Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Genitourinary > Cancer of the GU tract > Flashcards

Cancer of the GU tract Flashcards

1
Q

In which parts of the GU tract is cancer seen?

A

Kidney
Bladder
Prostate
Testis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Which is the most common type of kidney cancer?

A

Renal cell carcinoma (RCC)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Does renal cell carcinoma affect men or women more?

What age are people most affected?

A

Men more than women

Middle age, about age 55-60

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Which part of the kidney do RCC arise from?

A

Proximal convoluted tubule epithelium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What do RCC tumours look like under a microscope?

A

Tumour made up of large cells with clear cytoplasms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What causes RCC?

A

Genetic susceptibility

Irradiation
Hypertension
Smoking
Obesity
Exposure to heavy metals
Long term dialysis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

How does long term dialysis increase the risk of getting RCC?

A

Long term dialysis results in cysts in the kidney

These cysts sometimes develop into malignancies

More cysts = more chance of malignancy developing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What genetic conditions increase the risk of RCC?

A

Von Hippel Lindau disease: development of many cysts in the kidney, some of these are likely to become malignant

Birt-Hogg-Dube Syndrome: 1/3 of patients get kidney cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the pathogenesis of Von-Hippel Lindau disease?

A

A mutation of the Von-Hippel Lindau (VHL) gene

VHL is a tumour suppressor gene

Without it you get overexpression of vascular endothelial growth factor (VEGF)- leading to angiogenesis

Tumours can grow bigger as they can generate their own blood supply

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the clinical features of RCC?

A

Sometimes asymptomatic

Haematuria
Loin pain
Abdominal mass
Anorexia, weight loss
Nausea
Hypertension

Signs of metastatic disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How are kidney cancers often picked up?

A

Incidentally: often people are asymptomatic

Or they present with metastatic disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How would a patient with metastatic kidney cancer present?

A

Mets in the bone, lung, liver

Anaemia or polycythaemia (excess Hb, high RBC count)

Hypercalcaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Why does RCC sometimes cause hypertension?

A

Damage to kidney results in increased renin secretion

More renin = raised BP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Investigations of RCC?

A

Blood:

  • FBC to look for anaemia/polycythaemia
  • LFT to check for liver mets
  • Calcium levels

USS: to distinguish benign cyst from malignant

CT/MRI: look for mets

Bone scan: look for mets if raised Ca

Biopsy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What would a blood test looking at Ca levels help with when investigating RCC?

A

Low Ca = kidney damage

Raised Ca = bone mets/damage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How is RCC staged?

A

TNM staging

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is the link between a Varicocele and kidney cancer?

A

If you see a varicocele in men over 50 consider kidney cancer

In the under 20s they are usually benign

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Management of localised kidney cancer?

A

Surgery:

  • radical nephrectomy
  • partial nephrectomy

Radiotherapy for people unable to tolerate surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Management of metastatic kidney cancer?

A

Targeted biological therapies that block VEGF (vascular endothelial growth factor)
- Sunitinib

Radiotherapy

Palliative care

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is a Wilm’s tumour?

A

A tumour of children

Nephroblastoma: cancer of primitive renal tubule and mesenchymal cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

How do patients with Wilm’s tumour present?

A

Haematuria

Abdominal mass

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Where in the GU tract can transitional cell carcinomas (TCC) occur?

Which is the most common site?

A

Renal pelvis
Bladder (most common)
Ureters

They are lined with transitional cells

23
Q

Which gender are most affected by TCC, and which age group?

A

Males

After age 40

24
Q

What are the risk factors for TCC of the bladder?

A 
Cigarette smoking
Exposure to industrial chemicals
Exposure to certain drugs
Chronic inflammation
Radiation
25
Q

How do patients with bladder TCC present?

A

Painless haematuria

Symptoms suggestive of a UTI

  • dysuria
  • frequency
  • urgency

Recurrent UTIs

Signs of metastatic disease

26
Q

How do TCCs of the renal pelvis and ureters present?

A

Similarly to bladder TCC

Haematuria
Flank pain

27
Q

Investigation of bladder TCC?

