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Renal > Renal system malignancies > Flashcards

Renal system malignancies Flashcards

1
Q

Area ejaculatory ducts drain into

A

Verumontanum

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2
Q

Transitional zone of prostate

A

Surrounds prostatic urethra

Gives rise to BPH

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3
Q

Peripheral zones of prostate

A

Posterolateral

Most prostate cancers

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4
Q

Central zone

A

Surrounds ejaculatory ducts

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5
Q

Most common malignancy affecting men in the UK

A

Prostate cancer

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6
Q

Most common in who?

A

70-74 years
Western world
Black
FH

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7
Q

Presentation of prostate cancer

A

Usually asymptomatic - picked up by PSA
Haematuria, haematospermia
Bone pain, anorexia, weight loss

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8
Q

What is PSA?

A

Glycoprotein produced by epithelial cells of prostate

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9
Q

Serum and semen levels of PSA

A

In health: semen levels high, serum levels low

In cancer: serum levels high

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10
Q

Other conditions which elevate PSA?

A 
BPH
Prostatitis/UTI
Retention
Catheter
PR exam
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11
Q

Investigations for prostate cancer

A

PR exam
PSA
Transrectal US and biopsy
Bone scam, MRI, CT for staging

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12
Q

What type are most prostate cancers?

A

Multifocal adenocarcinomas

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13
Q

Most common prostatic mets

A

Spine - sclerotic

Pelvic nodes

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14
Q

What scoring system used for prostate cancer grading?

A

Gleason’s score - based on appearance

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15
Q

Appearance of prostate cancer

A

Loss of basement membrane then loss of glandular structure

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16
Q

Treatment of prostate cancer

A 
Watchful waiting
Surgery
Chemotherapy
Radiotherapy
Hormonal therapy
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17
Q

Hormonal control of prostate

A

Under influence of testosterone

Deprived of testosterone = apoptosis

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18
Q

Types of hormonal therapy

A

LHRH agonists

Anti-androgens

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19
Q

How do LHRH agonists work?

A

Chronic exposure results in downregulation of LHRH receptors = suppression of LH and FSH and suppression of testosteron
Provide anti-androgen for 3 weeks due to initial increase

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20
Q

Side effects of LHRH agonists

A 
Loss of libido
Hot flushes and sweats
Weight gain
Gynaecomastia
Anaemia
Cognitive changes
Osteoporosis
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21
Q

How do anti-androgens work?

A

Compete with testosterone for receptors = apoptosis of cancer cells

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22
Q

Side effects of anti-androgens

A

Steroidal: loss of libido, ED, gynaecomastia, hepatotoxic, cardiotoxic
Non-steroidal: gynaecomastia, hot flashes, hepatotoxic

23
Q

Diagnosis of bladder cancer

A

Xray
Uroscopy
CT

24
Q

Types of bladder cancer

A

Transitional cell 90%

SCC 9%

25
Q

Types of transitional cell cancer

A

Papillary - 50% are malignant

Non-papillary - all are malignant

26
Q

Appearance of transitional cell cancer

A

Multicentric

Bilateral

27
Q

Who gets bladder cancer?

A

Males >50

28
Q

Angiomyolipoma

A

Benign

Hamartoma: fragile BVs, fat, smooth muscle

29
Q

How to diagnose angiomyolipoma

A

CT

Biopsy (dangerous due to haemorrhage)

30
Q

Treatment of angiomyolipoma

A

Embolisation if bleed

31
Q

Oncocytoma

A

Benign, can look like malignant RCC

Central scar on CT

32
Q

Diagnosis of oncocytoma

A

CT central scar (strands radiate out)

Nephrectomy - high false negative rate of malignant

33
Q

Presentation of RCC

A

Loin pain
Renal mass
Frank haematuria
Paraneoplastic: weight loss, bone pain, anaemia, HT, hypercalcaemia

34
Q

Who gets RCC?

A

Males 65-75

35
Q

Types of RCC

A

Adenocarcinoma of PCT
Carcinoma (epithelial)
Clear cell and papillary
CD adenocarcinoma

36
Q

Syndrome which may lead to multiple, bialteral renal tumorus

A

VHL

37
Q

Diagnosis of RCC

A

US
CT
Biopsy

38
Q

How does RCC spread?

A

Haematogenous via renal vein

Mets to lung, liver, bone, brain

39
Q

Treatment of RCC

A

Surgery - total/partial nephrectomy

Biological therapies

40
Q

BXO

A

Balanitis Xerotica Obliterans
Pre-malignant lesion
Scarring of foreskin and up urethra, white demarcated line
White patches, bleeding, pain

41
Q

Treatment of BXO

A

Circumcision
Dilatation
Glans resurfacing, skin graft

42
Q

SCC of penis in situ

A

Red velvety patches

Bowen’s or Queyrat’s (pre-malignant) = 5FU or circumcision

43
Q

Invasive SCC of penis

A

Older men, red raised area, fungating mass, foul smelling, phimosis (narrowing)
HPV 16

44
Q

Treatment of invasive SCC of penis

A

Surgery
Chemo
Radio
Nodes

45
Q

Germ cell tumours of testicles

A

Seminoma
Teratoma
ITGCN (intra-tubular germ cell neoplasia)

46
Q

Presentation of testicular cancer

A

Painless swelling, hard

Neck nodes, SOB, clavicular nodes

47
Q

Diagnosis of testicular cancer

A

US
CXR
CT

48
Q

AFP marker

A

Raised in teratoma with yolk sac elements

49
Q

HCG marker

A

Raised in teratoma with trophoblast components

50
Q

LDH and placental ALP markers

A

Raised in seminoma

51
Q

Who gets testicular cancer?

A

20-35 years

Undescended testes

52
Q

Where does testicular cancer mets to?

A

Kidneys

53
Q

Treatment of testicular cancer

A

Radiotherapy
Chemotherapy
Surgery

Renal (19 decks)

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