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NMF: renal > Haematuria > Flashcards

Haematuria Flashcards

1
Q

What is the most common histological subtype of bladder cancer in the UK?

A

transitional cell carcinoma

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2
Q

What are the 2 week wait criteria for bladder cancer?

A

aged 45 and over and have:
unexplained visible haematuria without urinary tract infection or
visible haematuria that persists or recurs after successful treatment of urinary tract infection, or

aged 60 and over and have unexplained non-visible haematuria and either dysuria or a raised white cell count on a blood test.

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3
Q

Which of the following is not a common investigation in haematuria

flexible cystoscopy
CT urogram
USS KUB
MRI pelvis
urine cytology?
A

MRI pelvis

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4
Q

What is the definition of staging in cancer?

A

how far the cancer has spread from its original site

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5
Q

What is the definition of grading in cancer?

A

how well-differentiated the cancer is

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6
Q

Which of the following is a risk factor for the development of bladder cancer:

female sex
low BMI
smoking
malaria 
black ethnicity?
A

smoking

also
male sex
high BMI
schistosomiasis
caucasian
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7
Q

A 45 year old male presenting with flank pain, nausea and non-visible haematuria. What is the most likely diagnosis?

A

kidney stones

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8
Q

What is the gold standard imaging for kidney stones?

A

CT KUB

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9
Q

How should clot retention be managed?

A

bladder washout
3 way catheter
irrigation

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10
Q

Which of the following describes muscle invasive bladder cancer:

invasion of the lamina propria
G2 Transitional cell carcinoma
T2 Transitional cell carcinoma
profound haematuria
Solid looking tumour on cystoscopy?
A

T2 Transitional cell carcinoma

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11
Q

Why is squamous cell carcinoma more common in Egypt?

A

schistosomiasis

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12
Q

What risk is a transitional cell CIS?

A

high risk

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13
Q

Why is visible haematuria worrying?

A

it has a high positive predictive value for urological malignancy

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14
Q

Which sites can haematuria come from?

A 
kidney
ureter
bladder
prostate
urethra
other
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15
Q

What groups of aetiology cause haematuria?

A

MIST(e)

malignancy
infection
stones
trauma
extra
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16
Q

How does most kidney cancer present?

A

incidentally

17
Q

What does bladder cancer most commonly present with?

A

haematuria

18
Q

Give causes of pseudohaematuria?

A

menses
beetroot
rhabdomyolysis

19
Q

What does urine cytology look for?

A

malignant cells in the urine

20
Q

What bed side tests can be performed for haematuria?

A

observations
blood glucose
urinalysis
urine cytology

21
Q

What blood tests can be performed for haematuria? What do they look for?

A 
FBC for anaemia or infection
Us+Es
LFTs for liver mets
uric acid and bone profiling for stones
clotting for a bleeding disorder
22
Q

What imaging is done to investigate haematuria?

A

1st line is US KUB
CT urogram
CT thorax for lung cancer

23
Q

How can emergency haematuria present?

A

anaemia
shock
clot retention

24
Q

What is the gender distribution of bladder cancer?

A

3 males: 1 female

25
Q

Give congenital risk factors for developing bladder cancer

A

increasing Asian
Caucasian ethnicity
positive family history
male sex

26
Q

Give acquired risk factors for developing bladder cancer

A 
smoking
occupational (hair dresser, rubber, dyes)
medications (cyclophosphamide)
chronic inflammation (stones, catheters, schistosomiasis)
radiation
Crohn's disease
renal transplant (immunosuppression)
increased BMI
27
Q

Give symptoms of bladder cancer

A 
haematuria
recurrent UTI
LUTS
non-specific eg. weight loss, fatigue...
palpable mass
28
Q

In TNM staging of bladder cancer, what is

a) Ta?
b) T1?

A

a) non invasive

b) invades lamina propria

29
Q

What percentage of transitional cell carcinomas are non muscle invasive?

A

80%

30
Q

How is non invasive bladder cancer manage?

A 
transurethral resection (TURBT)
intravesical chemo w mitomycin
31
Q

How is invasive bladder cancer managed?

A

cystectomy

chemo + radio

32
Q

Bilaterally enlarged kidneys, flank pain + haematuria suggests what?

A

autosomal dominant polycystic kidney disease

NMF: renal (3 decks)

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