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My2 renal > Prostate and Urinary Cancer > Flashcards

Prostate and Urinary Cancer Flashcards

1
Q

where is the prostate located

A

base of bladder and circles the urethra

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2
Q

what is the function of the prostate

A

adds lubricant and fluid to sperm

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3
Q

what are the 3 zones of the prostate

A

transitional, central, peripheral

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4
Q

what age group does prostate cancer commonly affect

A

age 70-75 (is rare under 50)

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5
Q

what is a random risk factor for prostate cancer

A

cadmium batteries

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6
Q

what is a common presentation of prostate cancer

A

lower UTI symptoms, haematuria, haematospermia, bone pain, anorexia, weight loss

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7
Q

what investigations are done for prostate cancer

A

PSA test (high serum), PR, trans-rectal USS

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8
Q

what are abnormal findings from a PR prostate exam

A

asymmetry, nodules, fixed mass

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9
Q

what conditions beside prostate cancer may show an elevated PSA

A

benign prostate hyperplasia, prostatitis, retention, catheterisation

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10
Q

what is the most common type of prostate adenocarcinoma

A

95% multifocal

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11
Q

where do prostate adenocarcinomas locally extend to

A

through capsule –> urethra –> bladder –> seminal vesicles –> autonomic nerves

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12
Q

where does prostatic cancer commonly metastasise to

A

pelvic lymph nodes and skeleton (sclerotic legions)

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13
Q

what scale is used for grading prostate cancer

A

gleason’s: 1-5 (5 worst prognosis)

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14
Q

what investigations are done for staging of prostate cancer

A

bone scan, MRI, CT

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15
Q

what management is done for a confined prostate cancer

A

radiotherapy and surgery if needed

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16
Q

what management is done for metastases of prostate cancer

A

androgen deprivation (hormonal, orchidectomy), steroids, chemo

17
Q

what hormones cause proliferation of prostate cells

A

testosterone/ dihydrotestosterone

18
Q

what drugs reduce testosterone

A

LH receptor hormone analogue Aka GnRH agonists (and anti-androgens)

19
Q

how do LHRH agonists work to reduce testosterone

A

cause transient rise in LH, FSH and testosterone but negative feedback then down-regulates and reduces production

20
Q

what do LHRH agonists need to be covered with in first 1-2 weeks

A

anti-androgens

21
Q

how do anti-androgens work

A

compete with testosterone and DHT on prostate cells

22
Q

name a steroidal anti-androgen and the side effects they cause

A

cyproterone acetate - loss of libido and erectile dysfunction

23
Q

name a non-steroidal anti-androgen and the side effects they cause

A

nilutamide, fultamide, bicalutamide - gynaecomastia, breast pain, hepatotoxity (libido remains)

24
Q

what are common side effects of hormonal treatment to prostate cancer

A

loss of libido, hot flushes, weight gain, gynaecomastia, anaemia, osteoporosis

25
Q

which age group is commonly affected by BPH

A

affects 75% of men over 70

26
Q

what usually causes BPH

A

imbalance of hormones - decreases androgens and normal oestrogen

27
Q

what are symptoms of BPH

A

prostatism: poor stream, overflow incontinence, can’t start peeing, dribbling

28
Q

what are treatment options for BPH

A

1st line alpha blocker eg tamsulosin / 5a reductase inhibitor / surgery

29
Q

what are the main types of urinary tumours

A

transitional (90%), squamous (9%), 1% adenocarcinomas and sarcomas

30
Q

what are risk factors for urinary cancer

A

males and smoking (almost as big a risk factor as it is for lung cancer)

31
Q

what is the most common type of transitional urinary tumour and is it malignant

A

80% are papillary type and of those 50% are malignant (carcinoma or papilloma)

32
Q

what is the 2nd most common type of transitional urinary tumour and is it malignant

A

non-papillary (20%) and they are all malignant

33
Q

what is seen on a transitional cell urinary biopsy

A

multi-centric, striated, multiple discrete legions

34
Q

what increases risk of developing transitional cell carcinoma of the bladder

A

catheter

35
Q

what is urachal adenocarcinoma

A

remnant of allantois (connected umbilicus to bladder in embryo)

36
Q

how can SSC’s develop in the bladder

A

persistant inflam –> squamous metaplasia

My2 renal (27 decks)

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