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6- Renal Medicine > Urothelial Tumors > Flashcards

Urothelial Tumors Flashcards

1
Q

What is an upper urinary tract tumor

A

Neoplastic growth that affects lining of urinary tract from the calyx to the distal ureter

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2
Q

Which is more common, bladder urothelial cancer or upper urinary tract tumor

A

Bladder urothelial cancer

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3
Q

Main difference between bladder urothelial cancer and upper urinary tract tumors

A

Upper urinary tract tumors are less common and linked with familial syndromes

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4
Q

Centage of urothelial tumors involving the renal pelvis or ureter

A

5%

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5
Q

Which countries have the highest incidence in urothelial cancer representing 40% of all renal cancer there

A

Balkan countries

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6
Q

Who is more at risk of upper urinary tract tumors , men or women?

A

Men twice as likely

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7
Q

Who is more at risk of upper urinary tract tumors, whites or blacks?

A

Whites , twice as likely

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8
Q

Factors of upper urinary tract tumors

A

Dietary exposure to aristolochic acid
Smoking
Coffee consumption
AnalGesic abuse
Arsenic poisoning
Occupation in chemical , petroleum , plastic , coke, asphalt , tar
Aniline dye
Chronic inflammation , infection
Exposure to chemotherapeutic agents
Heredity ( lynch syndrome II)

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9
Q

Location of ureteral tumors

A

Lower part of ureter mostly 70%
Mid ureter 25%
Proximal ureter 5%

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10
Q

True Or false , patients with upper urinary tract tumors are at risk of development of bladder cancer

A

True

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11
Q

Centage of incidence of bladder cancer in people with upper urinary tract tumor

A

15 to 75% within five years

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12
Q

Prognosis . of upper tract urothelial cancer

A

Poor

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13
Q

Percentage of patient that presents with upper tract tomorrow already in metastatic disease

A

19%

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14
Q

Method of spread of upper tract tumor tumor

A

Epithelial
Lymphatic
hematogenous

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15
Q

Main form of upper tract tumors

A

Urothelial cancer’s

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16
Q

Main type of urothelial cancer

A

Transitional cell

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17
Q

Other types of urothelial cancer

A

squamous cell cancer
adenocarcinomas

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18
Q

most common symptom in upper tract urothelial tumors

A

hematuria gross or microscopic

19
Q

Gun must come on symptom in urothelial tumors

A

Flank pain- dull

20
Q

Percentage of asymptomatic patients diagnosed with incidental lesion found a radiologic evaluation

A

15

21
Q

Presentation of patients when advanced dx

A

Flank or Abdominal mass
weight loss
anorexia
bone pain

22
Q

Situation of upper tract lesion

A

Ct urography
IVU
Mri
Cytoscopy
Flexible and rigid ureteroscopy
Urine cytology

23
Q

Findings on radiologic evaluation in upper tract lesions

A

Radiolucent filling defects
obstruction or incomplete filling of parts of upper tract
non-visualization of collecting system

24
Q

Methods of investigation used to determine main contribution of diseased and presumed normal kidney to patient overall renal function

A

Split function renal scan

25
Q

method of investigation used in staging of upper tact tumort

A

ct or MRI

26
Q

What investigation do you used to always excludes coexistent bladder lesions in upper urinary tract tumor

A

Cystoscopy

27
Q

Single most important determinant of outcome in upper urinary tract tumors

A

Tumor stage ( tnm staging )

28
Q

Patient for surgery in upper urinary tract tumors

A

When nephron sparing for preservation of renal function required

Solitary kidney tumor
synchronous bilateral tumor
predisposition to multiple recurrences

29
Q

Patient for open radical nephroureterectomy

A

Large high-grade invasive tumors of renal pelvis and proximal ureter

30
Q

Indication for open segmental ureterectomy ureteroureterostomy

A

Noninvasive grade 1 and 2 tumors of proximal or midureter too large for complete endoscopic ablation

Grade 3/ invasive tumor with nephron sparing as goal

31
Q

Indications for Distal ureterectomy, direct neocystostomy, ureteroneocystostomy with bladder psoas,muscle hitch or boari flap

A

Tumor in distal ureter that can’t be removed by endoscopy

32
Q

Treatment of metastatic disease of urothelial tumors

A

Systemic chemotherapy used in TCC Of bladder

33
Q

Most common benign tumors of the bladder

A

Epithelial metaplasia
Leukoplakia
inverted papilloma
nephrogenic adenoma
Leiomyoma
cystitis cystica
cystitis glandularis

34
Q

Etiology of malignant tumors of the bladder

A

Aniline dyes
radiation
chemotherapy
artificial sweeteners
Vesicle schistosomiasis
vesicle calculi

35
Q

Symptoms of bladder urothelial carcinoma

A

Gross painless hematuria

36
Q

Investigation in bladder cancer

A

Cystoscopy, urine cytology for hematuria
Ct scan
PSA blood test

37
Q

Main diagnostic test for bladder cancer

A

Cystoscopy
Biopsy

38
Q

Urine markers of urothelial cancers

A

BTA stat
BTAtrak
NMP22
ImmunoCyt

39
Q

Initial treatment for visible lesions of bladder treatment

A

Transurethral resection of bladder tumor - TURBT

40
Q

Goal of TURBT

A

Remove all visible tumor
obtain specimen for pathologic examination for stage and grade determination

41
Q

Main Chemotherapeutic agents used perioperatively To prevent tomorrow in plantation in bladder cancer

A

Mitomycin C
Adriamycin
Intravesical BCG

42
Q

Indications for radical cystectomy and bilateral pelvic and iliac lymphadenectomy

A

Muscle invasive tumor

43
Q

What are the indications for partial cystectomy

A

Visible Lesion
Location is suitable for bladder preservation mostly on dome and away from ureteral orifices

44
Q

Management Metastatic bladder cancer

A

Systemic combination chemotherapy ( cisplatin based first Line)

6- Renal Medicine (8 decks)

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