>11

Question 22

MC urinary tract tumor?

Answer 22

Transitional cell carcinoma

can occur in renal calyces, renal pelvis, ureters, and bladder

Question 23

Painless hematuria (no casts) suggests?

Answer 23

bladder cancer

Question 24

Bladder Cancer is associated with?

Answer 24

Pee SAC: Phenacetin, Smoking (cyclic aromatic hydrocarbons**), Aniline dyes, and Cyclophosphamide.

Question 25

Two pathways with TCC?

Answer 25

Flat and Papillary

Question 26

Which one is worse Flat or Papillary?

Answer 26

Flat

Question 27

Why is Flat worse?

Answer 27

Invades early and has early p53 mutation

Question 28

Chronic irritation of the bladder can lead to?

Answer 28

Squamous metaplasia=>Squamous cell carcinoma

Question 29

Risk factor for Squamous cell carcinoma? Who does it happen most in?

Answer 29

Schistosoma haematobium infection (Middle East)

Middle Eastern Male

Question 30

Adenocarcinoma of the bladder arises from?

Answer 30

urachal remnants

Question 31

Adenocarcinoma is found in the?

Answer 31

DOME of the bladder