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GU > neoplasms and cancers > Flashcards

neoplasms and cancers Flashcards

1
Q

prostate cancer?

A

gnerally slow -growing, malignant neoplams of the adenomatous cells

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2
Q

what can Pr. CA lead to?

A

urinary obstruction and metastatic disase

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3
Q

where do th)e majority of pr Ca originate?

A

in the peripheral zone (outer portion that is palpable on rectal exam)

then the transition zone (portion that surrounds the urethra)

then the central zone (ejaculatory ducts)

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4
Q

epidemiology of pr cancer

A

most common non-skin cancer in men

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5
Q

what are some risk factors for Pr, Can?

A

genetic predisposition, hormonal influence, dietary and environmental factors, infectious agents

*** old age

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6
Q

what can be used for Pr cancer screening?

A

PSA, DRE

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7
Q

what are the clinical features of Pr. Ca?

A

+many asx

+ urinary obstruction or irritative voiding if tumor invaded into the urethra, bladder neck, or trigone of the bladder

+enlarged, nodular, asymmetric prostate

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8
Q

where may Pr Ca metastasize?

A

bone! may lead to possilbe spinal cord impingement if the vertebral bodies are involved

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9
Q

what dx studies can be done for Pr ca?

A

+PSA usually elevated
+patholgical exam
+ transrectal US
+biopsy

+may see incrased LFTs (alk phos)

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10
Q

what would apathologic exam of tissue reveal in Pr. Ca?

A

obstructive prostatic hyperplasia shows that 10% have malignancy

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11
Q

what would a US show for Pr ca?

A

hypoechoic lesions in prostate

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12
Q

what confirms the dx of prostate cancer?

A

biopsy; and allows histolgical grading

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13
Q

what grading system is used for prostate cancer?

A

the Gleason: adds together the pimary and secondary grades of the tumor; final score btw 2-10

*higher score, worse prognosis

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14
Q

tx of pro. c?

A

depends on staging

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15
Q

what dx tools/imaging is used to stage pros cancern?

A

abdominal/pelvic CT or MRI, pelvic lymphandencetomy, bone scan

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16
Q

low grade prs tumors

A

may not need tx

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17
Q

stages A and B pr cancer tx?

A

tumore confined to prostate

tx with Radical retropubic* prostatectomy (RRP), brachytheraphy, or external beam radiation therapy

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18
Q

stage C Pr. cancer tx?

A

tumor w/ local invasion; tx the same as stage A and B

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19
Q

stage D pr cancer tx?

A

hormonal manipulation using orchiectomy, antiandrogens, LH agonists, estrogens

palliative care

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20
Q

what is brachytheraphy?

A

are radiated and implanted in prostate They remain in prostate even after radiation has degraded about 60 days.

This treatment is best for localized, contained cancer.

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21
Q

bladder cancer general features?

A

uroepithelial tumors

+most are transitional cell carcinomas

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22
Q

what pt population is more likely to get bladder cancer?

A

men, pts 40-70

23
Q

what are some causal risk factors for bladder cancer?

A

exposure to tobacco, occupational carcinogens from rubber, dye, printing, and chemical industries, schistosmiasis,

exposure to cyclophosphamide, and chronic infection

24
Q

what is schistomiasis?

A

also known as bilharzia, is a disease caused by parasitic worms.

25
Q

what are the clinical features of bladder cancer?

A

painless hematuria is the most common

also, bladder irritability and infection

26
Q

what dx studies can be done for bladder cancer?

A

CBC and blood chemistry: infx, renal funx

27
Q

what is the definitive dx of bladder cancer?

A

cystoscopy, and bx confirms the pathologic diagnosis

28
Q

what other radiologic procedures can be used for staging and to find tumors?

A

IV urogram, Pelvic/abdominal CT, chest sr, bone scan, retrograe pyelography fro renal pelvic for uretral tumors

29
Q

how is bladder cancer trx?

A

depends on stage

30
Q

how are superficial bladder cancer lestions tx?

A

with endoscopic resection and fulguration followed by cystoscopy every 3 mtns

31
Q

how are recurrent or multiple lesion tx in bladder cancer?

A

intravesical instillation of thiotepa, mitomycin-C, or bacillus calmette- guerin (BCG)

32
Q

what can BCG also be used for?

A

prevent TB

33
Q

what can be used for recurrent bladder cancer? or diffuse TCC in situ, or for tumors tha have invaded the muscle

A

radical cystectomy,

34
Q

what is reserved for pts taht are not surgical candiddates due to significant comorbid medical conditions?

A

external beam irradiation therapy

35
Q

what is renal cell carcinoma?

A

aka hypernephroma or renal adneocarcinoma

+most common type of renal malignancy

36
Q

what population is most likely to get RCC?

A

men older than 55

american indian, alsakan native

37
Q

what risk factor has been linked with RCC?

A

cigarette smoking

38
Q

what are the other forms of RCC?

A

hereditary: von Hipple Lindau dz, herediatry papillary renal carcinoma

39
Q

what are the clinical features of RCC?

A

wide range of s/sx

“internists’ tumor” bc commonly discovered as an incidental finding on abdominal imagins

40
Q

what ist he most common sx of RCC?

A

gross or microscopic hematuria, followed by pain or an abdominal mass
+this triad is not commonly seen

41
Q

what other paraneoplastic syndromes is RCC associated with?

A

erythrocytosis, hypercalcemia, htn, hepatic dysfuction

42
Q

what dx should be done for RCC?

A

pts w/ hematuria should under go an US to r/o stone

43
Q

what is the primary technique for diagnosis RCC?

A

CT scanning w and w/o contrast

others: MRI w/ contrast or arteriography

44
Q

how is RCC graded?

A

using Fuhrman grade (1-4) and TNM of tumor

45
Q

how is localized RCC dz tx?

A

radical nephrectomy

46
Q

where may RCC dessiminate to?

A

brain, bone, lungs

*treat with radiation theraphy

47
Q

what meds have been shown to have some sucess in reduction grown of RCC?

A

interferon-A and interleukin

48
Q

testicular cancer general characteristics?

A

young men!

hx of cryptorchidism or previous hx of testicular cancer

49
Q

what are the clinical features of testicular cancer?

A

painless, solid testicular swelling

-may also complain of a heaviness

50
Q

what lymph nodes may be involved in testicular cancer?

A

para-aortic; may present as a ureteral obstrctions

51
Q

what part of the body may also be involved int testicuar cancer?

A

lungs- pulmonary metastases shown on chest xray

52
Q

what ist he most common type of testicular cancer?

A

nonseminomatous (embryonal carcinoma, teratoma, mixed cell type, and choriocarcinoma)

then seminomatous

53
Q

what is dx for nonseminomatous germ cell tumors?

A

elevated alpha-fetoprotein or Beta human chorionic gonadotrioub

GU (3 decks)

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