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Renal system cancers Flashcards

1
Q

What covers the prostatic urethra?

A

Transitional epithelium

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2
Q

Where is the transitional zone of the prostate?

A

Surrounds prostatic urethra

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3
Q

What does the transitional zone give rise to?

A

BPH

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4
Q

What is the central zone of the prostate?

A

Cone shaped region surrounds the ejaculatory ducts

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5
Q

Clinical presentation of prostate cancer

A

Haematuria/Haematospermia
Bone pain
Anorexia
Weight loss

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6
Q

What is PSA?

A

Glycoprotein enzyme produced by the secretory epithelial cells of the prostate gland

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7
Q

What is the function of PSA?

A

Involved in liquification of semen

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8
Q

What can cause raised PSA?

A

Prostatitis/UTI
Retention
Cathererisation
DRE

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9
Q

When is a PSA test indicated?

A

When patient has symptoms

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10
Q

Indications for a TRUS biopsy?

A

Men with abnormal DRE and elevated PSA
Previous biopsies showing PIN or ASAP
Previous normal biopsies but rising PSA trends

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11
Q

What type of cancer are 95% of prostate cancers?

A

Multifocal adeocarcinomas

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12
Q

What are the most common sites for prostate metastases?

A

Pelvic lymph nodes

Skeleton

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13
Q

Are metastases of prostate cancer sclerotic or lytic?

A

Sclerotic

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14
Q

What system is used to grade prostate cancers?

A

Gleasons

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15
Q

What imaging modalities can be used to stage prostate cancer?

A

Bone scan
MRI
CT scan

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16
Q

Treatment options

A

Watchful waiting

Radical prostatectomy rADICAL RADIOTHERAPY

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17
Q

Complications of radical prostatectomy

A

ED
Incontinence
Bladder neck stenosis

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18
Q

When would hormonal therapy be used for prostate cancer?

A

Symptomatic patients who need palliation of symptoms unfit for curative

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19
Q

Management of metastatic prostatic cancer

A

Androgen deprivation therapy (LHRH analogues, anti-androgens)
Steroids
Cytotoxic chemo

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20
Q

What influences the growth of prostate cancer cell?

A

Testosterone

Dihydrotestosterone

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21
Q

Sources of testosterone

A

Testis (90%)

Adrenal (10%)

22
Q

What happens if prostate cells are deprived of andorgenic stimulation?

A

They undergo apoptosis

23
Q

How do LHRH agonist work?

A

own regulate LHRH receptors with subsequent

24
Q

Why is anti-androgen given 1 week before and 2 weeks after LHRH agonists?

A

To prevent testosterone surge (can cause catastrophic spinal cord compression

25
Q

Side effects of LHRH agonists

A 
Loss of libido/ED
Hot flushes/sweats 
Weight gain 
Gynaecomastia 
Anaemia 
Cognitive changes 
Osteoporosis
26
Q

What is the action of anti-androgens?

A

Compete with testosterone and DHT for biding sites on prostate cell nucleus promoting apoptosis and inhibiting CaP growth

27
Q

What are the 2 types of anti-androgens?

A

Steroidal

Non-steroidal

28
Q

Which type of anti-androgen maintains sexual interest & libido?

A

Non-steroidal

29
Q

What are 90% of uroepithelial tumours?

A

Transitional cell

30
Q

Appearance of transitional cell carcinoma on imaging

31
Q

How are transitional cell cancers diagnosed?

32
Q

Examples of benign renal tumours

A

Renal cysts
Oncocytoma
Angiomyolipoma

33
Q

What is the embryonic tumour of the kidneys?

A

Nephroblastoma (Wilm’s tumour)

34
Q

What is the main risk with renal angiomyolipomas?

A

Haemorrhage

35
Q

What would be seen on a CT f an oncocytoma?

A

Central scar

36
Q

What is the classic triad of renal cell carcinoma? (only present in 15%)

A

Loin pain
Renal mass
Haematuria

37
Q

What could multifocal or bilateral renal cell carcinoma be suggestive of?

A

Von Hippel-Lindau

38
Q

What is the gold stanard investigation for RCC?

A

CT contrast

39
Q

Which investigation has a high false negative in RCC?

40
Q

Where does RCC tend to metastasize?

A

Lungs
Liver
Bone
Brain

41
Q

Management of RCC

A

Radical nephrectomy
Partial nephrectomy
Radiofrequency ablation

42
Q

What adjuvant therapy can be given in RCC

A

IL2
Interferon alpha
Tyrosine kinase inhibitors (reduces neovascularisation)

43
Q

What is BXO?

A

Pre-malignant cutaneous lesion

44
Q

Managemetn of lichen sclerosis at atrophicus

A

Circumcision
Meatal stenosis requiring dilation
Glans resurfacing

45
Q

Examples of squamous cell carcinomas in situ on the penis?

A

Erthyroplasia of Queyrats
Bowen’s disease
Zoon’s balantis

46
Q

Treatment of squamous cell carcinoma in situ

A

Circumcision

Topical fluorouracil

47
Q

Presentation of invasive SCC of the penis

A

Red raised area
Fungating mass
Foul smelling
Phimosis

48
Q

Which strain of HPV is linked to development of SCC of the penis

49
Q

In which testicular tumour is AFP never raised?

50
Q

Is a raised HCG more likely to be seminoma or teratoma?

AY Renal (15 decks)

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