Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Yr4 - Cancer Care > Urology > Flashcards

Urology Flashcards

1
Q

Risk factors for prostate cancer

A 
Increasing age
FHx
Being black
Being tall
Use of anabolic steroids
Genetics - BRCA2 mutation and lynch syndrome
Diet - red meat, fat, diary, calcium
Chemicals - high pesticide exposure
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Presentation of prostate cancer

A 
Often asymptomatic
Haematuria
Erectile dysfunction
Weight loss
Fatigue
Bone pain
LUTS
- hesitancy
- urgency
- frequency
- intermittency
- straining to void
- terminal dribbling
- incomplete emptying
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Features of PSA test

A

Done prior to DRE to avoid stimulating PSA release
Not very sensitive or specific
Most useful in monitoring progression of disease and success of treatment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Features of prostate examination

A

Benign prostate
- feels smooth, symmetrical and slightly soft with a maintained central sulcus
Cancerous prostate
- feel firm/hard, asymmetrical, craggy or irregular with loss of central sulcus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Ix for prostate cancer

A

DRE
PSA
Prostate biopsy
- not particularly sensitive because cancers may be located in areas not biopsied - multiple needle biopsies taken
- Transrectal Ultrasound-Guided Biopsy (TRUS)
- USS inserted into rectum and needle biopsy taken through rectal wall into prostate
- take around 10 biopsies
- Transperineal
- allows more biopsies to be taken
- takes longer than TRUS and requires general anaesthetic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Grading of prostate cancer

A 
Gleason Grading System
1 - well differentiated cancer
2 - moderately differentiated
3 - moderately differentiated
4 - poorly differentiated
5 - anaplastic (poorly differentiated)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Mx of prostate cancer

A 
Localised
○	Curative intent
■	Active surveillance
■	Radical prostatectomy
■	External beam radiotherapy
■	Brachytherapy 
○	Palliative intent
■	Watchful waiting
Metastatic
○	Surgical castration
○	Medical castration using LHRH agonists (in combination with anti-androgen initially to prevent excess testosterone effects) – patient eventually becomes resistant so add on an antiandrogen
○	Palliation
■	Single dose radiotherapy
■	Zoledronic acid
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Side effects of hormonal treatment of prostate cancer

A 
Hot flushes
Sexual dysfunction
Gynaecomastia
Fatigue
Osteoporosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Complications of radical treatment of prostate cancer

A

Erectile dysfunction
Urinary incontinence
Radiation induced enteropathy - gives PR bleeding, pain and incontinence
Urethral strictures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Define BPH

A

Benign Prostate Hyperplasia

  • caused by hyperplasia of the stromal and epithelial cells of the prostate
  • usually present with LUTS in older men
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

LUTS

A 
Hesitancy
Urgency
Frequency
Intermittency
Straining to void
Terminal dribbling
Incomplete emptying
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Ix for BPH

A

Urine dipstick - exclude infection
PSA - prior to DRE
Rectal exam to assess prostate size, shape and characteristics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Mx of BPH

A

Reassurance and monitoring
Medical
- alpha-blockers (Tamsulosin) - relax smooth muscle
- 5-alpha reductase inhibitors (finasteride) - block testosterone and reduce size of prostate
Surgery
- Transurethral resection of prostate (TURP)
- Transurethral electrovaporisation of prostate (TUVP)
- Holmium laser enucleation of prostate (HoLEP)
- Open prostatectomy via abdominal or perineal incision

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Features of TURP

A

Involves accessing the prostate through the urethra and shaving off prostate tissue using a diathermy
- aims to create a wider space for urine to flow through

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Major complications of TURP

A 
Bleeding
Infection
Incontinence
Retrograde ejaculation
Urethral strictures
Failure to resolve symptoms
Erectile dysfunction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Alternatives to TURP

A

TUVP - prostate tissue removed using a laser

HoLEP - prostate tissue removed using electrical current

17
Q

Presentation of renal cancer

A

Often asymptomatic
Haematuria
Vague loin pain
Non-specific symptoms of cancer - weight loss, fatigue, anorexia, night sweats

18
Q

Types of renal cancers

A

Tumour of the renal parenchyma

  • Clear cell carcinoma - 75-90%
  • Wilms Tumour in children < 5 years old
19
Q

Risk factors for renal cancer

A 
Smoking
Obesity
Hypertension
Long-term dialysis
Von Hippel-Lindau Disease
20
Q

Mx of renal cancer

A 
Surgery
- partial nephrectomy
Radiotherapy
Chemotherapy
Biological therapies
21
Q

Paraneoplastic features of renal cancer

A

Polycythaemia - RCC secretes unregulated erythropoietin
Hypercalcaemia - RCC secretes hormone that mimics the action of PTH
Stauffer Syndrome - abnormal liver function tests demonstrating an obstructive jaundice

22
Q

Types of bladder cancer

A

Transitional cell carcinoma - 90%

Squamous cell carcinoma - 10%

23
Q

Pathophysiology of bladder cancer

A

Arise from endothelial lining (urothelium)

24
Q

Clinical features of bladder cancer

A

Painless haematuria

25
Q

Ix for bladder cancer

A

Urinalysis
USS
Cystoscopy + biopsy

26
Q

Staging of bladder cancer

A

TNM

27
Q

Risk factors for bladder cancer

A

Smoking
Carcinogens - hair dyes, industrial pain, rubber, motor, leather and rubber workers
Schistosomiasis - squamous cell carcinoma

28
Q

Mx of bladder cancer

A 
Not invading the muscle
- transurethral resection of a bladder (TURBT)
- chemo into bladder post surgery
- weekly treatments for 6 weeks with BCG vaccine into bladder via catheter
Muscle-invasive
- radical cystectomy with ileal conduit
- radiotherapy 
- IV chemotherapy
29
Q

Features of testicular cancer on USS

A 
Non tender
Arising from testicle
Hard without fluctuance or transillumination
Irregular
Age 15-40 years
30
Q

Types of testicular cancer

A

Seminoma - 50%

Teratoma - 50%

31
Q

Tumour markers for testicular cancer

A

Alpha-fetoprotein - raised in teratomas
Beta-hCG - raised in teratomas and seminomas
LDH - raised in all

32
Q

Metastasis spread of testicular cancer

A

Lymphatics
Lungs
Liver
Brain

33
Q

Prognosis of testicular cancer

A

Good prognosis unless metastatic - 90% cure rate
Metastatic disease still often curable
Better prognosis for seminomas

34
Q

Mx of testicular cancer

A

Orchidectomy
- testicular prosthesis
Chemotherapy/radiotherapy based on staging
Monitoring post treatment with tumour makers and imaging

35
Q

Common causes of raised PSA

A 
Prostate cancer
UTI
Prostatic inflammation (prostatitis)
Enlarged prostate (BPH)
Acute urinary retention
36
Q

Issues for PSA screening

A

Overdiagnosis
Over-treatment
QoL - co-morbidities of establish treatments
Cost-effectiveness

37
Q

Ddx of haematuria

A 
Cancer
- RCC
- upper tract TCC
- bladder carcinoma
- advanced prostate carcinoma
Stones
Infection
Inflammation
BPH
Nephrological origin - glomerulonephritis
38
Q

BCG side effects

A 
Dysuria, frequency and urgency
UTI
Haematuria
Systemic BCGosis
Bladder contracture/ureteric stenosis

Yr4 - Cancer Care (12 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions