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Genitourinary > Genitourinary Malignancies (Exam 3) > Flashcards

Genitourinary Malignancies (Exam 3) Flashcards

1
Q

Prevalence of Prostate cancer in men

A

1/9

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2
Q

Number of men that will die from prostate cancer

A

1/41

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3
Q

Race that has 1/4 with 2-3 times higher or mortality with prostate cancer

A

African American men

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4
Q

Increased risk with first-degree relative w/ prostate cancer

A

2.5 x higher risk

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5
Q

What are two common associations with prostate cancer

A

BRCA / BRCA2
and
Lynch syndrome

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6
Q

Screening tool for Prostate Cancer

A

PSA - Prostate Specific Antigen Test

-anything that irritates the prostate can increase the PSA number- there are a lot of things, such as masturbation with ejaculation, infection, catheter placement, and anything that will agitate the prostate

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7
Q

True or False PSA only comes from prostate tissue

A

False- even women can produce PSA …

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8
Q

PSA is used with no controversy at all…

A

NO- false there has been significant controversy around the testing.

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9
Q

There is a screening recommendation of the AUA to screen PSA when

A

all men aged 59-69 1-2 years and earlier or later depending on history, risk, life expectancy

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10
Q

What is a classically normal PSA

A

< 4.0

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11
Q

average ranges of PSA for adults

A

40-49 < 2.5
50-59 < 3.5
60-69 < 4.5
70+ < 6.5

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12
Q

True or False- DRE is enough to screen for prostate cancer

A

False- Prostate examinations alone are not adequate for catching prostate cancer in your pt’s

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13
Q

Management strategy’s for Prostate cancer

A

Watchful waiting / active surveillance

Androgen deprivation- not trying to cure cancer just maintain it as low as possible (this can suppress cancer growth from 3-10 years)

Definitive treatment- Open or laparoscopic surgical excision (radical prostatectomy ) or radiation

Complicated cases- sx with external beam radiation

Other options exist including newer and older focal therapies

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14
Q

Complications from prostate caner treatment

A

Symptoms with low testosterone (low energy, fatigue, hot flashes)

sx causes stress incontinence (leakage of urine with coughing, sneezing, exercise) and impotence

Radiation can cause some incontinence, though usually les, impotence, as well as irritation to the bowel or bladder leading to urgency of urine or bowels, with or without leakage

Focal therapies also cause impotence commonly

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15
Q

Fourth most common cancer in men

A

Bladder cancer

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16
Q

Bladder caner affects men at ____ and women at ______

A

1/27 1/89

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17
Q

Most common cause of Bladder cancer

A

Smoking

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18
Q

Presentation of Bladder Cancer includes:

A

Painless Hematuria (gross or microscopic)

Rarely causes pain although it can

DDX- UTI, ureteral or kidney stones, UTI structure disease

19
Q

Significant hematuria is considered to be what on microscopy

A

> 3 RBC’s on high field.

Dipsticks can be fooled… so if you test positive you need to have a collection sent for microscopy

20
Q

Lower urinary tract includes

A

anything from the bladder and down

21
Q

Upper urinary tract includes

A

everything above the bladder

22
Q

What are the minimal things needed before you refer to a Urologist

A

A negative culture grown, and UA with microscopy

23
Q

Mainstay of treatment of Bladder cancer

A

Surgical resection of tumor

24
Q

True or false- Small tumors can be treated outside of the hospital just in office

A

True - however large tumors need same-day surgery or admission to hospital

25
Q

______ is utilized for recurrent disease with Bladder cancer

A

BCG or ( mitomycin C )

26
Q

14th most common cancer globally

A

Renal cell carcinoma

27
Q

What is the etiology of Renal cell carcinoma

A

Idiopathic and unknown in most cases

28
Q

Renal Cell Carcinoma Presentations

A

Classic Triad: Gross hematuria, flank pain, palpable flank mass

This is only in 10 percent of cases that you will see these all arise together.

29
Q

Gold standard for imaging of Renal Cell carcinomas

A

CT scan

30
Q

Where is the most likely metastasis of Renal cell carcinoma

A

Lung tissue.

Warrants a CXR or CT of chest fi cancer found in kidneys

31
Q

Renal Cysts

A

Cysts of the kidneys are very common. (10% of all people)

32
Q

Typically we find Cysts how

A

incidental findings

33
Q

simple cysts are not harmful at all. Do not progress to malignancy and require no further imaging. However, what kind of cysts do need further workup

A

Complex cysts. They do carry some risk for malignancy and require referral to Urology to assess the risk

34
Q

what does a complicated cyst mean

A

might have calcium components of the will. they . might have very thick sub area with walls or multiple sub sets not jsut one large open cyst.

35
Q

post removal of a kidney or part of a kidney what is an expected bump in the Cr that is expected

A

50% immediate bump.

36
Q

what is the most common cancer in men aged 18-35

A

Testicular cancer

37
Q

Testicular cancer how many pts will get this

A

1/250 pts in their lifetime

38
Q

Is Testicular cancer is typically unilateral or bilateral ?

A

Unilateral

39
Q

You do not need a biopsy to diagnose testicular cancer true or false

A

True . it is one of the diseases that can be diagnosed based off of

40
Q

Why should you never biopsy testicular cancer but must biopsy bladder tumors?

A

because the tumors of the testicle are at a high risk of spread if biopsied

41
Q

Primary care providers should do what prior to sx

A

Tumor markers need to be drawn and LDH

42
Q

Most testicular cancers show what type of pathology typically

A

Some combination of (seminoma, yolk sac tumor, choriocarcinoma, embryonal, teratoma)

43
Q

low grade non- seminomatous cancers are usually treated with adjuvant chemotherapy

how are high grade cancers often treated

A

High grade cancers often require retroperitoneal lymph node dissection (RPLND). not done routinely by genaral urologists

(they take the lymph nodes from way down all the way up to inguinal region)

44
Q

Suspicious testis are Urgent or non-Urgent

A

Urgent- very rapid growth. There are very small windows of to which they can take care of keeping the cancer growth low.

Genitourinary (11 decks)

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