OnlineMedEd: Surgery: Subspecialty - "Uro Cancer"

Question 1

Prostate cancer is a result of _____________.

Answer 1

testosterone (5-DHT)

Question 2

The USPSTF is moving away from _____________.

Answer 2

asymptomatic screening for prostate cancer (no DREs!)

Question 3

Obstructive symptoms are more typical of which kind of prostate pathology?

Answer 3

BPH

Question 4

Testers might describe a _____________ feeling prostate on DRE to clue you in to malignancy.

Answer 4

firm, nodular

Question 5

Prostate biopsy should be through ___________, though ____________ is also acceptable.

Answer 5

rectal (because of the proximity of the peripheral zone); urethral

Question 6

How is Gleason scoring done?

Answer 6

• Take 10-12 samples
• Pick the worst 2
• Add values

Question 7

Which procedure is best at treating prostate cancer?

Answer 7

Radiation = resection = brachytherapy (seeds)

No difference

Question 8

Medically, prostate cancer can be treated _____________.

Answer 8

with androgen receptor antagonists (enzalutamide, flutamide) or GnRH agonists (leuprolide)

Question 9

To monitor the treatment of prostate cancer, draw a _________.

Answer 9

PSA

• If it rises but the patient is otherwise asymptomatic, treat with androgen receptor antagonists.
• If it rises and the patient is symptomatic, treat with radiation too.

Question 10

Urothelial cell carcinoma usually arises from ___________.

Answer 10

transitional epithelium

Question 11

Patients with bladder cancer often present with ____________.

Answer 11

painless hematuria

Question 12

What factors increase the likelihood of bladder cancer?

Answer 12

• Aniline dye exposure

* Smoking

Question 13

To workup suspected bladder cancer, _______________.

Answer 13

first do an US, then a cystoscopy with biopsy

Question 14

How is bladder cancer treated?

Answer 14

• Resection
• BCG (yes, the TB vaccine: it induces an immune response that has been shown to help decrease tumor burden)
• Cisplatin
• Cystectomy

Question 15

What age group is most likely to develop germ cell testicular tumors?

Answer 15

18 - 35

Question 16

How do you work up and treat suspected testicular cancer?

Answer 16

• Painless mass
• Does not transilluminate
• Orchiectomy –FNA would seed the tract

Question 17

Which kind of testicular cancer is “exquisitely sensitive” to chemotherapy?

Answer 17

Seminoma

Question 18

Review the serum correlates with the non-germ cell tumors.

Answer 18

• Yolk sac tumor (aka endodermal sinus tumor): AFP

* Choriocarcinoma: b-HCG

Question 19

List five signs/symptoms of RCC.

Answer 19

• Flank pain
• Painless hematuria
• Palpable flank mass
• Anemia (if non-functional)
• Erythrocytosis (if functional)