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Y5 urology > Malignancy > Flashcards

Malignancy Flashcards

1
Q

what kind of cancer is RCC

A

adenocarcinoma (most commonly clear cell)

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2
Q

RF for RCC

A

smoking, obesity, dialysis, Von Hippel–Lindau disease

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3
Q

2WW for RCC

A

45+ with unexplained haematuria

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4
Q

triad of symptoms for RCC

A

haematuria, palpable mass, flank pain

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5
Q

which side varicocele is a sign of RCC

A

left (due to drainage, drains pampiniform plexus –> testicular vein –> left renal vein and then IVC. Not right side does not have a renal vein)

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6
Q

gold standard investigation for visible haematuria

A

CT urogram!!!

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7
Q

other investigations that may be done for a haematuria

A

bloods (Hb - due to paraneoplastic syndrome of increased EPO, Ca due to PTHrP), urinalysis, US, CT CAP for staging

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8
Q

Mx of RCC

A

partial / total nephrectomy depending on size. immuno/radio but NOT CHEMO

-the biological therapy uses anti VEGF

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9
Q

RF for testicular cancer

A

infertility, cryptorchidism, previous malignancy, klinefelters

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10
Q

what are the divisions of testicular cancer

A

germ cell tumours (seminoma / non seminomas) and NGCT ( leydig and sertoli - but these are usually benign)

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11
Q

features of a seminoma

A

average age for diagnosis is 40, good prognosis, rarely metastasise, no tumour markers

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12
Q

what are the 3 non seminomatous germ cell tumour

A

1) yolk sac (AFP) 2) teratoma 3) choriocarcinoma (HCG)

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13
Q

investigation for a testicular tumour

A

tumour markers, US, CT - never biopsy

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14
Q

MX of a testicular tumour

A

orchidectomy +/- chemo

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15
Q

what race are more at risk of testicular cancer

A

Caucasian

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16
Q

RF for prostate cancer

A

FHX (BRCA2) obesity and age

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17
Q

prostate feel on DRE with cancer

A

loss of median sulcus, irregular and craggy

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18
Q

Ix for prostate cancer

A

DRE, PSA, multi parametricMRI, transperineal US guided biopsy (TRUS outdated)

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19
Q

what is the gleason score

A

grade of the prostate cancer where 1 is least dysplasia and 5 is most. the two scores added from two most prominent cell types

20
Q

complications of prostatectomy

A

ED and stress incontinence

21
Q

mainstay of Tx for metastatic prostate cancer

A

hormonal (GnRH agonist - overstimulate receptors, they get down regulated and cause less testosterone after initial flare). Tumour flare needs to be covered with anti androgen to begin with.

Chemo can be used

22
Q

what is generally used for locally advanced prostate cancer

A

surgery - prostatectomy or radiotherapy

23
Q

what is used for localised early prostate cancer

A

watch and wait / active surveillance or may use prostatectomy / radiotherapy

24
Q

main side effect of using radiotherapy to treat prostate cancer

A

proctitis

25
Q

2WW criteria for haematuria

A

45+ and unexplained haematuria or 60+ with unexplained non visible haematuria AND dysuria/raised WCC

26
Q

Rf for TCC

A

SMOKING, exposure to aromatic dyes and age

27
Q

symptoms of TCC

A

haematuria and LUTS

28
Q

Mx of a Cis TCC

A

TURBT +/- BCG vaccine into the bladder (This is done for high risk cancers)

29
Q

RF for squamous cell carcinoma of bladder

A

long term catheter and schistosomiasis

29
Q

at what point is a TCC muscle invasive and needs radical cystectomy

A

T2

30
Q

what are the methods of urodiversion after a radical cystectomy

A

1) ileal conduit (part of ileum taken and bought to skin surface and the ureters plumbed in) 2) bladder reconstruction (neobladder)

31
Q

how is wilms tumour treated

A

nephrectomy

31
Q

What is wilms tumour

A

a nephroblastoma - in children. Present with mass, loin pain and haematuria.

32
Q

what is TURP syndrome

A

when there is absorption of the hypoosmolar irrigation fluid. Causes fluid overload and a low sodium. May present with confusion.

33
Q

RF for penile cancer (squamous cell cancer)

A

HPV, poor hygiene, smoking

34
Q

presentation of penile cancer

A

palpable, ulcerated lesion / skin changes +/- pelvic lymphadenopathy

35
Q

Mx of penile cancer

A

penectomy +/- chemo/radio

36
Q

what is it called where RCC cause problems with liver

A

stauffer syndrome (exact mechanism for this is not understood)

37
Q

staging of RCC

A

T1 - <7cm
T2 - >7cm
T3 - spread but not beyond gerotas fascia
T4 - spread beyond gerotas fascia

38
Q

what is gerotas facia

A

separates kidneys AND adrenal glands form other organs

39
Q

what is stauffer syndrome

A

in RCC it is a paraneoplastic syndrome which causes hepatic dysfunction without the presence of live mets. It then resolves after nephrectomy.

40
Q

RCC summarise

A
41
Q

Tx for bladder cancer Cis

A

TURBT + intravesicular chemo

42
Q

Tx for muscle invasive bladder cancer

A

radical cystectomy

43
Q

staging of bladder cancer

A

MRI pelvis and then CT CAP to look for more distant metastasis

Y5 urology (7 decks)

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