RENAL 3

Question 1

premalignant lezioso of penile cancer

Answer 1

balantix xerotica obliterans - white patches, fissuring, bleeding, scarring

bowens

erythroplasia of epidermis - red velvety patches

Question 2

treatment of pre malignant lesions

Answer 2

circumsise if prepuce alone

topical 5 FY, cryotherapy, excision

Question 3

squamous carcinoma of penis who
majority are what
symptoms/signs
rx

Answer 3

councorcumscised. poor hygiene. HPV. 80yo
in situ
presentation often delayed - red raised penis, fumigating, foul smelling
surgery, inguinal nodes biopsy, radiotherapy

Question 4

BPH affects what 
cause
symptoms 
cx
rx

Answer 4

both stromal and glandular tissue
hormone imbalance
prostates: difficulty starting, poor stream, overflow incontincane, retention, disturbance of bladder sphincter
bladder hypertrophy - diverticulum, hydroureter, hydronephresis, infection
surgery/tranuretheral resection, alpha blocker, 5 alpha RI

Question 5

prostate cancer commonest who where 
symptoms 
lymph spread 
blood spread 
ix
rx

Answer 5

adeno. prostatism, bladder outflow obstruction
lymph: sacral, iliac, paraaoritc
haem: bone (lumbar spine and pelvis), lungs, liver
DRE, PSA, USS, skeletal XR, biopsy 10-12 taken
hormone therapy: goserline and cryproterone, radical prostectomy, radio

Question 6

presentation of testicular tumours

ix

Answer 6

painless testicular enlargement, hydrocele, gynacamastia, 10% present due to mets - neck nodes
USS, CXR, CT

Question 7

AFP
bHCG
LDH
PLAP

Answer 7

yolk sac. never raised in seminoma
trophoblastic composants
tumour burden
seminoma

Question 8

seminoma

Answer 8

rare before puberty
potato
radiosensitive

Question 9

teratoma

Answer 9

can occur in childhood

trophoblastic

Question 10

treatment of testicular cancer

Answer 10

orchidectomy, radio/cehmo

Question 11

RPLND

Answer 11

residual LNs may harbour tumour
1/3 fibrous tissue
1/3 benign teratoma
1/3 residual teratome

Question 12

wilms tumour is what 
who 
symp
rx
prognosis

Answer 12

commonest intra abdominal tumour in children
<5. arises from residual primitive renal tissue
abd mass, painless haematuria, flank pain, commonly unilateral, mets in 20% - lung
nephrectomy, chemo, radio if advanced
prognosis is good 80% cure rate

Question 13

where does RCC arise from commonly

risk factors

Answer 13

proximal tues

M>F. >50s. smokers. VHL syndrome. tuberous sclerosis

Question 14

symptoms of RCC

Answer 14

frank haematuria, loin pain, abdominal mass

pyrexia, organomegaly, left varicocele (occlusion of left testicular vein), 25% have mets on presentation

Question 15

types of RCC
ix
rx

Answer 15

clear cell or papillary
urinalysis, USS, CT, biopsy
partial or total nephrostomy. alpha interferon/IL2

Question 16

paraneoplastic syndrome of RCC

secondary tumours to kidneys

Answer 16

erythropoietin - polycythaemia
rennin - htn
PTH - hypercalacaemia
ACTH

lung, breast, melanoma, lymphomas

Question 17

bladder cancer is mostly what

divided into what

Answer 17

transitional 90%
papillary 70%
non papillary solid/mixed - all malignant

Question 18

risk factors for bladder cancer
symptoms
ix
rx

Answer 18

dye industry (aniline dye), rubber industry, analgesics, smoking, cyclophosphamide, schistosomiasis (squamous)

painless haematuria

urinalysis, cytology, cytoscopy/biopsy, pelvic MRI, CT, TNM staging

transuretheral resection of bladder tumour, intravesical chemo
T2 and above - surgery/radical radiotherapy

Question 19

fibroma
adenoma
aniomyolipoma
JGCT
oncocytoma

Answer 19

medullary organ - white nodules
yellowish, <2cm, usually papillary 
assoc w TB
proudce rennin - htn
central scar on XR - remove to diagnose

Question 20

anapaestic and neuroendocrine malignancy renal cancer

embryonal rhabdomyosarcoma

Answer 20

similar to SCLC

commonest malignant bladder tumour in children