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Renal > Prostatic and Bladder Cancer > Flashcards

Prostatic and Bladder Cancer Flashcards

1
Q

What is the apex of the prostate continuous with?

A

striated spincter

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2
Q

What is the base of the prostate continuous with?

A

bladder neck

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3
Q

What is the ejacultory duct?

A

union of seminal vesicles and vas deferens

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4
Q

What is the verumontanum?

A

elevation in the prostatic urethra where the ejacultory ducts drain

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5
Q

What is the transitional zone of the prostate?

A

surrounds the prostatic urethra proximal to the verumontanum which gives rise to BPH

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6
Q

What is the central zone of the prostate?

A

cone shaped region that surround the ejaculatory ducts

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7
Q

What is the peripheral zone of hte prostate?

A

posteriolateral prostate- majority of prostatic glandular tissue

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8
Q

Where does the majority of prostate adenocarcinoma arise from?

A

peripheral zone

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9
Q

What ethnicity has the greatest risk of prostate cancer?

A

black men

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10
Q

How are most prostatic cancers picked up?

A

PSA tests and abnormal DRE findings

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11
Q

What is found on DRE with prostate cancer?

A

asymmetry; nodule; fixed craggy mass

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12
Q

What is prostate specific antigen?

A

a glycoprotein enzyme produced by the secretory epithelial cells of the prostate

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13
Q

What is the function of PSA?

A

liquefaction of semen

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14
Q

What can elevate PSA aside from prostate cancer?

A

BPH; prostatitis/UTI; retention; catheterization; DRE

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15
Q

What are teh indications for trans-rectal USS guided prostate biopsy?

A

men with abnormal DRE or eleated PSA

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16
Q

What are the complications of TRUS?

A

sepsis; rectal bleeding; haematospermia and haematuria

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17
Q

What type of cancer are the majority of prostate cancers?

A

multifocal adenocarcinomas

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18
Q

What is the pattern of growth with prostate cancer?

A

local extension through the prostatic capsule, to the urethra, bladder base and seminal vedicals with perineural invasion along autonomic nerves

19
Q

Where are the most common sites for mets with prostate cancer?

A

pelvic lymph nodes and the skeleton

20
Q

What is the Gleason’s score system?

A

based on the architectural appearance rather than cytological features of CaP

21
Q

What increases the Gleason score?

A

loss of the glandular structure and replacement by a disorganised malignant cell growth pattern

22
Q

Why is Gleason’s score used?

A

a very good predictor of prognosis

23
Q

What is the T3 PaC?

A

tumour has extended through the prostatic capsule

24
Q

What are the complications of radical prostatectomy?

A

erectile dysfucntion; incontinence; bladder neck stenosis

25
Q

What are the complications of radical radiotherapy for CaP?

A

irritative LUTS; haematuria; GI symptoms; erectile dysfunction; incontinence

26
Q

What is the hormonal therapy for CaP?

A

LNRH (GNRH) analogues; anti-androgens; bilateral subcapsular orchidectomy; maximal androgen blockade

27
Q

What is growth of prostate cancer cells under the influence of?

A

testosterone and dihyrotestosterone

28
Q

Where does testosterone come from?

A

90%- testis; adrenals

29
Q

What happens if prostate cells are deprived of androgenic stimulation?

A

undergo apoptosis

30
Q

What happens with chronic exposure to LNRH agonists?

A

down-regulation of LNRH receptors with subsequent suppression of LH and FSH

31
Q

What can happen initially with LNRH analogues?

A

initially have transient rise in LH and FSH and so testosterone

32
Q

What complication can happen with the testosterone surge phenomenon?

A

spinal cord compression

33
Q

What is given before and during initial treatment with LNRH agonists to prevent spinal cord compression?

A

anti-androgen covers

34
Q

What are the side effects of LNRH agonists?

A

ED; hot flushes and sweats; weight gain; gynaecomastia; anaemia; cognitive changes; OP

35
Q

What is the action of anti-androgens?

A

compete with testosterone for binding sites in the prostate cell nucleus to promote apoptosis

36
Q

What are the 2 types of anti-androgens?

A

steroidal and non-steroidal

37
Q

What are the side effects of cyproterone (stseroidal anti-androgen)?

A

loss of libido and ED; gynaecomastia; CVS toxicity and hepatotoxicity

38
Q

hat are the SE and non-steroidal anti-androgens (nilutamide, flutamide)?

A

gyaecomastia, breast plain and hot flashes and hepatotoxicity but retain sexual interest

39
Q

What are the 2 main types of bladder cancer?

A

mainly transitional cell, some squamous

40
Q

What is the classification of transitional cell carcinoma?

A

papillary and non-papillary

41
Q

What is the more common typ of transitional cell carcinoma?

A

papillary type

42
Q

What is the difference between papillary nad non-papillary carcinoma?

A

papillary only half are infiltrative malignances whereas all non-papillary are considered malignent

43
Q

What is the investigations for bladder carcinoma?

A

CT urography and cystoscopy

44
Q

What is squamou cell carcinoma of the bladder associated with?

A

schistosomiasis

Renal (33 decks)

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