Renal Carcinomas Flashcards Preview

Foundations II Exam 5 (Jess) > Renal Carcinomas > Flashcards

Flashcards in Renal Carcinomas Deck (24):
1

MC primary renal malignancy

renal cell carcinoma

2

MC age and gender a/w renal cell carcinoma

6th-8th decade, ~64 avg
M>W

3

Risk factors for renal cell carcinoma

SMOKING!!!
HTN
Obesity
chronic dialysis
toxic exposures
heavy aspirin, NSAIDS
genetics

4

MC type of renal cell carcinoma? What is the genetic mutation?

Clear cell
deletion of chromosome 3p

5

What are the usual sx of renal cell carcinoma?

usually asymptomatic until advanced disease
-hematuria
-abdominal mass
-flank pain

Others:
weight loss
scrotal varicocele

6

What is the usual diagnostic scan for renal cell carcinoma?

CT abd w/ & w/o contrast

7

What must be done w/ all solid renal masses and why?

tissue biopsy
even smaller masses may by malignant

8

In what type/stage of RCC is surgery curative?

localized RCC (stages I, II, III)

9

What is considered a small renal mass?
why is increasing size important?

< 4 cm
the larger the mass, the more likely it is high-grade or advanced RCC

10

What studies/management is indicated w/ a small renal mass?

-urology
-dedicated renal CT or MRI w/o and then w/ contrast
-CMP and BMP- paraneoplastic syndrome
-renal fxn to eval for CKD
-chest imaging for mets
-biopsy

11

When is surveillance an option with small renal masses?

if the mass is < 1 cm

12

MC type of renal tumor in children?

Wilms tumor

13

MC presentation of pt w/ Wilms tumor?
Other sx?

Abdominal mass= MC

others:
-abd pain
-hematuria
-fever
-hypertension

14

What is the initial study done in pts done w/ possible Wilms tumor?
What is done for definitive dx?

initially= abd U/S

Definitive= histologic confirmation (surgical excision or biopsy)

15

What is tx for Wilms tumor? Prognosis?

chemo and surgical excision

good, 5-year survival 90%

16

What does renovascular disease cause?

Secondary HTN

17

What is gold standard for diagnosing renovascular diseases?
But... what is more commonly done?

Duplex Doppler US= gold standard

CTA = MC

18

What is the cause of atherosclerotic renal artery disease?

reduced blood flow to kidney
usually involves aortic orifice or proximal main renal artery

19

What are Risk factors for atherosclerotic renal artery stenosis?

-hyperlipidemia
-cigarette smoking
-age > 50

20

What result is needed for dx of atherosclerotic renal artery stenosis?
how do you treat?

luminal occlusion of at least 60-75%

Tx:
tx HTN, monitor CKD, revascularization

21

What age group/gender is most at risk for fibromuscular dysplasia?

women < 50 yo

22

What is fibromuscular dysplasia?

noninflammatory, nonatherosclerotic disorder leading to arterial stenosis, occlusion, aneurysm, dissection, and arterial tortuosity

23

What are clinical signs of fibromuscular dysplasia?

-HA, pulsatile tinnitus, neck pain, flank pain, abd pain
-HTN, cervical or abdominal bruit, TIA, stroke

24

How do you manage fibromuscular dysplasia?

-ACE or ARB
-Surgical= angioplasty