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Phase 2 Metabolic > Renal and Urological Malignancy > Flashcards

Renal and Urological Malignancy Flashcards

1
Q
  1. From which cells does renal cell carcinoma arise from?

2. What is the epidemiology of renal cell carcinoma?

A
  1. proximal tubular epithelium

2. men > women; usually present after 50

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2
Q

Name 7 risk factors for the development of renal cell carcinoma

A
  1. smoking
  2. obesity
  3. hypertension
  4. renal transplantation
  5. dialysis
  6. exposure to pelvic radiation
  7. fam hx
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3
Q

What is the clinical presentation of renal cell carcinoma?

A
  • often asymptomatic and discovered incidentally (30% of patients present with metastatic disease)
  • heamaturia, loin pain, mass in flank
  • malaise, anorexia, weight loss
  • hypertension (secretion of renin by tumour)
  • anaemia (depression of EPO)
  • ipsilateral varicocoele - tumours invade renal vein, causing obstruction to drainage of the left testicular vein (although this rarely happens on the left side)
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4
Q

Which investigations are useful for ?renal cell carcinoma?

A
  • urinalysis - haematuria
  • FBC - anaemia
  • Lactate dehydrogenase - indicator of tissue damage
  • Serum calcium - raised
  • creatinine - elevated
  • pelvic ultrasound - used to distingiosh between cystic and solid lesions
  • CT/MRI - often CT contrast is contraindicated due to renal insufficiency
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5
Q

How is renal cell carcinoma managed?

A
  • nephrectomy
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6
Q

Which autosomal dominant condition is associated with increased risk of renal cell carcinoma and why?

A

Von Hippel-Lindau Disease

  • autosomal dominant
  • VHL is a tumour suppressor; inactivating mutations leads to the formation of multiple tumours
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7
Q
  1. Which renal tumours are common in children?
  2. How do patients with these tumours present?
  3. How is this condition managed?
A
  1. Wilms’ Tumour
  2. abdominal mass
  3. nephrectomy and chemoradiation
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8
Q

Which is the most common type of bladder cancer?

A

Transitional cell carcinoma

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9
Q

Describe the epidemiology of transitional cell carcinoma

A
  • more common in men

- uncommon under 40

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10
Q

Name 4 risk factors associated with the development of Transitional Cell Carcinoma

A
  • smoking
  • exposure to industrial carcinogens
  • exposure to drugs - cyclophospamide,
  • chronic inflammation
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11
Q
  1. What is the most common presenting symptom of transitional cell carcinoma?
  2. Describe other symptoms of transitional cell carcinoma?
  3. Name ways in which pain can result from TCC
A
  1. painless haematuria
  2. symptoms suggestive of UTI in the absence of significant bacteraemia
    pain
  3. Local nerve involvement; metastases; urinary tract obstruction
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12
Q

Name 4 investigations for ?Transitional Cell CA

A
  1. urine cytology for malignant cells
  2. urinary tumour markers
  3. cystoscopy to assess tumour burden and for biopsy
  4. CT/MRI for staging
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13
Q

Management of TCC:
1. Early stage renal pelvis and ureteric tumours

  1. superficial bladder cancers
  2. Muscle invasive bladder cancers
A
  1. nephro-ureterectomy
  2. transurethral resection and chemotherapy
  3. neoadjuvant cisplatin based chemo; radical cystectomy or radical radiotherapy
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14
Q

Name 6 risk factors for prostate cancer

A
  1. advancing age
  2. race - common in afro-caribbean population
  3. family hx
  4. prostatitis and STIs
  5. Obesity
  6. Elevated blood levels of testosterone
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15
Q
  1. What kind of cancer are the majority of prostate tumours?
  2. Which zone of the prostate do cancers commonly arise?
  3. Which tissues do prostate cancers commonly metastasise to?
A
  1. prostate adenocarcinoma
  2. peripheral zone
  3. bones and lymph
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16
Q

Describe clinical features of prostate cancer

A
  • LUTS
  • back/skeletal pain if bone mets
  • weight loss/anaemia
  • hard, irregular gland on digital rectal examination
  • raised PSA (however this test is NON SPECIFIC)
17
Q
  1. Which test is used to definitively diagnose prostate cancer?
  2. Which test is used in the monitoring of prostate cancer?
  3. Name 2 other investigations that are useful in prostate cancer
A
  1. transrectal ultrasound of the prostate - guides biopsy
  2. PSA
  3. bone scan (mets)
    CT/MRI (staging)
18
Q
  1. What is used in the radical management of prostate cancer?
  2. How can prostate cancer be medically managed? (4)
A
  1. radical prostatectomy/radiotherapy
  2. GnRH agonists - goserelin
    Androgen receptor blockers - bicalutamide
    Androgen synthesis inhibitors - abiraterone
    Corticosteroids and oestrogen

Phase 2 Metabolic (12 decks)

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