05b: Urinary tract/Kidney Flashcards Preview

Oncology > 05b: Urinary tract/Kidney > Flashcards

Flashcards in 05b: Urinary tract/Kidney Deck (46):
1

Most common presenting feature of genitourinary tract cancer

Hematuria

2

The vast majority of renal tumors in adults prove to be (X), (benign/malignant) tumors.

X = clear cell renal tumors (80%)
Malignant

3

T/F: Autosomal dominant polycystic kidney disease (ADPKD) does not increase risk of renal cancer.

True

4

T/F: Renal cancer accounts for under 3% of all malignancies in adults.

True (2.6%)

5

T/F: Cancer of renal pelvis arises from renal epithelium and accounts for 40% of renal cancers.

False - considered urothelial (transitional cell) cancer and accounts for 5% of renal cancers

6

Genetic disorders that increase irsk of CCRC carcinoma:

1. von Hippel-Lindau disease
2. Familial chromosome 3 translocations
3. Tuberous sclerosis

7

Non-genetic diseases/factors that increase irsk of CCRC carcinoma:

1. ESRD (acquired cystic kidney disease)
2. Smoking (2-4x risk)
3. Heavy metal exposure (2-4x risk)

8

CCRC carcinoma: cells of origin?

Prob proximal tubule

9

CCRC carcinoma: cells are filled with (X) and express high levels of (Y) growth factor.

X = lipid (high glycogen content)
Y = VEGF (highly vascular)

10

Classic triad of CCRC:

1. Flank pain
2. Hematuria
3. Abdominal mass

**found in less than 10% of cases! So many various Sx presentation

11

The "internist's tumor"

CCRC (due to wide breadth of paraneoplastic features/Sx)

12

CCRC carcinoma: most effective therapy

Nephrectomy

13

CCRC carcinoma: 5y survival if disease confined in renal capsule is (X)%.

X = 90

14

CCRC carcinoma: 5y survival if disease invades renal capsule but has not spread past (X) is (Y)%.

X = Gerota's fascia
Y = 60

Stage III

15

CCRC carcinoma: 5y survival if disease spreads beyond Gerota's fascia is (X)%

X = 10%

Locally invasive - Stage IV

16

(X) renal cell cancers may undergo spontaneous remission. Which characteristic of this cancer may account for this?

X = CCRC carcinoma

This carcinoma may be relatively responsive to chances in host immunity

17

T/F: Renal cancer responds poorly to conventional cytotoxic chemotherapy and radiation therapy.

True

18

T/F: Renal cancer that responds to chemo "completely" implies the patient has been cured.

False! Indicates disappearance of radiographic evidence of tumor, but relapses may occur

19

CCRC carcinoma: 5y survival if disease spread to renal vein is (Y)%.

Y = 60%

Stage IIIA

20

CCRC carcinoma: 5y survival if disease spread to one lymph node is (Y)%.

X = 20%

Stage IIIB

21

Von Hippel-Lindau (VHL) disease: most common cause of death

CCRC carcinoma

22

Major renal cancer cell gene in adults:

VHL (tumor suppressor)

23

Von Hippel-Lindau (VHL) disease: inheritance pattern

AD

24

VHL protein function

Down-regulates hypoxia-induced genes by targeting HIF-alpha (TF) for destruction

25

Renal cancer: VHL loss results in overexpression of which key factors?

1. VEGF
2. PDGF-beta
3. TGF-beta

Angiogenic factors!

26

Renal cancer: VHL loss allows cancer cell to form cooperative relationship with (X)

X = neighboring endothelial cell (gives it oxygen, nutrients via neovascularization)

27

T/F: loss of second VHL allele results in renal cancer

False -forms cyst that (with additional mutations)can become cancer

28

(X) renal tumors are small (<5mm), present in (cortex/medulla) as pale yellow nodule with papillary growth pattern. If larger than (Y) size, they're re-classified as...

X = renal papillary adenoma
Cortex
Y = 3 cm
RCC (due to malignant potential)

29

List some tyrosine kinase inhibitor targets for RCC

VEGF-R
PDGF-R

30

List the urothelial tumor cell types and star the most common

1. Transitional cell* (95%)
2. Squamous Cell
3. Adenocarcinoma

31

Bladder cancer: (X) is the major risk factor and is responsible for (Y)% of cases

X = smoking (4x risk)
Y = 50

32

Chronic inflammation, such as in (X) conditions, increases risk of which urothelial cancers?

X = catheter or schistosomiasis

Squamous and transitional cell carcinomas of bladder

33

Which drug causes 9x increased risk of bladder cancer?

Cyclophosphamide

34

Bladder cancer: T1 involves (X) layer. T2 involves (Y) layer. T3 involves (Z) layer.

X = mucosa
Y = mucosa and muscularis
Z = mucosa, muscularis, and fat

35

Bladder cancer: Rx and prognosis for stage T1

TUR (Transurethral resection)
Good prognosis, but can recur

36

Bladder cancer: Rx and prognosis for stage T2

Cystectomy
60% 5y survival

37

Bladder cancer: prognosis for stage T3

10% 5y survival

38

Bladder cancer can be identified early with thorough work-up of (X) patients that present with (Y)

x = >40 years old
Y = hematuria (evaluate by cytoscopy)

39

Bladder cancer: Deletion of (X) is an early event. Deletion of (Y) happens later and has been linked to poorer prognosis.

X = chromosome 9q
Y = Rb and p53

40

List the two main benign tumors of the kidney

1. Renal papillary adenoma
2. Oncocytoma

41

(X) renal tumors are small (<5mm), present in (cortex/medulla) as pale yellow nodule with papillary growth pattern. If larger than (Y) size, they're re-classified as...

X = renal papillary adenoma
Cortex
Y = 3 cm
RCC (due to malignant potential)

42

Oncocytoma: composed of (small/large) (eosinophilic/basophilic) cells thought to arise from the (X) cells.

Large; eosinophilic
X = interacalated cells of collecting duct

43

Oncocytoma: (X) color and can grow up to (Y).

X = mahogany-brown
Y = 12 cm

44

Pt has renal mass resected that shows numerous mitochondria on EM. Which type of tumor is this a characteristic of?

Oncocytoma

45

Aside from the most common malignant renal tumor, (X), which other malignant tumors can arise in kidney? Star the one with the best prognosis.

X = CCRC carcinoma (80%)

1. Papillary carcinoma
2. Chromophobe renal carcinoma*

46

Characteristic chromosomal abnormalities of CCRC largely involve chromosome (X).

X = 3
loss of the short arm of chromosome 3 or translocations involving chromosome 3