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Urinary System > Tumours of Urinary System > Flashcards

Tumours of Urinary System Flashcards

1
Q

What is the most common cause of bladder cancer?

A

TCC

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2
Q

Where is SCC of the bladder commone?

A

Where schistosomiasis is endemic

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3
Q

What are the causes of TCC?

A

Smoking, aromatic amines, non-hereditary genetic abnormalities

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4
Q

What are the causes of SCC?

A

Schistomiasis, chronic cystitis, pelvic radiotherapy

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5
Q

What are the presenting features of bladder cancer?

A

Painless, visible haematuria, recurrent UTI, Dysuria, frequency, nocturia, urgency, bladder pain

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6
Q

What tests should be done to investigate HAEMATURIA?

A

Urine culture, CT, ultrasound, cystourethroscopy, BP, u&es, dipstick

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7
Q

What are the grades of TCC?

A

G1 - well differentiated (commonly non-invasive)

G2 - moderately differentiated (often on-invasive)

G3 - poorly differentiated (often invasive)

Carcinoma In Situ - non muscle invasive but V aggressive

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8
Q

Ta or T1 grading

A

Low grade, non-muscle invasive

  • resection and chemotherapy
  • endoscopic follow up
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9
Q

High grade non-muscle invasive or CIS?

A

V aggressive
Endoscopic resection alone isnt sufficieny
-BCG Therapy

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10
Q

T2/T3 grading bladder cancer

A

Muscle invasive bladder cancer

-neoadjuvant therapy, radical radiotherapy, cystoprostectomy, urethrectomy

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11
Q

What is the prognosis for bladder cancer?

A

non invasive and low grade - 90% survival rate after 5 years

high grade and invasive - 50% survival after 5 years

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12
Q

What are the main presentations of an Upper Tract Urothelial Cancer ?

A

Frank haematuria, unilateral ureteric obstruction, flank or loin pain, symptoms of metastatic disease

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13
Q

How is UTUC diagnosed?q

A

CT-IVU, urine cytology or ureteroscopy and biopsy

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14
Q

What does an IVU/CT-IVU show in UTUC?

A

defect in filling renal pelvis

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15
Q

What are features of UT TCC?

A

Renal pelvis/collecting system > ureter

Tumours high grade and recurrence risk is high

Treated via nephro-ureterectomy

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16
Q

Name some benign renal tumours?

A

Oncocytoma, angiomyolipoma

17
Q

Name a malignant renal tumour?

A

Renal adenocarcinima

18
Q

What are risk factors for Renal Adenocarcinoma?

A

FH, smoking, anti-hypertensive medication, obesity, end-stage renal failure

19
Q

What are the stages of renal cancer?

A 
T1 - Tumour <7cm with intact renal capsule 
T2 - Tumour >7cm with intact renal capsule
T3 - local extension outside capsule 
    T3a - into adrenal or 
    peri-renal fat
    T3b - into real 
    vein/IVC below 
    diaphragm
    T3c - Tumour 
    thrombus in IVC 
    extends above 
    diaphragm
T4 - tumour invades beyond Gerota's fascia
20
Q

Where does renal adenocarcinoma spread?

A

Direct spread through renal capsule > venous invasion to renal vein and IVC > spread to lungs and bone or to paracaval nodes

21
Q

What investigations should be done in renal adenocarcinoma?

A

CT or abdo and chest
FBC, U&E
Ultrasound

22
Q

What treatment is given for renal adenocarcinoma?

A

Radical nephrectomy

23
Q

How does locally invasive prostate cancer present?

A

Haematuria, perineal and suprapubic pain, impotence, incontinence, loin pain/anuria, haemospermia or tenesmus

24
Q

How does distant metastasis present in prostate cancer?

A

Bone pain or sciatica, paraplegia due to spinal cord compression, lymphnode enlargement, loin pair or anuria, lethargy, weight loss, cachexia

25
Q

What test should be done to confirm prostate cancer?

A

PSA, CT, FBC, MRI, Rectal Examination

26
Q

What can cause elevations in PSA levels?

A

UTI, Chronic Prostatitis, Catheterisation, Ejaculation, BPH, Prostate cancer

27
Q

What are the stages of prostate cancer?

A

Localised
Locally Advanced
Metastatic
Hormone Refractory

28
Q

What is the treatment for localised prostate cancer?

A

Radiotherapy, prostatectomy

29
Q

What is the treatment for locally advanced prostate cancer?

A

Hormone therapy followed by surgery/radiation

30
Q

What forms of hormonal therapy are delivered in prostate cancer?

A

Surgical castration, chemical castration, anti-androgens, oestrogens

31
Q

What is the most common type of testicular cancer?

A

GCT -95%

32
Q

What age groups do seminomas affect?

A

30-40 Year Olds

33
Q

What age groups do no-semiomatous cancers affect?

A

20-30 year olds

34
Q

What is stage 1 testicular cancer?

A

Disease confined to testis

35
Q

What is stage 2 testicular cancer?

A

infradiaphragmatic nodes involved

36
Q

What is stage 3 testicular cancer?

A

supradiagphragmatic nodes involved

37
Q

What is stage 4 testicular cancer?

A

Extralymphatic disease

38
Q

What is the treatment for testicular cancer?

A

Orchidectomy, chemotherapy, radiotherapy, lymph node dissection

Urinary System (15 decks)

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