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Urogenital 2 > Bladder and Kidney Cancer > Flashcards

Bladder and Kidney Cancer Flashcards

1
Q

What are the main risk factors of bladder cancer?

A

PeeSAC
Chronic cystitis
Long term catheter
Pelvic radiotherapy

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2
Q

What does PeeSAC stand for in terms of bladder cancer risk factors?

A

Phenacitin
Smoking (#1 risk factor)
Analine
Cyclophosphamide

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3
Q

What is the most common type of bladder cancer?

A

Transitional cell carcinoma

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4
Q

What are the two main types of bladder cancer?

A

Urothelial

Non-urothelial

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5
Q

Non-urothelial consists of what types of bladder cancer?

A

Adenocarcinoma

Squamous cell carcinoma

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6
Q

What defines a low grade urothelial carcinoma?

A

Non muscle invasive

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7
Q

What are the major presenting features of bladder cancer?

A

Haematuria (visible/invisible)

Weight loss/loss of appetite

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8
Q

What are the two types of renal cancer?

A

Renal carcinoma

Urothelial cancer

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9
Q

What are the different types of renal carcinoma?

A 
Clear cell
Papillary type 1 & 2
Chromophobe
Collecting duct
Renal medullary
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10
Q

What is the meant by urothelium?

A

Special type of transitional epithelium of the bladder.

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11
Q

What step precedes squamous cell carcinoma?

A

Squamous cell metaplasia

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12
Q

Squamous cell carcinoma of the bladder is commonly caused by what?

A

Chronic irritation e.g urinary tract infection or kidney stones.
Schistosoma parasitic infection

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13
Q

How does schistosoma parasitic infection cause squamous cell carcinoma?

A

Schistosoma causes chronic inflammation of the bladder.

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14
Q

Primary adenocarcinomas of the bladder are commonly derived from where?

A

Glandular tissue (therefore produce mucins)

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15
Q

What is the allantois?

A

Allowed urine to flow from the fetal bladder to the amniotic sac.

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16
Q

What is the urachus?

A

The embryological remnant of the allantois.

17
Q

What are the two main types of urothelial carcinomas?

A

p53 dependant

p53 independant

18
Q

What is characteristic of p53 dependant urothelial carcinomas?

A

Invasive

Flat tumour

19
Q

What is characteristic of p53 independant urothelial carcinomas?

A

Less aggressive

Papillary tumour

20
Q

What is the most common type of kidney cancer?

A

Renal cell carcinoma aka adenocarcinoma

21
Q

Where do renal cell carcinomas form from?

A

Epithelial cells in the proximal convoluted tubule.

22
Q

What are the main symptoms of renal cell carcinomas?

A 
Flank pain or near hip
Palpable mass
Haematuria
Inflammation
Paraneoplastic syndromes
23
Q

What is a paraneoplastic syndrome?

A

The tumour cells generate a hormone which causes it’s own set of symptoms.

24
Q

What effect can renal paraneoplastic syndromes have.

A

Excessive EPO production can lead to polycythemia.
Excessive renin increasing bp.
Excessive PTHrP leading to hypercalcemia.
Excessive ACTH which can lead to cushings.

25
Q

How can a large renal cell carcinoma affect the left renal vein and what symptoms may be seen?

A

Can occlude the left renal vein, which can then impede the venous drainage of the left testes.
This can lead to a varicocele (dilated veins in the tests bag of worms).

26
Q

Why does a large renal cell carcinoma not affect the right testes in the same way?

A

The right testicular vein drains directly into the right vena cava, and thus will not form a varicocele.

27
Q

What does TNM stand for in the TNM cancer staging system?

A

T - size of the tumour and whether it has grown into nearby areas.
N - degree of spread to reteroperitoneal lymph nodes.
M - Degree of metastasis.

28
Q

What cells make up Willm’s tumour?

A

Metanephric blastemal cells (cells evolved in kidney development).

29
Q

Amongst which population is Willm’s tumour seen?

A

Children

30
Q

What is the presentation of Willm’s tumour?

A

Large flank mass (palpable, unilateral)
Haematuria
Hypertension (caused by excess renin)

31
Q

Willm’s tumour aka

A

Triphasic nephroblastoma

32
Q

What are the general risk factors of kidney cancers?

A 
Obesity 
Smoking 
Previous thyroid cancer
Chronic renal failure - dialysis
Hypertension
33
Q

What is the “classic triad” of presenting features in renal cancers?

A

Haematuria
Loin pain
Mass

34
Q

Presentation of bone pain with renal cancer suggests what?

A

Metastisis

35
Q

What are the main investigations carried out in renal cancers?

A

Urine test
Blood test
US/MRI/CT scan

36
Q

Renal cell carcinomas arise from where?

A

Renal cell carcinomas (RCCs) arise from proximal tubular epithelium.

37
Q

Storage symptoms

A

The collective term for symptoms including urgency, frequency and nocturia.

Urogenital 2 (22 decks)

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