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48 Cards in this Set

  • Front
  • Back
6 main causes of hematuria
Prostatic (BPH)
what tests for everyone who presents with gross, painless hematuria?
microscopy (urine culture)

WBC, platelet, creatinine, INR, PTT
how to distinguish b/w hematuria from glomerulonephritis and from malignancy in terms of microscopy and urine dipstick
microscopy: glomerulonephritis pts will have crenated RBCs, and RBC casts/granular casts

urine dipstick: glomerulonephritis pts will have severe proteinuria; whereas non-glomerular only shows trace protein
what is the most common cause of renal malignancies in adults?
RCC (90%)
RFs for RCC?
-hereditary aspect
-PATIENTS ON DIALYSIS (acquired cystic disease of dialysis)
von Hippel-Lindau syndrome is the best-known hereditary form of which cancer?
what is the "classic triad" and what are its components
=the three most common Sx a/w RCC. 10% of ppl with RCC have all three.

gross hematuria (40%)
flank pain (40%)
palpable flank mass (20%)
what are paraneoplastic syndromes a result of?
cytokines/hormones from teh primary tumor
list some paraneoplastic syndromes a/w RCC
elevated ESR
weight loss/cachexia
fever of unknown origin
polycythemia (erythropioetin)
stage T3a of RCC would be confined within...
gerota's fascia - but may invatde adrenal or perirenal fat
what is the only curative therapy for RCC
surgical resection
what does radical nephrectomy refer to?
complete removal of contents of gerota's fascia (kidney, perirenal fat, adrenal gland)
is RCC responseive to immunotherapy? chemotherapy? radiotherapy?
immunotherapy - no
chemotherapy - no
radiotherapy - no
where do you find most cases of TCC
in the bladder
occupational exposure to aniline dyes and aromatic amines is a RF for what cancer?
what are 5 different primary renal tumors?
1. RCC
2. TCC
3. oncocytoma (very low malignant potential)
4. sarcomas
5. wilms tumor
what is an angiomyolipoma?
benign lesion made up of SMCs, bl vessels and adipocytes

dx with a CT

not a tumor persay, more like a hamartoma
best Tx for a localized RCC in one kidney
if the opposite kidney is normal, your safest bet is to do a RADICAL NEPHRECTOMY

but if there is a clear margin of normal kidney around the tumor in the maimed kidney, then partial nephrectomy may be just as good a cure.
3 RFs for the development of TCC
1. smoking
2. previous abdominal/pelvic irradiation (e.g. Tx of cervix cancer)
3. exposure to aniline dyes and aromatic amines
what are the two common behaviours of TCC?
1. superficial (low grade)
2. muscle invasive (hi grade)
will bleeding in bladder TCC be constant or intermittent?
Tx options for pt with superficial TCC of the bladder
-transurethral resection of all visible tumors
-regular followup exams

IF tumor is multifocal, recurs radiply, or can't be fully resected, then:
-->intravesical chemo
Tx of TCC invading detrusor (invasive, hi grade)
radical cystectomy
-urine divered to ileum, or urinary resevoir made with a bowel segment
Tx for TCC of renal pelvis
a) with normal contralateral kidney/ureter
b) with metastatic TCC or locally advanced, unresectable
a) radical nephroureterectomy (kidney, ureter, and sm. cuff oc bladder)
b) chemo - but complete response rate = low
4 life threatening conditions that may present with abdominal/flank Sx similar to renal colic
1. abd. aortic aneurysm
2. abd. aortic dissection
3. ectopic pregnancy
4. appendicitis
is renal colic a/w nausea/vomiting?
if stone is <4mm, what is its chance of spontaneous passage?
if stone is b/w 5-7mm, what is its chance of spontaneous passage?
if stone is >8 mm, what is its chance of spontaneous passage
ESWL is best for stones that are under what size? if larger, why is ESWL not as useful
<20 mm
if larger, the fragments may still be too large to pass
waht stones are resistant to ESWL?
can you use ESWL in pregnancy?
what are teh most common types of stones
calcium oxalate
tea or cola coloured urine suggests
if you develop hematuria 1-2 days after an Upper rest tract infection, the Dx is usually
post-streptococcal GN
IgA nephropathy
is goodpasture's syndrome AB mediated>
which of teh following malignancies are often a/w pain/outflow obstruction

renal carcinoma
prostatic carcinoma
urethral carcinoma
bladder carcinoma
ureteric carcinoma

(whereas renal and bladder are usually painless)
80% of renal tumors of childhood are caused by?
wilms' tumor
name the tumor: a kidney tumor of renal blastema with a mix of primitive renal epithelial and stromal elements
wilm's tumor
name 3 types of urothelial carcinomas
1. TCC
2. squamous cell carcinoma
3. adenocarcinoma (rare)
schistosomiasis is a/w waht type of UT cancer?
urothelial ca.
from a histological p.o.v, what is the most common type of RCC?
clear cell
what do the "clear cells" in clear cell RCC contain
lipid and glycogen
why does RCC have a propensity to metastasize to the lung?
b/c it tends to invade the renal vein
besdies the lung, what is another common area that RCCs metastasize to?
waht is teh 5 year survival for RCC?
what are the 3 major ways of classifying TCCs?
noninvasive papillary


carcinoma in situ (hi grade)
what is the difference in nat. Hx of papillary TCC vs. carcinoma in situ (CIS) TCC?
papillary - generally low grade; can be resected; often recur - risk of developing CIS

CIS TCC: hi risk of evolving into invasive carcinoma