A

Cystoscopy + biopsy

Urine sample: may see sterile pyuria (WBCs)

CT scan: useful for staging

MRI: to look for any lymph involvement

28
Q

What is pyuria?

A

Presence of white blood cells in urine

Can be sterile (cancer) or not (infection)

29
Q

Management of bladder TCC?

A

Surgery:

  • cystoscopic resection: removal of tumour
  • bladder resection: removal of whole bladder
  • local diathermy: heat/burning off tumour

Radiotherapy
Chemotherapy

30
Q

Management of renal pelvis + ureter TCC?

A

Nephroureterectomy: removal of kidney + ureter

31
Q

What type of cancer is prostatic cancer?

A

Adenocarcinoma

32
Q

What region of the prostate does prostate cancer occur?

A

Peripheral zone

as opposed to central zone in BPH

33
Q

Which age group is most often affected by prostate cancer?

A

Older men, mean age = 72

Incredibly rare to see it in under 40s

34
Q

What are the risk factors of prostate cancer?

A

Family history

Having higher levels of testosterone

Age

Race: African American men are at a higher risk than Caucasians

Obesity

35
Q

How do patients with prostate cancer present?

A

Asymptomatic sometimes

Problems with urination:

  • Nocturia
  • difficulty initiating
  • poor stream
  • dribbling after urination

Weight loss

Signs of metastatic disease, such as bone pain

36
Q

Investigation of prostate cancer?

A

Blood:
- raised PSA

Digital rectal examination

Trans-rectal ultrasound

Biopsy

CT/MRI/X-ray: show up metastases

37
Q

What would you feel in a DRE of a patient with prostate cancer?

A

Hard, irregular, enlarged prostates

Nodules

38
Q

Does a raised PSA definitely mean cancer?

A

No!

Could be BPH, infection, trauma/surgery

39
Q

Management of prostate cancer?

A

Very small tumours are managed with watchful waiting

Cancer confined to prostate:

  • prostatectomy
  • radiotherapy

Metastatic disease:
- Remove androgenic drive of tumour growth, i.e. remove testosterone using drugs or orchiectomy

40
Q

What is orchiectomy?

A

Removal of the testicles

41
Q

How come localised prostate cancer is not treated but managed with watchful waiting?

A

It is slow growing

Only 1 in 3 men progress from mild to advanced prostate cancer

Men are more likely to die WITH prostate cancer than OF it

42
Q

What types of testicular cancer are there?

Which is most common?

A

Seminoma
Non-seminomatous (teratoma)
About a 50:50 split

43
Q

What is a seminoma?

A

A tumour of the germ cells of seminiferous tubules of the testicle

44
Q

What age group of males are most affected with seminomas?

A

Men aged 15-35

45
Q

What are the clinical features of testicular tumour?

A

Painless lump on testis
Sometimes, no pain
Sometimes testicular atrophy
Haemospermia

Signs of metastasis

46
Q

Where do testicular tumours metastasise to?

A

Retroperitoneum causing lower back pain

Lung causing dyspnoea

47
Q

What is a teratoma?

A

Non-seminomatous germ cell tumour

Tumour is made up of healthy tissue but tissue that is not supposed to be found in that area

48
Q

Which age group of males are most affected with teratoma?

A

Children and young men

49
Q

What are the risk factors for testicular cancer?

A

Undescended testes, even after orchiopexy

Infant hernia

Infertility

50
Q

What is undescended testes?

A

During development, the testis are formed within the abdomen

About 2 months before birth the testes move down the spermatic cord into the scrotum

If they don’t this is called undescended testes

51
Q

What is orchiopexy?

A

Surgical procedure to move an undescended testicle into the scrotum and fix it there

52
Q

Investigations of testicular tumour?

A

Pregnancy test: in some seminomas HCG levels are raised

Blood:
- tumour markers

CXR: look for lung mets

CT: staging of tumour

Biopsy

53
Q

Treatment of testicular tumour?

A

Radical orchiectomy (removal of testicle) no affect on fertility + sexual function if only 1 is removed

Radiotherapy is effective

Chemotherapy

54
Q

What is prognosis like for testicular cancer?

A

Very good

If caught before metastasis survival is 100%

Genitourinary (13 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions