Urological cancers lecture Powerpoint

Question 1

Due to close proximity to the vasculature, cancer of the kidney…

Answer 1

…metastasizes quickly

Question 2

Gross or microscopic hematuria is….

Answer 2

…cancer until proven otherwise, it occurs in up to 85% of bladder cancers and 40% of renal cancers

Question 3

(T/F) color does not reflect amount of blood in urine specimen

Answer 3

True

Question 4

Microscopic hematuria marker under sediment microscopic evaluation

Answer 4

> 3 indicates hematuria

Question 5

Hematuria occuring primarily at the beginning of urination is usually from…

Answer 5

…urethra

Question 6

Blood that is noticed as dicharge between voiding or as a stain on undergarments while voiding itself is clear indicates…

Answer 6

….origin of blood at urethral meatus or anterior urethra

Question 7

Hematuria appearing toward the end of voiding is usually from…

Answer 7

….bladder neck of prostatic urethra

Question 8

Hematuria occuring throughout voiding can originate from…

Answer 8

…anywhere in the urinary tract

Question 9

Imaging study of choice in adults to detect urological cancer

Answer 9

CT

Question 10

Imaging study of choice in children and pregnant women to detect urologicl cancer

Answer 10

Ultrasonography

Question 11

Cystoscopy is performed in what situations to detect urological cancer?

Answer 11

-all patients older than 35 with asymptomatic hematuria or suspicion of cancer

Question 12

Cytology is performed in what situations to detect urological cancer?

Answer 12

-all patients with asymptomatic hematuria or suspicion of cancer because a cystoscope can only reach the bladder to visualize cancer

Question 13

1 Risk factor for urological malignancy

Answer 13

smoking history

Question 14

Loin pain hematuria syndrome definition

Answer 14

Idiopathic hematuria that occurs with flank pain despite absence of discernible cause

Question 15

Most common type of kidney cancer

Answer 15

Renal cell carcinoma

Question 16

Renal cell carcinoma prognosis

Answer 16

Doubled 5 year survival rate caus eof higher detection

Question 17

Renal cell carcinoma definition and 6 subtypes

Answer 17

Cancer that originates in the renal cortex and is very common, includes clear cell carcinoma, papillary carcinoma, chromophobe, oncocytic, collecting duct, and translocation

Question 18

Renal cell carcinoma treatment

Answer 18

Resection of tumor to analyze via biopsy

Question 19

Clear cell carcinoma definition

Answer 19

A benign highly vascular subtype of renal cell carcinoma predominantly found, associated with von hippel lindau disease

Question 20

Papillary carcinoma definition

Answer 20

A subtype of renal cell carcinoma that originates in the proximal tubule and is associated with painful cutaneous leiomyomas

Question 21

Chromophobe carcinoma definitiion

Answer 21

A subtype of renal cell carcinoma that is uncommon and slower progressing that originates in collecting duct

Question 22

Oncocytomas definition

Answer 22

A subtype of renal cell carcinoma that is slow growing and typically benign

Question 23

Collecting duct tumor (bellini’s duct) definition

Answer 23

A subtype of renal cell carcinoma that is rare and aggressive and has poor prognosis

Question 24

Triad for renal cell carcinoma in 9% of patients

Answer 24

• flank pain
• hematuria
• palpable abdominal renal mass

Question 25

Most common sites for renal cell carcinoma metastasis(5)

Answer 25

-lung
-lymph nodes
-bone
brain
-liver

Question 26

If renal cancer has metastasized to the bone might see measurable increase in blood ___ levels

Answer 26

Ca2+

Question 27

1st order for patient with suspected renal cell carcinoma

Answer 27

CT of abdomen

Question 28

TNM classification of tumors

Answer 28

• T is tumor size and how far its invaded past fascia (0-4)
• N is nodes checking for regional metastasis (0-1)
• M is for metastasis either close or distant (0-1)

Question 29

Renal cell carcinoma treatment

Answer 29

-surgery is only long term care available

Question 30

Wilm’s tumor definition

Answer 30

A childhood cancer that is the most common renal malignancy in children and causes palpable nontender abdominal mass to grow extensively, must be ultrasound and CT’d to stage it from there

Question 31

Wilm’s tumor staging

Answer 31

Stage I - tumor is limited to kidney with intact capsule
II
III
IV - hematogenous metastases present
V - bilateral renal involvement at time of initial diagnsois

Question 32

Wilm’s tumor prognosis

Answer 32

Very good, 85-100%

Question 33

Staging of bladder cancer

Answer 33

• non muscle invasive
• muscle invasive
• metastatic

Question 34

Bladder cancer definition

Answer 34

Tumor arising in bladder, ureters, or urethra, 6th most common cancer in US

Question 35

Urothelial carcinoma

Answer 35

Common location of bladder cancer due to changing of cells in the ureters and bladder to transitional cells

Question 36

Bladder cancer 2 greatest predisposing factors

Answer 36

• occupational

- tobacco smoking

Question 37

Bladder cancer clinical presentation

Answer 37

• painless hematuria

- decrease in voiding capacity, straining, or feeling of incomplete voiding

Question 38

gold standard for initial diagnosis and staging of bladder cancer

Answer 38

Cystoscopy followed by urine cytology

Question 39

Transurethral resection of bladder tumor definition

Answer 39

Removal of all visible lesions to determine tumor depth and presence of invasion during cystoscopy to then confirm diagnosis and classify tumor

Question 40

Imaging study for bladder cancer

Answer 40

CT scan

Question 41

Treatment for non muscle invasive bladder cancer

Answer 41

-Resection followed by BCG therapy 4-6 weeks post op

Question 42

Treatment for muscle invasive bladder cancer (2)

Answer 42

• stoma formation

- neobladder used from small piece of bowel