Transitional cell carcinomas

Question 1

Where is transitional epithelium present?

Answer 1

urinary tract lining
renal pelvis
ureter
bladder
urethra

Question 2

Causes of haematuria

Answer 2

cancer:
- bladder
- kidney
- ureter
- urethra
- prostate

stones

infection:
- lower UTI
- pyelonephritis

Question 3

Bladder cancer risk factors

Answer 3

older age
smoking
occupational exposure to aromatic amines
drugs (cyclophosphamide, phenacetin)
chronic irritation (stones, catheter, schistosomiasis)
pelvic radiotherapy

Question 4

Occupations associated with TCC

Answer 4

rubber manufacture
dye manufacture
fine chemicals
retort houses of gas works
rope and textile manufacture
hairdressers
leather workers
plumbers
painters
drivers - diesel exhaust

Question 5

How is suspected TCC investigated?

Answer 5

upper tracts - US, IVU, CT
bladder/urethra - cystoscopy
MSU
cytology

Question 6

How does TCC present?

Answer 6

haematuria
LUTS (storage sx)
recurrent UTI
pneumaturia
pain

Question 7

How can urine be diverted away from the bladder?

Answer 7

ileal conduit
orthotopic neobladder
continent pouch
ureterosigmoidostomy

Question 8

Renal pelvis TCC presentation

Answer 8

painless frank haematuria
clot colic
asymptomatic

Question 9

Upper tract TCC treatment

Answer 9

curative = nephro ureterectomy, uretero-renoscopic laser ablation

palliative = chemo, surgery, arterial embolisation (block blood supply therefore block haematuria)