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Block 34 metabolic -Ellen > Haematuria Pt2 > Flashcards

Haematuria Pt2 Flashcards

1
Q

commonest cancer in men

A

prostate

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2
Q

lifetime risk of prostate cancer

A

1/5

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3
Q

risk factors for prostate cancer

A

family history
African Caribbean
lycopene and selenium protective

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4
Q

signs and symptoms of prostate cancer (7)

A
  • nocturia
  • urinary frequency
  • urinary hesitancy
  • dysuria
  • haematuria
  • back pain
  • nodular asymmetrical prostate
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5
Q

type of prostate cancer=

A

adenocarcinoma

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6
Q

most common area for formation of cancer cells in prostate

A

peripheral

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7
Q

prostate carcinoma in situ/ prostatic intraepithelial neoplasia =

A

small lumps of cancer cells remain confined to pre-exisiting ducts and glands - precursor lesion

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8
Q

nearby organs prostate cancer can invade

A

seminal vesicles
ejaculatory ducts
rectum

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9
Q

where can prostate cancer metastasise (5)

A 
bones 
lymph nodes 
rectum 
bladder 
lower ureters
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10
Q

investigations for prostate cancer

A

PSA
serum testosterone
FBC
transrectal biopsy

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11
Q

staging of prostate cancer done by

A

gleason grading system

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12
Q

how is gleason score done

A

via prostate biopsy -microscopic appearance

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13
Q

cancer with high gleason score =

A

more aggressive and worse prognosis

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14
Q

scores in the gleason score

A

-1-10
<6 well-differentiated or low grade
->7 are moderately differentiated or intermediate grade
-8-10= poor differentiated or high grade

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15
Q

low risk prostate cancer (Gleason 5-6) preferred treatment

A

active surveillance

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16
Q

medium risk prostate c (gleason 7 or T2) preferred treatment

A
  • radical prostatectomy

- radical radiotherapy

17
Q

high risk prostate c (>8 gleason, T3/T4) preferred treatment

A
  • radical prostatectomy

- radical radiotherapy with neoadjuvant hormone therapy

18
Q

active surveillance of prostate cancer=

A

PSA every 6 months

PR examination and prostate biopsy every 12 months

19
Q

prostate metastatic disease treatment

A

palliative care, treatment not curable

  • anti-androgens
  • oestrogens
  • LHRH analogues (goserelin)
  • bilateral scrotal orchiectomy
20
Q

what does prostate specific antigen (PSA) do

A

stimulates the development of prostate cancer by increasing folate levels for cancer cells to survive

21
Q

most common presentation of prostate cancer

A

LUTS

22
Q

spread of advanced prostate cancer

A

lymphatic
haematogenous
contiguous local spread

23
Q

testicular tumour signs and symptoms

A
  • painless unilateral swelling
  • solid, firm mass within testes
  • dull aching in supra-pubic area
  • gynaecomastia from excessive HCG from testicular germ cell tumours
24
Q

risk factors for testicular tumours (6)

A
  • cryptochidism
  • family history
  • testicular atrophy
  • 20-34 years
  • trauma
  • white ethnicity
25
Q

cryptochildism=

A

both testes fail to descend into scrotum

26
Q

what type of tumour is testicular cancer

A

germ cell tumour

27
Q

2 types of testicular cancer

A

seminoma

teratomas

28
Q

most common form of testicular tumour

A

seminoma

29
Q

when is testicular cancer believed to have started

A

in foetal development

30
Q

what is carcinoma in situ of testicular cancer called

A

intratubular germ cell neoplasia unclassified -pre-cancerous lesion

31
Q

what is the malignant transformation of carcinoma in situ characterised by

A

growth beyond the basement membrane

32
Q

where do seminomas originate

A

germinal epithelium of seminiferous tubules

33
Q

survival rate of seminomas

A

95%

34
Q

slower rate of grow and spread between 2 testicular cancers

A

seminomas

35
Q

what can some seminomas increase the level of

A

HCG (human chroninic gonadotropin)

36
Q

teratomas are histologically characterised by

A

3 layers of trigeminal disc

37
Q

what are teratomas made up of

A

several different types of tissue; hair, muscle, bone

38
Q

what can non-seminomas increase levels of

A

alpha-fetoprotein

39
Q

management of testicular cancer (3)

A
  • inguinal radical orchiectomy +retroperitoneal lymph node dissection
  • external beam radiation post-orchiectomy
  • carboplatin chemo post-orchiectomy

Block 34 metabolic -Ellen (8 decks)

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