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Knowledge Rehab > Testicular and Bladder Cancer > Flashcards

Testicular and Bladder Cancer Flashcards

1
Q

Which of the following is FALSE about testicular cancer?
A. Most common solid tumor in men 20-34 y/o
B. Most are germ cell tumors
C. Cryptorchidism increases risk of testicular cancer
D. Pre-pubertal orchiopexy hasnotshown to decrease risk of cancer

A

D. It does decrease risk

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2
Q

T/F:Seminomasare radiation sensitive.

A

True

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3
Q

T/F: Pure seminomas produce alpha fetoprotein (AFP)

A

False. Theyneverproduce AFP

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4
Q

T/F: Seminomas grow slower than NSGCT

A

True

NSGCT doubling time = 10-30 days

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5
Q

What are the 3 types of the seminomas?

A

Typical (classic) - 85%
Anaplastic - 5-10%
Spermatocytic - 2-12%

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6
Q

What type of seminoma?
Seen in older patients
Favorable prognosis

A

Spermatocytic

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7
Q

What type of seminoma?
Greater metastatic potential
Higher bHCG production

A

Anaplastic

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8
Q

Seminomas produce ____

A

beta-human chorionic gonadotropin (bHCG)

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9
Q

What are the 4 types of NSCGT?

A

Teratoma
Embryonal
Choricarcinoma
Yolk Sac

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10
Q

What type of testicular cancer is NOT chemosensitive?

A

Teratoma (NSGCT)

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11
Q

What kind of testicular cancer spreads hematogenously?

A

Choricarcinoma (NSGCT)

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12
Q

What type of testicular cancer is most common in children?

A

Yolk Sac (NSCGT)

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13
Q

What type of testicular cancer may hemorrhage?

A

Choricarcinoma

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14
Q

Regional spread nodes in what direction?

A

Right to left

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15
Q

Right testis spread to ____

A

interaortocaval area

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16
Q

Left testis spreads to ____

A

para-aortic area

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17
Q

T/F: Patients typically present with painful enlarged testis.

A

False.Painless

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18
Q

Alpha-fetoprotein is produced by (2)

A 
Yolk sac tumors (NSGCT)
Embryonal cancer (NSGCT)
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19
Q

Human chorionic gonadotropin (hCG) produced by (2)

A

Choriocarcinoma

15% of seminoma

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20
Q

Best imaging modality to diagnose testicular cancer

A

Scrotal ultrasound

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21
Q

T/F: Testicular mass biopsy should be performed in order to confirm diagnosis of testicular cancer.

A

False. NEVER perform a testicular mass biopsyAny solid intratesticular mass is neoplastic until proven otherwise

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22
Q

T/F: Advanced testicular cancer has a high mortality rate due to its rapid progression.

A

False.

23
Q

Radiation is used to treat ____

A

seminoma

24
Q

Most serious long term SE of chemotherapy

A

Second malignancy

25
Q

T/F: Retroperitoneal Lymph Node Dissection (RPLND) causes erectile and ejaculatory problems.

A

False. No erection problems. Ejaculation problems.

26
Q

T/F:Retroperitoneal Lymph Node Dissection (RPLND) is an effective treatment of low stage seminoma.

A

False. Not used b/c seminoma is “sticky”

Low stage seminoma treated w/ adjuvant radiotherapy

27
Q

High stage seminoma is treated with ____

A

Cisplatin-based chemotherapy

28
Q

Stage 1 NSGCT treated with ____

A

Orchiectomy
Retroperitoneal Lymph Node Dissection (RPLND)
Surveillance
Chemotherapy

29
Q

What should you do if tumor markers are still elevated after orchiectomy as treatment for NSGCT?

A

Sign of distant mestastasis –> treat with chemotherapy

30
Q

High stage NSCGT treated with ____

A

Chemotherapy
Postchemotherapy residual masses treated w/ RPLND

*Teratoma is NOT responsive to chemotherapy

31
Q

T/F: Bladder cancer is predominently in old men.

