Renal Cell Carcinoma for USMLE

No video

Renal Cell Carcinoma for USMLE

Рет қаралды 64,516

9 жыл бұрын

Renal Cell Carcinoma Anatomy, Epidemiology, Etiology, Clinical Signs and Symptoms, Treatment and Management. Handwritten, full lecture for medical students taking USMLE.
Renal Cell Carcinomas make up 90-95% of kidney neoplasms.
ETIOLOGY of Renal Cell Carcinoma
Smoking is the largest risk factor. Obesity and Hyppertension is a known risk factor for Renal Cell Carcinoma in Women. Occupational Exposure such as Trichloroethylene, Benzine, Herbicides, Vinyl Chloride. Drugs associated with Renal Cell Carcinoma (phenacitin). Long term dialysis increases the risk of cystic Diseases which increase risk of renal cell carcinoma.
Von Hipel Lindau - Loss of 3p increases HIF which increases angiogenesis. Also increase risk of pheochromocytoma, pancreatic cysts/islet cell tumors, retinal angiomas, CNS hemangioblastomas.
Hereditary Papillary Renal Carcinoma - MET Gene mutation of tyrosine kinase domain and will have bilateral multifocal papillary renal cell carcinoma.
Burt-Hogg-Dube Syndrome - Bilateral Multifocal oncocytoma which has a better prognosis. Also may cause pulmonary and colonic tumors.
CLINICAL SIGNS AND SYMPTOMS of Renal Cell Carcinoma.
The three most common presenting signs and symptoms is flank pain, hematuria, flank mass. A large percentage of patients may be asymptomatic. Patients with renal cell carcinoma may also have wieght loss, varicocele, malaise, fever.
Paraneoplastic syndromes are very common in renal cell carcinoma. Increase EPO may lead to polycythemia, Renin production may lead to hypetension. Finally may also have hypercalcemia, polyneuropathy.
Shauffer Syndrome - Non-metastatic Hepatic Dysfunction and therefore it is important to monitor liver function, even if no metastasis has occurred.
Metastasis to Lungs (45%), Soft tissue and Liver.
Work Up for Renal Cell carcinoma
Labs - Urinalysis, CBC, Electrolytes, Renal Profile, LFT (AST/ALT) and Serum Calcium.
Imaging - CT scan is the imaging of choice and can identify the tumor and rule out cystic mass. Also allows visualtion of Lymph nodes, Renal Vein, IVC and helps rule out angiolipoma.
For staging abdominal ;pelvic CT with or without contrast. Chest X-ray and Brain MRI.
Histology
Clear Cell Carcinoma - 75%, lipid/glycogen
Chromphilic - Bilateral mulftifocal
Chromophobic - Large polygonal Cells
Oncocytoma - Rarely metastasize
Collecting Tubules
STAGING OF Renal Cell Carcinoma
Stage 1 - Within the kidney and less than 7cm.
Stage 2 - Within the kidney and greater than 7cm.
Stage 3 - Invasion Renal Vein and Inferior Vena Cava or Adrenal Gland, but does not invade Gerota's Fascia
Stage 4 - Extends below Gerota's Fascia, invade nearby lymph nodes and metastasis to organs.
MANAGEMENT of Renal Cell Carcinoma
Surgical
Partial nephrectomy for stage 1 and sometimes stage 2
Radical Nephrectomy - remove complete removal of Gerota's fascia, Removal of kidney with adrenal gland, dissect enlarge lymph nodes.
Palliative Nephrectomy - remove kidney to alleviate pain, polycythemia and hypertension.
Adjuvant Treatment for Renal Cell Carcinoma
Biologic Response Mediators - IL2 (activates T Cell and NK), IFN
Molecular Targeting - Suritinib, Bevacizumab, Dazopomib, Temsirolimu, Sorafenib.
Chemotherapy - 5 floururacil, Vinblastine, Paclitaxel, Caboplatin, Ifosfamide, Gemcitabine.
Radiation - Renal Cell Carcinoma is not sensitive to radiation but the brain metastasize are sensitive.
Renal Artery Embolization inject ethanol or gelatin sponge pledgets in artery feeding tumor to help kill off the tumor. Also done palliative for non-surgical patient.

Пікірлер: 42

@Be1smaht 2 жыл бұрын

You are a life savior people don’t understand how imp, this is

@dr.yannish1120 4 жыл бұрын

Right from Robbins !! Though saved the time ♥️

@pramitpratimdas8198 7 жыл бұрын

Slight correction - Stauffer syndrome otherwise great video. Very helpful.

@nishanthnagendran7901 6 жыл бұрын

Extremely helpful thank you so much

@suprateekat5338 5 жыл бұрын

Great video. How do you differentiate whether it is a solid tumour mass or a cystic mass on abdo CT?

@Roger-hu4tk 3 жыл бұрын

Thank you so much, please update more

@dr.ahmedkhalifa5966 8 жыл бұрын

Really Excellent and helpful

@mazharshaukat1300 6 жыл бұрын

It was such a nice video, covering all aspects of the topic. Thanks, helped alot.

@waqarhassanpk 4 жыл бұрын

Hello, a future urologist here, and believe it or not but my exam is tomorrow and right now i am going through this video and thinking, oh man how easy have you summarized this topic. I was wondering if you could tell me what gadget do you use for this note taking and what app. Also, if you could share this file so that i could add my notes on top of that. Thanks

@chetanchetan23 8 жыл бұрын

video is simply outstanding. thanks.

@thestudyspot 8 жыл бұрын

+chetanchetan23 Thank you, glad you found it hlepful

@vino1234567890123 6 жыл бұрын

Good one.... thanks a lot.

