Bladder Cancer

Question 1

diagnosis of bladder trauma

Answer 1

CT urography

retrograde urethrogram

Question 2

types of bladder cancer

Answer 2

transitional (90%)

squamous cell cancer

Question 3

classification of transitional cancer

Answer 3

1. papillary (stippled appearance)

2. non-papillary (always metastatic)

Question 4

RF for squamous cell carcinoma

Answer 4

schistosomiasis
chronic infection
long-term catheter

Question 5

RF for transitional cancer

Answer 5

50s (median age 65)
males
smokers
dye industry chemical (aromatic amines - clothing, printing, petrochemical and aluminium smelting)

Question 6

latency period

Answer 6

can be up to 20 years

Question 7

presentation of bladder cancer

Answer 7

painless haematuria
recurrent UTIs
storage symptoms

Question 8

diagnosis of bladder cancer

Answer 8

flexible cystoscopy (halo sign)
CT urography, USS or IVU
urine cytology

Question 9

staging system in bladder cancer

Answer 9

TNM

Question 10

management of bladder cancer

Answer 10

TURTB (resection/removal)
radical cystectomy
chemotherapy/ radiotherapy
BCG vaccine
diathermy via transurethral cystoscopy/ resection

Question 11

presentation of UTI

Answer 11

dysuria/ burning
frequency
incomplete emptying

Question 12

diagnosis of UTI

Answer 12

urinalysis= nitrites + leukocytes + RBCs

flexible cystoscopy, FVC or USS for abnormalities

Question 13

when to avoid trimethoprim?

Answer 13

1st trimester (folate antagonist)

Question 14

when to avoid nitrofurantoin?

Answer 14

3rd trimester (haemolysis)

Question 15

normal antibiotic choice in women of child-bearing age?

Answer 15

nitrofurantoin 3 days (7 in men)

Question 16

management of recurrent UTIs

Answer 16

prophylactic antibiotics