A

True. Peak age 70-80 y/o

32
Q

Which of the following is NOT a risk factor of bladder cancer?
A. Smoking
B. Rubber, textile, dye exposure
C. Being a hair dresser
D. Pesticide exposure
E. Chronic cystitis (indwelling catheter)
F. Schistosomiasis

A

D. Pesticide is NOT a significant risk factor

33
Q

T/F: Family history is a significant contributor to getting bladder cancer.

A

False. Only 8% contribution. However RR increases 2x w/ FHx.

34
Q

Most common histological type of bladder cancer

A 
Urothelial carcinoma (95%)
Squamous cell carcinoma (5%)
35
Q

2004 grading classification of bladder cancer

A

PUNLMP = papillary urothelial neoplasm of low malignant potential
Low grade
High grade

36
Q

What stage?

Muscle invasive bladder cancer

A

T2 = stage of invasion

37
Q

T/F: Stage T3 bladder cancer is treated by resection of the tumor.

A

False. T3 has invaded into perivescal fat. Can’t resect into the fat.

38
Q

T/F: Stage T4bladder cancer is treated by resection of the tumor.

A

True. T4 = prostatic stromal invasion

39
Q

Regional lymphatic spread of bladder cancer spreads to _____

A

pelvic lymph nodes

40
Q

Advanced disease of bladder cancer spreads to the _____ lymph nodes

A

retroperitoneal

41
Q

Most common clinical sign of bladder cancer

A

Intermittent, gross, painless hematuria (80-90% of cases)

42
Q

T/F: AUA guideline requires 2 out of 3 positive dipstick tests for hematuria to diganose asymptomatic microhematuria in association with bladder cancer.

A

False. Require only 1 + UARequring more than 1 lowers cancer detection rate b/c hematuria associated with bladder cancer is highly intermittent.

43
Q

T/F: Patients with bladder cancer have positive PE findings, including palpable bladder/pelvic mass.

A

False. PE is normal unless in advanced disease

44
Q

T/F: Urine cytology is highly sensitive to detecting bladder cancer.

A

False. Highly specific (ruling inbladder cancer diagnosis)

45
Q

Best imaging modality for bladder cancer

A

CT abd/pelvis +/- contrast = CT urogram

46
Q

Alternative imaging modality for patients who can’tget contrast due to allergy or azotemia

A

Retrograde pyelogram orMRI

47
Q

T/F: A positive finding on the CT urogram is diagnostic of bladder cancer.

A

False. Allcurent imaging studies are inadequate to clear bladder

48
Q

Gold standard for bladder cancer diagnosis

A

Cystoscopy (w/ biopsy if necessary)

49
Q

Treatment of primary bladder tumor

A

Transurethral resection of bladder tumor (TURBT)

Diagnostic and therapeutic modality for superficial disease Visually confirms diagnosis
Tissue recovery for histology
Ablation of lesion

50
Q

When shouldrepeat resectionbe performed prior to additional intravesical therapy?

A

patients w/ lamina propria invasion (T1) but without muscularis propria in specimen

51
Q

T/F: An intitial single dose of BCG should be administered immediately postoperatively for bladder cancer according to AUA recommendation.

A

False.Can’t give BCG immediately postop d/t risk of infection and deathHowever, you should give an initial single dose of intravesical chemotherapy.

52
Q 
Indications of intravescical therapy for bladder cancer include all of the following EXCEPT:
A. Multiple/rapid recurrence
B. Carcinoma in situ
C. Stage T2 cancer
D. High grade disease
A

C. NOT for T2 or greater disease.Grade =/= stage

53
Q

Preferred treatment for muscle invasive bladder cancer

A 
Radical cystectomy (bladder removal)
Radical TURBT rarely effective

Knowledge Rehab (24 decks)

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