Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

GU > Lecture 6: Other Renal Disorders > Flashcards

Lecture 6: Other Renal Disorders Flashcards

(51 cards)

Start Studying
1
Q

When are renal cell carcinomas most common and in who?

A
  • Usually in males
  • 60s

Most common type of renal cancer.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the primary cause of RCCs?

A

Idiopathic, sporadic.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the risk factors for developing RCCs?

A
  • Poor lifestyle
  • Chronic diseases (chronic kidney stones)
  • Substance abuse (smoking esp)

analgesics are specifically more toxic to kidneys.

Smoking is the biggest risk factor!!!!!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the primary type of RCC?

A
  • Clear cell carcinoma
  • Arise from epithelial cells of proximal tubule

75-85% of all RCCs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is unique about a papillary tumor?

A
  • Usually bilateral
  • Usually multifocal
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the S/S of RCCs?

A
  • Hematuria (#1)
  • Flank pain or abdominal mass
  • Metastatic disease symptoms (cough, bone pain)

Usually, the tumor is found incidentally and asymptomatically

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the classic triad of RCCs?

A
  1. Hematuria
  2. Flank pain
  3. Abdominal mass
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What CBC findings are expected in a patient with RCC?

A
  • Anemia (MC)
  • Erythrocytosis

Anemia is due to either heavy hematuria or cancer taking up tissues that make EPO.
Erythrocytosis: pretends to be EPO tissue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is stauffer syndrome?

A

Hepatic dysfunction with elevated LFTs in the absence of metastases

Kidneys are in close proximity to the liver.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

If I see a solid renal mass, what should I suspect and order?

A
  • Any solid renal mass is guilty until proven innocent!
  • Initial with US, but preferred CT or MRI.
  • MRI or US w/ doppler is to check for IVC involvement.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the standard evaluation for a suspected RCC?

Labs and imaging

A
  • CT abd/pelvis
  • CXR/CT chest
  • CMP, CBC, UA, urine cytology

Liver: possible metastases or stauffer syndrome
Chest cavity: metastases
CBC: anemia or erythrocytosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How do the 4 stages of RCC progress in general?

A
  • Increasing in size
  • Stage 3 invades the IVC.
  • Stage 4 involves regional lymph nodes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the primary treatment for RCC?

A
  • Surgical excision via radical nephrectomy
  • Can consider partial.
  • Chemo is not very effective.

Radical involves removal of kidney, ipsilateral adrenal gland, and adjacent lymph nodes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the survival rate of an RCC confined to the capsule?

A

90-100%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Who is nephroblastoma/Wilms tumor most common in?

A

Pediatric patients who are otherwise healthy.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the etiology of a nephroblastoma and characteristics?

A
  1. Abnormal renal development
  2. Loss of tumor suppressor and transcription gene functions
  3. Generally sporadic.
  4. Presents as a single unilateral lesion usually.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are the primary S/S of a nephroblastoma?

A
  • Abd pain (MC)
  • HTN
  • Hematuria
  • Fever, anemia, N/V

Abd mass symptoms.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is the preferred initial study for nephroblastoma?

A

Abd US

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is the primary treatment for nephroblastoma?

A

Surgical resection followed by chemo

High survival unless advanced.

Cancer can relapse, so monitoring is required.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is difficult about diagnosing an oncocytoma?

A

A generally benign tumor that is indistinguishable from RCC on imaging.

Trreatment is identical.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Who is an angiomyolipoma MC in?

Study These Flashcards
A

Middle-aged women

22
Q

How is an angiomyolipoma treated?

Study These Flashcards
A
  1. Bleeding = embolization or nephrectomy
  2. > 5cm = prophylactic embolization

Usually benign, but bleeding risk increases if big

23
Q

What are the most common metastases for secondary renal cancer?

Study These Flashcards
A
  1. Lung (MC)
  2. Breast, stomach, kidney
  3. Lymphoma (sometimes)

AKA lung cancer metastasizing to the kidney.

24
Q

Who are kidney stones more common in?

