Urinary Bladder Flashcards
Patent urachus/urachal cyst think:
adenocarcinoma
Recurrent pyelonephritis think:
Vesicoureteral reflux
Diverticula increase risk for:
stasis –>
infection
calculi
Common cause of cystic (bladder) diverticula?
bladder outlet obstruction
ie. BPH, neoplasm
Failure of development of anterior abdominal wall:
Exstrophy
incr. risk of chronic infx, adenocarcinoma
Tissue character in adenocarcinoma?
glandular, mucous secreting
Conditions predisposing to bladder inflammation:
anything that causes stasis:
extrophy
obstruction
fistula
catheters
cystocele (multiple pregnancies)
calculi
neoplasms
Diabetes (bugs like sugar)
pyelo
pregnancy
neurogenic bladder
common presentation of bladder infx in old people?
altered mental status
Triad of sx for cystitis:
frequency
pain
dysuria
Cause of cystitis in immunosupressed?
candida
cryptococcus
Cause of cystitis in young sexually active pts:
chlamydia
mycoplasma
Most common causes of cystitis:
bacteria
E. coli
Proteus
Enterococcus
non-infx causes of cystitis:
radiation
chemo
-cyclophosphamide– HEMORRHAGIC
Hunner ulcer
PAINFUL
autoimmune related (SLE)
CULTURE NEGATIVE
cystitis
Hunner ulcer (interstitial)
Histo of acute cystitis:
PMNs
exudate
Histo of chronic cystitis?
LYMPHOCYTES
epithelial hyperplasia
fibrosis
soft, yellow raised plaques
Michaelis-Gutman bodies
E. coli, Proteus
foamy macrophages
Malacoplakia
Most common bladder neoplasm:
Transitional cell carcinoma (uroepithilial)
Prognosis for “sea anemone” appearing tumors:
good
Prognosis for cauliflower appearing tumors:
bad
Environmental toxin associated with bladder cancer in workers?
Aniline dye
High suspicion for bladder CA with this exam finding:
Gross, painless hematuria
Gross, painless hematuria in pt over 40:
bladder CA until proven otherwise
RBC casts present on UA indicate:
kidney etiology
Hgb on UA but no cells = ?
systemic hemolysis
ie. sickle cell
Grade for Transitional cell CA with atypical cells slosely resembling normal?
grade I
Grade fro Transitional cell CA with increased mitoses, nuclear pleomorphism, tumor giant cells:
Grade III
Most important determinant for prognosis in CA?
Staging!
Stage if limited to mucosa but flat:
TIS – POOR PROG
Staging if muscle layer affected:
T2a/b
superficial vs deep
Stage if invading perivesical fat:
T3
Stage if invading adjacent structures?
T4
What does N1-3 staging indicate?
nodal involvement
M1 staging denotes?
distant metastases
POOR PROG
**not surgical candidate
Tx= chemo
Stage if limited to mucosa and pappilary appearance:
Ta
Stage if invading lamina propria:
T1
Schistosoma haematobium infx, think:
Squamous cell CA
**not in USA
Childhood associated CA with good prog?
Rhabdomyosarcoma
Non-epithelial bladder CA in adults with poor prog?
Leiomyosarcoma
Two classifications of Urethritis:
Gonococcal
-Neisseria gonorrhea
Nongonococcal
- E. coli, other enterics
- Chlamydia in sexual active young adults
Benign urethral neoplasm at meatus
HPV related
Papilloma
Benign urethral neoplasm in females
painfull
red mass
meatus
Caruncle
Malignant urethral neoplasm in elderly women
Squamous cell CA
