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Year 2 Renal > Bladder cancer > Flashcards

Bladder cancer Flashcards

1
Q

is nephrologic / glomerular hematuria associated with proteinuria? casts?

A
  • proteinuria: YES

- casts: YES (RBCs)

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2
Q

what are the components of a hematuria evaluation?

A
  • UA with microscopic analysis
  • urine culture
  • urine cytology
  • CT urogram (standard of care) / renal US / IV urogram
  • cytoscopy
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3
Q

what is the standard of care for hematuria evaluation?

A

CT urogram

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4
Q

what is the second most common GU cancer?

A

bladder

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5
Q

bladder cancer is almost always of what type?

A

urothelial (transitional cell) carcinoma

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6
Q

where does adenocarcinoma arise in the bladder? from what embryological structure?

A

dome (from urachus)

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7
Q

what is the biggest risk factor for bladder cancer?

A

cigarette smoking

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8
Q

what type of analgesic can cause bladder cancer?

A

phenacetin

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9
Q

what is the presentation for bladder cancer?

A
  • painless gross hematuria
  • microscopic hematuria
  • possible irritative lower urinary tract symptoms
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10
Q

what is the most specific bladder tumor marker diagnostic test?

A

urine cytology

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11
Q

what stage indicates invasiveness for bladder cancer? why?

A
  • stage 2

- lymphatic spread

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12
Q

what tests are done for staging of muscle invasive bladder cancer (T2, T3)?

A
  • CT abdomen, pelvis
  • chest radiography
  • serum chemistries
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13
Q

bladder cancer metastasizes to which four areas?

A
  • pelvic lymph nodes
  • lung
  • liver
  • bone
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14
Q

what are adjuvant intravesicle therapies for noninvasive disease? which is most successful?

A
  • BCG
  • mitomycin C
  • interferon alpha
  • doxorubicin, valrubicin, epirubicin

BCG

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15
Q

what are the indications for BCG treatment?

A
  • prophylaxis for T1 and high grade recurrent Ta
  • CIS
  • residual / multiple / persistent
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16
Q

when is mitomycin used? for what reason?

A
  • immediately post-op after a tumor is resected

- to prevent tumor implantation

17
Q

when a tumor gets into muscle, what are the options? what is the standard of care?

A
  • radical cystectomy (standard of care)
  • partial cystectomy
  • radiation
  • chemo
18
Q

what are the indications for radical cystectomy?

A
  • muscle invasive
  • recurrent high grade T1s despite BCG
  • diffuse CIS
19
Q

what are the two indications for a partial cystectomy?

A
  • small solitary invasive tumor in posterior wall or dome

- tumor identified in bladder diverticulum

20
Q

when is radiation used for bladder cancer?

A

patient unable to undergo surgery

21
Q

when is chemo used for bladder cancer?

A
  • adjuvant or neoadjuvant to surgery or radiation

- regional or distant metastasis

22
Q

what is the only therapy to BOTH reduce recurrence and progression of noninvasive urothelial cancer?

A

BCG

Year 2 Renal (38 decks)

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