Clinical (Week 4) Flashcards Preview

Year 2 - Renal (DP) > Clinical (Week 4) > Flashcards

Flashcards in Clinical (Week 4) Deck (274)
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1

What is a hamartoma?

A tumour with the correct constituencies of the organ it's from but in wrong distribution

2

What is the most common renal pelvis tumour?

Transitional cell carcinoma

3

What is the most common renal parenchymal tumour?

Renal cell carcinoma

4

What is the most common renal embryonic tumour?

Nephroblastoma (Wilm's Tumour)

5

What sort of CT is useful in diagnosing a urological malignancy?

Triple phased contrast enhanced

6

What is the most common benign asymptomatic renal lesion?

Renal cyst (70%)

7

How do we investigate renal cysts and why can we use this modality?

USS (it is fluid-filled)

8

When would we biopsy an angiolypoma?

If fat-sparse:
- Risk of bled

9

What feature of vessels in an angiolypoma make it prone to bleeds?

They are fragile

10

How can we measure lesion density on a CT of angiolypomas?

Hounsfield

11

What is Wunderlich's Syndrome?

Collapse due to retroperitoneal bleed in an angiolypoma

12

How does an oncocytoma appear on CT?

Central scar:
- Stellate due to central necrosis
-> No angiogenesis therefore benign

13

What is the only way to definitively diagnose an oncocytoma and why is a biopsy not totally useful?

Nephrectomy
Biopsy has a high false negative rate

14

What is the classic triad of symptoms in a renal cell carcinoma?

Loin pain (40%)
Renal masses (25%)
Frank haematuria (60%)

15

Which of the following is not a paraneoplastic effect of renal cell carcinoma:
- Weight loss
- Hyperthyroidism
- Anaemia
- Hypertension
- Hypercalcaemia (As it produces parathyroid-like hormone)

Hyperthyroidism

16

What is the M:F ratio for the incidence of a renal cell carcinoma?

2:1

17

What is the peak incidence age for renal cell carcinoma?

65-75 years

18

What type of cancer of a renal cell carcinoma and where is it found?

Adenocarcinoma
The PCT

19

How do renal cell cancers appear histologically?

Clear cells
Papillary subtypes

20

If there are bilateral or multifocal renal cell carcinomas, what condition should you suspect and what implications does this have?

Von Hippel-Lindau:
- Implications for surgery

21

What is the first line investigation for renal cell carcinoma, and what is the best investigation?

1st line - USS
Gold standard:
- Triple phase contrast CT

22

What is the downside to using biopsy in the diagnosis of renal cell carcinomas?

High false negative rate

23

What staging system is used for renal cell carcinomas?

Robson

24

True or false; Direct perinephric fat invasion is rare in renal cell carcinomas?

True

25

How do renal cell carcinomas tend to spread?

Lymphatics
Via IVC

26

Where do renal cell carcinomas commonly spread?

Lungs ('Cannon ball' metastases)
Liver
Bone
Brain

27

What is the standard treatment for a renal cell carcinoma? What does the treatment involve?

Radical nephrectomy (preferably laparoscopically):
- Whole kidney within Gerota's fascia
- Perinephric fat removed

28

When is the standard treatment for a renal cell carcinoma most often carried out?

Within a month of diagnosis

29

When would the adrenal gland be removed in the treatment of renal cell carcinoma and why is it not routinely removed?

If it is involved
Reduces the risk of adrenal insufficiency (Addison's syndrome)

30

How is a partial nephrectomy carried out? What implications does this have on the operation?

Under cold ischaemic:
- Must be done in 20-30 minutes