Rakib pearls

Question 1

Proctitis grade

Answer 1

GrI: mild diarrhea/cramping
GrII: moderate diarrhea, freq >5 times
Gr III: obstruction/ bleeding that requires surgery
Gr IV: presence of necrosis/fistula

Question 2

Palliative radiotherapy to lung dose

Answer 2

16 gy in 2 fraction
20 gy in 5 fraction
36 gy in 12 fraction

Question 3

esophagus and stomach lining

Answer 3

esophagus: non keratinized squamous epithelium
stomach: columnar epithelium

Question 4

Preferred neo adjuvant therapy for bladder cancer

Answer 4

DDMVAC:
- dose dense methotrexate
- vinblastin
- Doxorubicin
- cisplatin

Question 5

Urinary bladder evaluation

Answer 5

confirm by cystoscopic biopsy and evaluation
urine cytology
CT urogram
Uretero renoscopy
+-MRI of pelvis

Question 6

histopathological classification of bladder

Answer 6

transitional cell carcinoma
squamous cell carcinoma
adenocarcinoma
sarcoma
melanoma
lymphoma
carcinoid

Question 7

Radical cystectomy indication

Answer 7

high risk NMIBC after TURBT
BCG unresponsive NMIBC
positive nodal disease
recurrent disease primary treated with CCRT
Hydronephrosis
poor renal function
multiple
extensive carcinoma in situ
squamous cell carcinoma
adenocarcinoma variety
from another source
-Extensive bladder involvement with inability to attain complete resection of all visible disease despite multiple attempts at TURBT
- men with CIS involving the prostatic ducts/acini
- pure squamous cell or adenocarcinoma histology
- T1 tumor with lymphovascular invasion or variant histology, such as micropapillary, neuroendocrine/small cell or sarcomatoid features
- T1 grade 3 tumors that are large/diffuse/ multifocal or persistant lesions identified on re resection
- T1b tumors (deep or extensive involvement of the lamina propria)

Question 8

Risk factor for bladder carcinoma

Answer 8

smoking
occupation
aniline dye
aromatic amines
polycyclic aromatic and chlorinated hydrocarbons
leather
paints
rubber industry worker
analgesic abuse: phenacetin
chemotherapy
cyclophosphamide
chronic irritation
indwelling catheter
bladder stone
chronic urinary bladder infection
pelvic RT
infection
bacterial
schistomia hematobium
HPV virus
Genetic
chromosome 9
P53 mutation
Rakib sir favorite: pestide

Question 9

Renal carcinoma variety

Answer 9

clear cell type (75%)
non clear cell type:
- papillary
- chromophobe
- oncocytic
- sarcomatoid (bad prognosis)
rakib sir will wait till hearing sarcomatoid)

Question 10

supra tentorial and infra tentorial tumor

Question 11

presentation of nasopharyngeal carcinoma

Question 12

skin malignancy classification

Question 13

mucositis grade