Study These Flashcards
A
  • Males, esp 30s-50s
25
What are the risk factors for urinary stone disease?
1. High protein and salt intake 2. Inadequate hydration 3. High humidity and elevated temps | Primary goal is to prevent the crystals from clumping
26
What are the 2 primary substances that kidney stones are made of?
1. Calcium Oxalate 2. Calcium Phosphate | Calcium is visible on XRAY ## Footnote KUB XRAY
27
What is the most common urinary stone not made of calcium?
Uric acid stones (gout)
28
When do urinary stones cause symptoms?
Entering ureter | Stone size does not correlate with symptom severity.
29
What are the S/S of urinary stone disease?
1. Acute, severe pain in the flank (often episodic) 2. Urinary urgency and frequency 3. N/V common | Pain often follows the flank down the ureter.
30
What are the lab abnormalities associated with urinary stone disease?
* Hematuria * Abnormal pH ## Footnote Higher pH = calcium or struvite Lower pH = uric acid or cystine
31
If a patient presents with recurrent stones/FMHx, what tests can we order?
Patient must first decrease Na and protein intake, with increased fluid intake, and then you can order: * 24 hour urine * Serum PTH/calcium/uric acid/lytes/BUN/Cr * Litholink panel
32
What are the primary imaging modalities for kidney stones?
* KUB XRAY * Renal US * Noncontrast CT (in ER) | A noncon CT can detect all stones
33
What is a staghorn calculus?
* Renal pelvis involvement * 2 Calyces involvement
34
What is the treatment for urinary stone disease presenting as acute renal colic?
* Pain Control (NSAIDs or opioids) * Hydration (voluntary) * Alpha blocker (tamsulosin) * Steroids (maybe) | If obstruction + signs of infection = emergency
35
What is the MOA of tamsulosin and the main SEs?
* Alpha-1 antagonist * **Orthostatic hypotension**, HA, dizziness, abnormal ejaculation, or priapism ## Footnote Caution with other anti-HTNs
36
At what size do urinary stones tend to get stuck and where?
* > 10 mm generally do not pass. * Uteropelvic junction * Passage of ureter over iliac vessels * Ureterovesicular junction | Should pass within 4 weeks!
37
What is ureteroscopic stone extraction?
Small endoscope with a laser or mesh basket | OP procedure usually.
38
What is shock wave lithotripsy?
* Energy waves to break up stone. * Usually works on smaller stones. * Avoid in women of childbearing age!
39
What is percutaneous nephrolithotomy?
* For large stones or inferiorly located. * Needle with ureteroscope to pull out the stone | Requires incision in the flank
40
How do you prevent kidney stones?
* Drink water frequently * Eat bran (can decrease calciuria) * DO NOT DECREASE dietary calcium | Decreasing Na and protein is better for preventing stones.
41
What is the primary cause of hypercalciuric stones?
Absorptive hypercalciuria, characterized by increased urine Ca even without high dietary Ca intake. | High Ca absorption in small bowel.
42
What can be given to treat hypercalciuric stones?
* Thiazide diuretics (decreases calciuria) * Cellulose phosphate
43
What is resorptive hypercalciuria and its treatment?
* Secondary to hyperparathyroidism. * Presents with hypercalcemia, hypophosphatemia, and elevated PTH * Need to treat elevated PTH. (Cinacalcet?)
44
What is renal hypercalciuria and its treatment?
* Secondary to tubule instability in reabsorbing Ca * Presents with normal or low serum calcium, but high urine calcium * Treated with thiazides
45
What are hyperoxaluric calcium stones and the usual precipitating factors and the treatment?
* Primarily oxalate stones. * People with intestinal disorders, such as IBD. * Treatment is stopping their diarrhea or calcium carbonate. | Avoid excess ascorbic acid ## Footnote A result of absorbing more oxalate than calcium.
46
What causes hyperuricosuric calcium stones?
* Dietary purine excess or uric acid metabolic defects. * Purine restriction works well, but can use allopurinol as well. | Avoid meat and alcohol?
47
What causes hypocitraturic calcium stones and treatment?
* Chronic diarrhea, HCTZ, or metabolic acidosis. * Either drink lemonade or potassium citrate supplements
48
What are uric acid calculi usually caused by?
* Hyperuricemia * Myeloproliferative disease * Cancer * Abrupt weight loss | High cell turnover => uric acid ## Footnote Usually still visible on XRAY due to some calcium.
49
What pH are uric acid calculi and treatment?
* Generally < 5.5 (they have acid in the name) * Boosting the pH can make them easier to pass. * Treatment: potassium citrate or allopurinol.
50
Who are struvite calculi MC in?
* Women with recurrent UTIs with urease-producing organisms * Can present as staghorn calculi
51
What is a cystine calculi?
* Abnormal cystine excretion 2/2 genetic predisposition * Can prevent stones by upping urine pH to > 7 * Treated with potassium citrate or bicarb. * Often described as smooth-edged ground glass on XRAY (FYI) | Need to pee 3-4L/day!!!!!

GU (14 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions