revision course

Question 1

differentials for haematuria?

Answer 1

Malignancy; prostate cx, bladder tcc

Obstructive; renal calculi

Infectious; UTI, schistosomiasis

Trauma

Question 2

presentation of bladder cx?

Answer 2

Painless haematuria - visible 20%

Painless haematuria - NOT visible 5%

LUTS - urgency, suprapubic PAIN

Reccurent UTI

Pain, weight loss, lymphedema

Question 3

first line bloods in Haematuria?

Answer 3

Urine dip + MSU - rule out infection

Bloods - wccc, tumour markers

Question 4

referral criteria for haematuria?

Answer 4

Age 60+ : recurrent/persistent UTI - non urgent referal

urgent referral - 2WW;
45+, w/visible haematuria but NO UTI OR comes back after rx

60+;
non visible haematuria AND
dysuria/ raised WCC

Question 5

after referal to urology which ivx would be done next - assuming infection was ruled out?

Answer 5

1. Flexible cystoscopy

CT urogram - if visible haematuria
- will see a filling deffect if tumourr present

USS KUB - if non-visible haematuria

Question 6

A tumour is found in the bladder on imaging. What is the next mx step?

Answer 6

TURPT - transurethral resection of bladder tumour

during which biopsy taken to check for invasive disease

Question 7

what determines prognostic significance of bladder tumours?

Answer 7

muscle invasiveness

therefore it is staged this way

Question 8

which stages of bladder cancer would get TURPT?

Answer 8

Non MUSCLE invasive ones;

Ta, Tis
T1 - invaded submucosa

Question 9

bladder tumour stages?

Answer 9

T2 - muscle layers

T3 - perivesical structures

T4 - pelvic organs

Question 10

MUSCLE invasive bladder cancers are treated how?

Answer 10

Cystectomy - usually for young/fit

Radiotherapy - older pmts