@Drdahri 4 жыл бұрын

Very good video but there should be 3 to 5 scenario bcqs in last after covering the topic...this will help alot ...

@nataliegudzman6462 3 жыл бұрын

My mother was able to overcome her colorectal cancer naturally via the professional guidance of an African herbal practitioner - Dr. Harry Obiego. My mother had undergone a biopsy in March 7th, 2019 that revealed she was suffering from stage IV colon cancer after having experienced loss of appetite, loss of weight, diarrhea and vomiting in her late fifties. Although, the symptoms had only started to occur at the critical stage of this condition. After receiving the news of my mother's exposure to terminal colorectal cancer, the whole family was completely taken aback at this discovery and at that critical point in time the family instantly became attuned to her ordeal. The medical expert had informed us that she had a relative 5-year survival rate of about 14%. But inwardly, I knew the year survival rate could be lesser than that, especially when the symptoms had grown more persistent and as the cancer in the colon was spreading to distant organs and tissues. A surgery was clearly detrimental at that period of time and as such, was totally out of the picture. For the betterment of her condition I took it upon myself to carry out an extensive research in accordance with the nature of this disease and holistic remedies in overcoming it. Initially, I knew this possibility for a permanent remedy could be futile, but I had never wanted to take defeat as an option. It was during my relentless search for an everlasting remedy for this disease that I had came across the talented works of this herbal expert - of whom is fully responsible for my mother's complete recovery from colon cancer. . I had seen some testimonial articles on the net in relation with the professional, herbal standards of this African talented herbalist Dr. Obego and his successful theories in overcoming most life threatening cancers naturally. There was a testimonial article shared by a woman about this herbalist assisting her overcome her lupus and cancer problems in the most natural way. I was elated in receiving the news as I could clearly relate to the woman who had pictured her health problems in the shared testimonial. I had decided to inquire more about healing colon cancer naturally when I had contacted this herbal practitioner for more elaboration regarding this natural remedy for my mom's condition. I was very pleased at the doctor's hospitality in wanting to help my mother beat this disease naturally. With a given illustration of the possibility of reversing the disease naturally the herbalist had administered some herbs of which my mother had used in a little period of time before her absolute recovery had set in. In some few weeks of usage of these recommended herbs by my mother the colon cancer was completely gone. It was a miracle as our medical specialist in Oslo had confirmed that the colon cancer was completely eliminated. My mother is now completely freed from colon cancer as a result of trying this natural remedy to a successful outcome. I wish to use this medium to reach out to anyone facing any similar health problems or the other to find a confidant like Dr. Harry Obego in overcoming their health problems. For more reliable insight to this naturopathic therapy for cancer you can contact Dr. Obego directly via his email address: drharryobego@gmail.com. Whatsapp: +234901 616 1406.

@doc.mai1 5 жыл бұрын

thank you so much! how do you tell the difference between renal cell carcinoma and renal transitional cell carcinoma?

@fantasyx0x0 4 жыл бұрын

Thank you you make it easy for me

@HafizahHoshni 7 жыл бұрын

thanks a lot for the great video!

@mcsmama 6 жыл бұрын

Well done... thanks so much for this! :)

@HafizahHoshni 6 жыл бұрын

thank you so much! 27/5/2018 :D

@indigomelendez5903 4 жыл бұрын

Learned so much thank you!

@rahmahl5762 4 жыл бұрын

im thanking him from 26 march 2020 :D

@bilalmarwat81 2 жыл бұрын

correction Please.. RCC is More common in Men men to women Ratio 2:1

@ismailsaad5107 3 жыл бұрын

Thank you 2021❤🤟

@zendelosreyes6300 3 жыл бұрын

Hi sir! what application are you using in making the video? thanks

@dr.ayousuf6465 8 жыл бұрын

this was really helpful!!thanks :)

@dr.gokulprakash8222 8 жыл бұрын

Thankx much

@basharnassar7384 4 жыл бұрын

Is that for step 2?

@ronkmossawi493 6 жыл бұрын

thanx verrrryyyyyyyyyyyyyy much ))

@romaisa4446 8 жыл бұрын

hello I wounder if you can help me please I had a kidney pain 15 years ago I was given pain an unknown killer in that time since then blood shows a urine in strip test CT scan and Cystoscopy was negative I t's now over 14 years because I have pain related to IBS lower left abdominal pain dry lips fatigue and it's impossible to sleep on my right side because of the pain it causes I appreciate any advice or help given I start to doubt Doctors are not telling the truth about my CT scan I don't smoke or drink regards

@thestudyspot 8 жыл бұрын

+roma isa My advice to you is to find a doctor you can trust. It would be literally impossible for me to try and figure out what is medically wrong with you without the ability to do physical examination and run some tests. Healthy skepticism about your doctor is helpful because there are many out there that are either sometimes too dismissive of patients or make mistakes. But thank god there are many great doctors out there who do the best they can do for all of their patients. That is why I think continue looking for a doctor that you feel comfortable with and takes your medical issues seriously. I am sure you will find one.

@thestudyspot 8 жыл бұрын

+the study spot Also, having blood in your urine is very serious and if you are still having that, you need to figure out why.

@dominiclai2528 8 жыл бұрын

Excellent and very informative. I really enjoy your presentation style. Do you mind sharing what software you used to create this? Do you know if a presentation like this can be given live vs. pre-recorded? Thank you.

@thestudyspot 8 жыл бұрын

+Dominic Lai I use Microsoft OneNote. I do sometimes give the presentations pre-recorded to medical students in the hospital. I just turn the sound off and start talking. Live would be possible, but you would have to write quickly and neatly so it may be a little impractical.

@dominiclai2528 8 жыл бұрын

+the study spot Thank you!!