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