Bladder Disorders

Question 1

Patient presents with urinary frequency, burning sensations w/urination, hematuria, strong smelling urine, and feeling of discomfort in lower abdomen. What does this patient most likely have?

Answer 1

cystitis

Question 2

Bladder pain of variable severity lasting over a protracted period of time

Answer 2

interstitial cystitis

Question 3

Cells that play a central role in interstitial cystitis that damage urotheial lining

Answer 3

mast cells (histamine)

Question 4

Only medical treatment available for interstitial cystitis

Answer 4

Pentosan polysulfate sodium

Question 5

Requires work up especially in the older or smoking patient where it may suggest bladder cancer or renal disease

Answer 5

hematuria

Question 6

Why does bladder cancer present in patients with h/o includes repeated UTIs, kidney stones, chronic urinary retention requiring catheter.

Answer 6

Chronic inflammation of the bladder increases the risk of bladder cancer

Question 7

Other factors besides smoking and recurrent infections that increase risk of bladder cancer

Answer 7

exposure to arsenic, irradiation, aromatic hydrocarbons

Question 8

Helps lower risk of bladder cancer

Answer 8

increased fluid intake

Question 9

Most common type of bladder cancer

Answer 9

transitional cell carcinoma

Question 10

Most common presenting symptom or sign for bladder cancer

Answer 10

hematuria

Question 11

What type of hematuria does bladder cancer typically present with?

Answer 11

microscopic

Question 12

Most important method for the initial work-up of bladder cancer

Answer 12

cystoscopy with biopsy

Question 13

Treatment of superficial lesions of bladder cancer (T0, T1S, T1, low grade T2)

Answer 13

endocscopic resection and fulguration w/cystoscopy. Repeat every three months

Question 14

used prophylactically to prevent new lesions and delay or prevent development of both metastasis and muscle invading tumors, and therapeutically to eradicate an existing lesion

Answer 14

Intravesical Therapy with BCG

Question 15

can be used for patients whose tumors are not amenable to transurethral resection of bladder tumor

Answer 15

partial cystectomy

Question 16

Treatment for muscle invasive tumors (T2, T3, and T4)

Answer 16

Radical cystectomy with urinary diversion

Question 17

Percentage of patients with high grade invasive disease who are cured?

Answer 17

50%

Question 18

no longer shown to be of benefit and is no longer used routinely is reserved for frail, elderly pts or those unfit for other approaches to pallliate local symptoms

Answer 18

pre-op radiation

Question 19

are generally insensitive to chemotherapy and should NOT be considered for neoadjuvant bladder-sparing approach

Answer 19

non-urothelial (transitional) histology bladder cancer

Question 20

5 yr survival rate for metastatic bladder disease

Answer 20

15%

Question 21

Performed every year in patient who had been diagnosed with bladder cancer

Answer 21

CXR and CT of abdomen and pelvis