Tumours of the Urinary System 2

Question 1

UTUC

Answer 1

Upper tract urothelial cancer

Question 2

90% of baldder cancers in the UK are:

Answer 2

transitional cell carcinomas

Question 3

TTC

Answer 3

transitional cell carcinoma

Question 4

Where Schistosomiasis is endemic - what kind of cancer occurs in the bladder?

Answer 4

Squamous cell carcinoma

Question 5

Schistosomiasis, also known as snail fever and bilharzia, is a disease caused by

Answer 5

parasitic flatworms

Question 6

TCC risk factors

Answer 6

smoking

aromatic amines

non-hereditary genetic abnormalities (P53 etc)

Question 7

SCC risk factors

Answer 7

schistosomiasis

chronic cystitis

pelvic radiotherapy

Question 8

What is the most frequent presenting symptom in bladder cancer?

Answer 8

painless visible haematuria

Question 9

in bladder cancer: haematuria can be either……. or ……….

Answer 9

frank

microscopic

Question 10

What are some other presenting features of bladder cancer?

Answer 10

recurrent UTI

storage bladder symptoms (dysuria, bladder pain etc)

Question 11

what are the 5 main investigations you would carry out when investigation haematuria?

Answer 11

urine culture

cystourethroscopy

upper tract imaging (CT scan or Ultrasound)

Urine Cytology

BP and U+Es

Question 12

What are the 3 types of haematuria?

Answer 12

frank (macroscopic)

dipstix

microscopic

Question 13

in the bladder, tumours will be treated with regards to if they are …

Answer 13

Low grade non-muscle invasive

high grade non-muscle invasive or CIS

muscle invasive bladder

Question 14

UTUC presenting features include:

Answer 14

frank haematuria

unilateral ureteric obstruction

flank or loin pain

symptoms of nodal or metastatic disease (bone, lung, brain etc)

Question 15

UTUC investigations

Answer 15

CT - IVU

urine cytology

ureteroscopy and biopsy

Question 16

most upper tract TCCs are treated by …….

Answer 16

nephro-ureterectomy

Question 17

What are the 4 histological cells types of renal cancer?

Answer 17

clear cell (85%)

papillary (10%)

chromophobe (4%)

bellini type ductal cacrinoma (1%)

Question 18

renal adenocarcinoma risk factors

Answer 18

family history

smoking

anti-hypertensive medication

obesity

end-stage renal failure

Question 19

renal carcinoma symptoms:

Answer 19

asymptomatic

CLASSIC TRIAD: flank pain, mass, haematuria

paraneoplastic disease

metastatic disease

Question 20

renal adenocarcinoma investigations

Answer 20

CT scan

Bloods: U+Es, FBC

Ultrasound

urinalysis (if cause of haematuria is unknown)

Question 21

What is treatment not very effective in metastases of RCC?

Answer 21

RCC is radio and chemoresistant

Question 22

treatment of RCC is usually

Answer 22

radical nephrectomy