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Reproductive > Lec 9-10 Male GU > Flashcards

Lec 9-10 Male GU Flashcards

1
Q

What should you look for in urine sample with RBCs to tell if it was a good specimen?

A

look for epithelial cells –> could mean contamination

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2
Q

How common is bladder cancer?

A

4th most common cancer in US in men

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3
Q

What are risk factors for bladder cancer?

A
  • smoking = biggest factor
  • radiation to pelvis
  • narcotic use
  • chemical exposure [aromatic amines, benzenes]
  • schistosomiasis
  • age > 40
  • male
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4
Q

What is transitional cell carcinoma of the bladder?

A

most common tumor of urinary tract system

have painless hematuria [no casts]

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5
Q

What is squamous cell carcinoma of bladder?

A
  • 1-2% of all bladder cancers
  • chronic irritation of urinary bladder causes squamous metaplasia leading to dysplasia
  • associated wtih schistosoma
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6
Q

What is adenocarcinoma of the bladder?

A

1-2% of all bladder cancers
aggressive
can be urachal

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7
Q

What is CIS in bladder?

A

carcinoma in situ in bladder = superficial high grade cancer; can invade

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8
Q

Why is bladder cancer so hard to treat?

A

can recur anywhere in ureters, bladder, renal pelvis = thought to be a field defect of the mucosa

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9
Q

What are principles of bladder cancer treatment?

A

superficial low grade –> survey
superficial high –> re-resect
- muscle invasive: cystectomy

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10
Q

What does it suggest if testicular cancer with HCG and AFP?

A

mixed germ cell tumor

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11
Q

What is median age at diagnosis testicular cancer?

A

33 yo

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12
Q

What are risk factors for testicular cacner?

A
  • cryptorchidism [undescended testicle]
  • family history
  • HIV
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13
Q

What is most prevalent type of tersticular tumor?

A

seminoma = 33%

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14
Q

What are characteristics of anaplastic seminoma?

A

more aggressive than classic

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15
Q

What are characteristics of spermatocytic seminoma?

A

more common > 50 yo

less aggressive

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16
Q

What are characteristics of embryonal carcinoma?

A

malignant; hemorrhagic; painful
more aggressive = worse prognosis
often mixed with other tumor types
high ACG and normal AFP when pure; also high AFP when mixed

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17
Q

What are characteristics of teratoma?

A

mature teratoma in adult males can be malignant
resistant to chemo and radiation
have high HCG an/or AFP

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18
Q

What are characteristics of yolk sac tumor?

A 
yellow, mucinous
aggressive
see schiller duval bodies = look like primitive glomeruli
high AFP
seen commonly in boys < 3 yo
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19
Q

What are characteristics of choriocarcinoma?

A

malignant
hematogenous spread to lungs and brain
high HCG
may cause gynecomastia or symptoms of hyperthyroidism

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20
Q

What 2 cancers have alpha fetoprotein [AFP] marker?

A
  • embryonal and yolk sac

NOT seminoma or choriocarcinoma

21
Q

What 3 cancers have bHCG marker?

A
  • embryonal, choriocarcinoma, seminoma

high level –> causes nipple tenderness/gynecomastia

22
Q

What does LDH tell you?

A

marker of bulk disease = not sensitive or specific for recurrence
elevated in seminomas

23
Q

What is pattern of spread for testicular cancer?

A

local spread to epididymis and spermatic cord
retroperitoneal lymph nodes
lungs
lymph nodes in chest

24
Q

What are survival rates of testicular cancer?

A

99% if localized

25
Q

What is treatment for testicular cancer?

A

always start with radical orchiectomy

26
Q

What is primary type of penile cancer?

A

squamous cell

27
Q

What are risk factors for penile cancer?

A
  • HPV
  • lack of circumcision
  • chronic irritation
  • smoking
  • age > 55
  • AIDS
28
Q

What is pattern of spread penile cancer?

A

spreads from penis to inguinal lymph nodes

29
Q

What is cause of death in penile cancer?

A

locally invasive disease causes infection, erosion of nodes into femoral vein

30
Q

Can you treat penile cancer with chemo/radiation?

A

nope!

31
Q

Who gets renal cancer?

A

2/3 male

av age 64

32
Q

What are risk factors for kidney cancer?

A
  • smoking
  • obesity
  • occupational exposure
  • genetic
  • htn
  • male
33
Q

What is classic triad of renal cancer?

A
  • flank pain
  • hematuria
  • palpable mass
34
Q

What should you think if enhancing renal mass where you can see fat?

A

its AML

35
Q

What 3 things likely if enhancing renal mass with no fat?

A
  • collecting system: transitional cell carcinoma
  • parenchyma: oncocytoma (20-30%)
  • parenchyma: renal cell carcinoma (70-80%)
36
Q

Why don’t you use kidney biopsy?

A
  • high error rate
  • oncocytic RCC looks like oncocytoma
  • risk of seeding the tumor
37
Q

What is treatment for RCC?

A

surgical or ablation

poor response to chemo/radiation

38
Q

What is the most common cancer in american men?

A

prostate cancer

39
Q

What are risk factors for prostate cancer?

A
  • increased age
  • family history

vasectomy/STDs/BPH/testosterone levels = not risk factors

40
Q

What are risks of prostate biopsy?

A

bleeding
infection
difficulty urinating
complication of ED w/ repeat biopsies

41
Q

What is the problem wtih PSA?

A

varies day to day

42
Q

Who should get localized cancer treatment?

A

people who do not have significant problems voiding or history of pelvic radiation

43
Q

Where does prostate cancer spread to?

A

regional lymph nodes

bones

44
Q

What is first line treatment for metastatic prostate cancer?

A

androgen deprivation = controls cancer size for limited amount of time

45
Q

What are side effects of using androgen deprivation to treat cancer?

A
  • hot flashes
  • osteoporosis
  • breast tenderness
  • loss of muscle mass
  • weight gain
46
Q

What are major characteristics of bladder cancer?

A
  • tends to recur
  • high grade cancers are bad
  • therapy is multimodal
47
Q

What are major characteristics of penile cancer?

A
  • very dangerous
  • does not respond to RT or chemo
  • refer penile lesions early
48
Q

What are major characteristics of kidney cancer?

A
  • solid, no fat lesions that have contrast enhancement
  • watch small lesions
  • surgery is mainstay
49
Q

What are major characteristics of testicular cancer?

A
  • not usually painful
  • sonogram is first imaging
  • check serum markers
  • good survival

Reproductive (14 decks)

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