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clin med GU > Neoplastic disease of GU & PCKD > Flashcards

Neoplastic disease of GU & PCKD Flashcards

1
Q

bladder cancer is the ___ most common cancer in men and ___ most common in women

A

4th MC in men

13th MC in women

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2
Q

what is the mean age of Dx for bladder cancer

A

73yo

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3
Q

who is bladder cancer more common in for race?

A

whites

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4
Q

what are causes of bladder cancer?

A 
smoking contributies 50-60% of dx
high risk continues 10 yrs after smoking
dyes and solvent exposure
Schistosoma haematobium parasite 
catheter use
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5
Q

bladder cancer originated from what cell line?

A

98% are epithelial malignancies

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6
Q

what are S/S of bladder cancer

A

hematuria presenting symptoms in 85-90% of pts with bladder cancer
Irritative voiding
may be asymptomatic
palpable tumors, organomegaly and lyphadenopathy

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7
Q

Diagnostic testing for bladder cancer

A

U/A shows hematuria
US,CT,MRI may show masses in bladder
Dx confirmed by cystoscopy with Bx

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8
Q

what is the Tx for bladder cancer?

A

depends on stage dz
superificial cancers-lesions and intravesical chemo
radio-therapy with chemo

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9
Q

renal cell carcinoma causes

A

smoking only identifiable RF

2:1 male:female

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10
Q

renal cell carcinoma s/s

A

gross or microscopic hematuria
flank pain
abdominal mass

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11
Q

renal cell carcinoma dx testing

A

U/A hematuria, anemia

CT,MRI,US incidental findings

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12
Q

renal cell CA Tx

A

partial nephrectomy-small tumor

radical nephrectomy-large tumor

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13
Q

renal cell 5 yr prognosis

A

90-100% for tumor confined to renal capsule
50-60% for tumors beyond renal capsule
0-15% for node positive

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14
Q

Wilms tumor

A

rare kidney cancer that affects children also called nephroblastoma
MC in kids 3-4 yrs old
occurs in 1 kidney

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15
Q

wilms tumor s/s

A

abdominal swelling/pain/mass
fever
hematuria

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16
Q

wilms tumor testing

A

CBC,LFT, Renal funx, UA, CT/MRI

PET scan, Bx resection

17
Q

wilms tumor tx

A

nephrectomy, chemo, radiation, lymphnode bx

18
Q

wilms tumor prognosis for 5 yrs

A

> 90%

19
Q

prostate cancer in men is the MC what type of cancer?

A

non cutaneous cancer

20
Q

what increases risk for prostate cancer?

A

50yo american male 40% chance of developing latent CA

Blacks, FHx, high fat diet

21
Q

what type of cancer is prostate cancer

A

95% are adenocarcinomas

22
Q

prostate cancer s/s

A

may find on DRE or PSA
obstructive or voiding symptoms
hematuria or hematospermia(blood in sperm)
lymph node involvement may cause LE edema
METs are common to bone>back pain and pathologic fx

23
Q

Prostate cancer dx findings

A

Increased PSA but can be falsely elevated in BPH and prostatitis
Controversial test, 4.0 ng/ml considered “normal” PSA level

24
Q

what is the Tx of prostate cancer

A

based on tumor stage and age/ health of pt
Prostatectomy-incontinence and ED
Brachytherapy
cryosurgery
chemo
Androgen deprivation dz because prostate cancer is hormone sensitive

25
Q

what are S/E of androgen deprivation

A

decreased libido, impotence, weight gain, fatigue, anemia, hot flashes,

26
Q

prostate cancer screening

A

Discussion should start at 50yo with avg risk, 45 yo with high risk, 40yo with highest risk

27
Q

testicular cancer incidence

A

MC in men 20-35yrs old
MC in right testicle
MC in cryptorchidism

28
Q

testicular caner s/s

A

MC is painless enlargement of testes
sensation of heaviness
discrete mass or diffuse testicular enlargement

29
Q

testicular cancer testing

A

HCG, alpha fetoprotein, LDH
LFT, CBC
Scrotal U/S
Orchiectomy is needed for Bx

30
Q

testicular CA tx

A

orchiectomy
retroperitoneal radiation
chemo
lymph node bx

31
Q

testicular surveillance

A

pt followed monthly for 2 yrs then bimonthly in 3rd yr

tumor marker q visits, CXR and CT q 3months

32
Q

what are identifiable genes for PCKD?

A

ADPKD1 on chromosome 16 (85-90% of pts)

ADPKD2 on chromosome 4 (10-15% of pts)

33
Q

PCKD affects how many americans?

A

500,000

34
Q

of cysts in PCKD depends on what

A

age

35
Q

PCKD s/s

A 
abdominal/flank pain
microscopic or gross hematuria
hx of UTI and kidney stones common
FHx in 75% of cases
Large kidneys on exam
HTN+abdominal mass suggest dz
36
Q

PCKD diagnostic testing

A 
CBC, U/A
U/S confirms Dx
2+ cysts <30yo
2+ cysts in each kidney 30-59yo
4+ cysts in each kidney at 60+
37
Q

PCKD tx

A 
aimed to control complications
BP monitoring goal <125/75
Tx HTN w/ ACE or ARB 
Tx for UTI and stones
avoid contact sports 
renal transplant 
Pts at risk for cerebral aneurysm MRA screen
38
Q

PCKD prognosis

A

50% will have ESRD by 60yo

Accounts for 10% of pts on dialysis

clin med GU (6 decks)

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