Friday - Bladder

Question 1

what is wrong in patent urachus

Answer 1

persistent allantoic duct (where the bladder drains into the umbilicus)

if it turns into cancer, its an adenocarcinoma

(on the dome of the urachus)

Question 2

what is a painful full thinkness inflammatory and fibrotic disease of the bladder that is probably autoimmune

Answer 2

Hunner ulcer

Question 3

cystitis that is hemmorhagic what are you thinking

Answer 3

chemo or radiation

Question 4

infection in folks who have a defect in macrophages that causes soft yellow raised plaques and foamy macrophages in the bladder as well as other organisms?

What are the “bodies” called that are lysosomes filled with calcium

what organisms cause it?

Answer 4

malacoplakia

michaelis-gutman bodies (they loook like grey targets with puple centers)

e coli, proteus

Question 5

common neoplasia in bladder in the US

Answer 5

urothelial carcinoma

transitional cell carcinoma

Question 6

what would cause a “field effect” cancer

what would cause this in the kidney and ureter

Answer 6

exposure of a general area to a carcinogen

smoking

aromatic amines
azo dyes
(these are bound to glucuronic acid and non toxic in the blood but glucuronidase in the urine splits this bond)

Question 7

what two clinical signs makes you worried about bladder cancer

Answer 7

over 40

gross hematuria

Question 8

grade 1,2,3 of transitional cell carcinoma

Answer 8

1 - some cytologic and arch atypia, but closely resemble normal transitional cells

2 - tumor cells recognizable as transitional cells, mitoses, greater loss of polarity

3 - transitional origin difficult to define; disarray of cells with loosening and fragmentation. Mitoses increased, nuclear pleomorphism, tumor giant cells

Question 9

CIS of bladder means what

Answer 9

Carcinoma in situ (sometimes called TIS)

its a very high grade but flat neoplasm that has not “invaded” yet

it is very high risk and will probably invade

Question 10

stage 2 of bladder cancer signifies what

Answer 10

invasion of the muscular layer of the bladder (detrusor muscle)

Question 11

stages 3 and 4 of bladder cancer invade what

Answer 11

3 - outside the bladder in the perivesical fat

4 adjacent structures

Question 12

how do most low stage bladder tumors get resected

Answer 12

transurethreal resection of the bladder tumor

with a cystoscope

Question 13

intravesicular BCG

Answer 13

Bacillus Calmette-Guerin

introduce a modified mycoplasma that causes an immune response that also kills the tumor

Question 14

this parasitic worm can crawl up you urethra and set up shop in the bladder after circulating once through the heart.

it is associated with this bladder cancer

Answer 14

schistosoma

squamous cell carcinoma

Question 15

name a few rare and bad bladder cancers if you can hehe

Answer 15

rhabdomyosarcoma - not as bad in kids

leiomyosarcoma - malignant tumor of smooth muscle - bad