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Y3 - Renal > Bladder Cancer > Flashcards

Bladder Cancer Flashcards

1
Q

What tissue do renal cell carcinomas arise from?

A

proximal tubular epithelium

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2
Q

What is the most common renal tumour in adults?

A

renal cell carcinomas

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3
Q

Do renal cell carcinomas affect more men or women?

A

men (2:1)

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4
Q

At what age threshold do renal cell carcinomas typically present?

A

50+ years of age

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5
Q

True or false: renal cell carcinomas are a type of adenocarcinoma

A

True

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6
Q

What is the most common sub-type of renal cell carcinoma?

A

clear cell (80%)

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7
Q

Name three subtypes of renal cell carcinoma:

A

1) clear cell (80%)
2) papillary (15%)
3) chromophobe (5%)

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8
Q

What is a chromophobe renal cell carcinoma?

A

tumour that forms in the cells lining the small tubules in the kidney

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9
Q

Give 6 risk factors for renal cell carcinomas:

A

1) smoking
2) obesity
3) Von Hippel Lindau disease
4) hypertension
5) tuberous sclerosis
6) end-stage renal failure

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10
Q

What inheritance pattern does Von Hippel-Lindau disease follow?

A

autosomal dominant

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11
Q

Give 5 pathological features of Von Hippel Lindau disease:

A

1) bilateral renal cell carcinomas
2) retinal and cerebella hemangioblastomas
3) pheochromocytomas
4) pancreatic neuroendocrine tumours
5) renal cysts

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12
Q

What mutation leads to Von Hippel-Lindau disease?

A

VHL mutation leads to inactivation of the VHL protein which acts as a tumour suppressor

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13
Q

Give the classic triad of renal cell carcinoma symptoms:

A

1) haematuria
2) flank pain
3) palpable mass

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14
Q

Give 4 non-specific symptoms associated with renal cell carcinomas:

A

1) weight loss
2) fatigue
3) anorexia
4) night sweats

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15
Q

Why might a renal cell carcinoma cause hypertension?

A

the tumour may produce renin

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16
Q

Why may a renal cell carcinoma cause anaemia or polycythaemia?

A

the tumour may produce varying levels of erythropoietin

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17
Q

What is Stauffer’s syndrome?

A

liver symptoms due to paraneoplastic syndrome of renal cell carcinoma without liver metastasis

18
Q

Why might a renal cell carcinoma cause hypercalcaemia? (2)

A

1) bone metastasis
2) the tumour may secrete a hormone that mimics the action of parathyroid hormone

19
Q

How is a renal cell carcinoma diagnosed?

A

CT scan is used to identify the lesion and then stage (assessing involvement of the renal vein or inferior vena cava)

20
Q

What staging system is used for both renal cell carcinomas and bladder (urothelial) carcinomas?

A

TNM (tumour node metastasis)

21
Q

What is the first line treatment for renal cell carcinomas?

A

nephrectomy (the adrenal gland, lymph node and surrounding tissue may be removed too depending on the stage)

22
Q

When would a partial nephrectomy be used over a radical nephrectomy for renal cell carcinoma? (2)

A

1) bilateral tumours are present
2) the contralateral kidney functions poorly

23
Q

Name 3 surgeries that could be used to treat renal cell carcinoma when the patient is not suited to a nephrectomy:

A

1) arterial embolisation (cutting off blood supply to affected kidney)
2) percutaneous cryotherapy (injecting liquid nitrogen to freeze and kill the tumour)
3) radiofrequency abolition (needle is inserted into tumour with an electrical current passed through to kill tumour cells)

24
Q

What is the name of the fascia that surrounds the kidneys and adrenal glands?

A

Gerota’s fascia

25
Q

What X-ray sign is highly indicative of renal cell carcinoma metastasis to the lungs?

A

cannon ball metastases (clearly defined circular opacities scattered throughout the lung fields)

26
Q

What is another name for a nephroblastoma?

A

Wilms tumor

27
Q

In what age group does a Wilm’s tumour present?

A

within the first 3 years of life

28
Q

What tissue is affected by bladder carcinoma?

A

transitional cell epithelium (urothelium)

29
Q

Is bladder cancer more common in men or women?

A

men (4:1)

30
Q

What is the most common transitional cell carcinoma?

A

Bladder

31
Q

What type of bladder cancer is schistosomiasis associated with?

A

squamous cell

32
Q

Give 4 risk factors for bladder carcinoma:

A

1) smoking
2) chronic inflammation e.g. schistosomiasis
3) exposure to industrial carcinogens
4) exposure to drugs such as phenacetin and cyclophosphamide

33
Q

Give two industrial carcinogens associated with bladder carcinoma:

A

1) beta-naphthylamine
2) benzidine
(common in petroleum and rubber industries)

34
Q

What are the 2 most common signs of bladder malignancy?

A

1) painless haematuria
2) UTI symptoms in the absence of bacteriuria

35
Q

Give the 2 parts of the two week wait referral criteria for bladder carcinoma:

A

1) 45+ with unexplained haematuria
2) 60+ with microscopic haematuria plus either dysuria or raised WCC or FBC

36
Q

Name 3 investigations used for bladder carcinoma:

A

1) urine cytology for malignant cells
2) urinary tumour markers
3) cystoscopy (camera through urethra)

37
Q

Name 4 management strategies for bladder carcinoma:

A

1) transurethral resection of the bladder
2) intravesical chemotherapy (chemo given via a catheter)
3) radical cystectomy
4) intravesical BCG vaccine

38
Q

Why is a BCG vaccine to the bladder thought to manage bladder carcinoma?

A

it is thought to stimulate the immune system to attack bladder tumours

39
Q

What is the most common method of urine drainage following radical cystectomy?

A

urostomy with an ileal conduit

40
Q

What is the difference between non-muscle-invasive bladder cancer and muscle-invasive bladder cancer?

A

non-muscle-invasive bladder cancer does not invade the muscle bladder layer

41
Q

What is Schistosomiasis?

A

Schistosomiasis, also known as bilharzia, is an infection caused by a parasitic worm that lives in fresh water in subtropical and tropical regions.

42
Q

What is the clinical presentation of schistosomiasis?

A

The classic sign of urogenital schistosomiasis is haematuria (blood in urine). Kidney damage and fibrosis of the bladder and ureter are sometimes diagnosed in advanced cases. Bladder cancer is another possible complication in the later stages

Y3 - Renal (13 decks)

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