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MET3b > Breast & Urology > Flashcards

Breast & Urology Flashcards

1
Q

National Breast Screening Programme

A
  • every 3 years

- 50-70yrs

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2
Q

Stag Horn Calculus

A

Struvite

  • urease producing bacteria
  • slightly radio-opaque
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3
Q

THP (uromodulin)

A

Inhibits stones

Binds to crystals and prevent binding to renal epithelium

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4
Q

Dx for renal colic

A
  • ureteric colic
  • bowel colic
  • leaking AAA
  • ectopic
  • MI
  • pancreatitis
  • pneumonia
  • biliary colic (RUQ -> shoulder)
  • pyelonephritis
  • bleeding RCC
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5
Q

Ix for renal colic

A
  • CT KUB
  • low dose
  • urate lucent
  • urine dip for infection
  • MSU
  • FBC
  • CRP
  • U&E
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6
Q

Tx for renal colic

A
  • analgesia = NSAIDs
  • Tamsulosin
  • removal
  • hydration (2L/d)
  • urate = allopurinol
  • calcium = thiazides
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7
Q

Renal Clear Cell Carcinoma

A
  • VHL

- polycythaemia

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8
Q

Renal Cancer Triad

A
  • palpable mass
  • flank pain
  • macrohaematuria
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9
Q

Renal - transitional cell carcinoma

A
  • occupational dyes and rubber
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10
Q

Renal Cancer Treatment

A
  • TKI (sutinib, pazopanib sorafenib)
  • IL2 (not if anaemic)
  • mTORI (sirolimus, everolimus)
  • nephrectomy if not metastatic
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11
Q

Bladder Cancer

A
  • 2-Naphthylemene dye/paint
  • smoking
  • TCC
  • SCC = schistosomiasis and smoking RF only not dye
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12
Q

Bladder Cancer Chemo

A

Cisplatin & Gentamycin

Cisplatin & Methotrexate

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13
Q

PSA Norm

A

<4

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14
Q

Prostate Cancer Tx

A
  • bilateral orchidectomy
  • gosrelein (GnRH agonist) with flutamide before
  • if castration resistant = peripheral androgen receptor antagonist = bicalutamide
  • Enzalutamide x 5 affinity overcoming bicalutamide resistance
  • Cyp17 inhibitor and dexamethasone and oestradiol
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15
Q

Prostate Cancer Palliative Tx

A
  • bone bisphosphonates, RANKL inhibitor (denosumab)
  • Anaemia blood
  • analgesia
  • radiotherapy
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16
Q

Prostate Cancer Chemo

A

TAXANES
Docetaxel
Carbataxel

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17
Q

Testicular vs Prostate RF

A 
Testicular = Caucasian
Prostate = Afro-Caribbean
18
Q

Testicular germ cell Tx

A
  • chemo = cisplatin and etoposide and bleomycin

- stem cell rescue if relapse

19
Q

Testicular cancer serum tumour markers

A
  • LDH
  • AFP
  • BHCG
20
Q

Penile Cancer Tx

A
  • removal and nodal block dissection
  • radiotherapy and drain inguinal nodes
  • chemo = cisplatin, fluorouracil, docetaxel
21
Q

Epididymo-orchitis

A
  • infection of epididymis and testes
  • pain and swelling
  • chlam and gonorr of genital tract or bladder
  • amiodorone causes
  • ceftriaxone and doxycycline
  • urethral discharge
22
Q

Testicular torsion

A
  • urethral stricture
  • medical emergency to prevent ischaemia
  • severe pain
  • surgical exploration of both
  • if cremasteric reflex present = torsion affects testicular appendage only
  • elevation of testes does not alleviate pain
  • if do not fix both = bell clapper testes
23
Q

Hydronephrosis

A
  • from obstruction
  • children = from patent processus vaginalis
  • remove obstruction and drain urine = nephrostomy tube if acute and ureteric stent if chronic
24
Q

Breast Tx

A
  • Surgery first line
  • if <4cm = wide local excision (and if peripheral tumour)
  • if >4cm = mastectomy (and if central tumour)
  • radio after wide local to reduce recurrence
  • radio after mastectomy if high stage tumour and >4 axillary nodes affected
  • Hormonal if receptors positive
  • biological = traztuzumab (Herceptin) only for HER2 positive tumours (not if heart disorders)
  • chemo
25
Q

Breast Hormonal Tx

A
  • tamoxifen for pre and peri menopausal women

- aromatase inhibitors if post menopause = anastrozole

26
Q

SE of tamoxifen

A

endometrial cancer
VTE
menopausal symp

27
Q

Pagets

A
  • nipple crusty lesion
  • no areolar affect
  • lymphadenopathy
  • invasive carcinoma liekly
28
Q

Breast Abscess

A
  • mastitis from breast feeding = recommended to keep breastfeeding
  • S. aureus
  • tender, fluctulant
  • AB and US
  • overlying skin necrosis
  • mammary duct fistula
29
Q

Duct Ectasia

A
  • discharge from single or multiple ducts
  • thick and green
  • NDI
  • common during menopausal breast involution
30
Q

Intraductal Papilloma

A
  • single duct

- clear or bloody discharge

31
Q

TB

A
  • child bearing women
  • chronic breast or axillary sinuses
  • biopsy, culture, histology
32
Q

Fibroadenoma

A
  • from lobule
  • mobile, firm
  • 2yrs get smaller
  • if >3cm surgery
  • phyllodes widely excised
33
Q

Cyst

A
  • smooth, disceret
  • increased risk of cancer if young
  • aspirate and biopsy
34
Q

Sclerosing adenosis

A
  • lump, pain
  • mimic carcinoma on mammography
  • lobular distortion
  • ANDI
  • biopsy
35
Q

Epithelial hyperplasia

A
  • variable lumpiness
  • FH
  • conservative if no atypical features
36
Q

Fat necrosis

A
  • mimic carcinoma
  • increases in mass and size
  • core biopsy and image
  • skin tethering
37
Q

Cause of ED

A
  • vascular
  • SSRI
  • Beta blockers
38
Q

Renal Colic Management

A
  • If <5nm = spontaneously pass in 4w
  • if obstructing = nephrostomy tube, ureteric catheter, ureteric stent
  • shockwave lithotripsy first (analgesia need, organ injury, obstruction)
  • ureteroscopy (ureter-> pelvis, pregnancy, when lithotripsy not possible, complex stone, left with stent)
  • percutaneous nephrolithotomy (remove via renal collecting system)
39
Q

Calcium oxalate

A
  • hypercalciuria

- radio-opaque

40
Q

Cystine

A
  • inherited metabolic disorder
  • malabsorption of cysteine
  • multiple stones
  • radiodense as contain sulphur
41
Q

Urate

A
  • product of purine metabolism
  • radiolucent
  • low urine pH
  • excessive tissue breakdown = malignancy
  • children inborn errors of metabolism
42
Q

Calcium phosphate

A
  • renal tubular acidosis
  • high urine pH
  • radio-opaque

MET3b (20 decks)

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