8.12 Lower Urinary Tract

Question 1

most common malignant tumor of ureter

Answer 1

transitional cell carcinoma

Question 2

present w/ obstruction in 60s-70s

Answer 2

transitional cell carcinoma

Question 3

bladder exposed through anterior abdominal wall called

- increased risk for

Answer 3

exstrophy

adenocarcinoma of colon or bladder

Question 4

what drugs and treatments can cause cystitis (UTIs)

Answer 4

chemo drugs (cyclophosphamide) and radiation

Question 5

histo appearance of chronic cystitis

Answer 5

lymphocytes and plasma cells

Question 6

chronic cystitis without evidence of bacterial infection, but might have chronic mucosal ulcers (Hunner ulcers) and mast cells in bladder wall

Answer 6

interstitial cystitis

Question 7

soft, yellow mucosal plaques with foamy macrophages and also lymphocytes
- also see what

Answer 7

malacoplakia

Michaelis Gutmann bodies (laminated mineralized concretions resulting from calcification of enlarged lysosomes)

Question 8

exaggerated Brunn nests

Answer 8

cystitis glandularis / cystica

Question 9

results from shed renal tubular cells that implant in injured urothelium

Answer 9

nephrogenic metaplasia “adenoma”

Question 10

Urothelial / transitional cell tumors are in

Answer 10

bladder

Question 11

bad prognosis for urothelial cell tumors

Answer 11

invasion of muscularis propria

Question 12

retain blood group antigens (A,B,H)

Answer 12

low grade papillary urothelial carcinoma

Question 13

papillary tumors w/ loss of polarity, cytologic atypic, frequent mitoses

Answer 13

high grade papillary urothelial carcinoma

Question 14

lacks blood group antigens (A,B,H)

Answer 14

high grade papillary urothelial carcinoma

Question 15

malignant cells within a flat urothelium (basement membrane is intact w/ no invasion)

Answer 15

carcinoma in situ

Question 16

tumor cells in urine

Answer 16

high grade papillary urothelial neoplasm

carcinoma in situ

Question 17

schistosomiasis increases risk of what cancer

Answer 17

squamous cell carcinoma

Question 18

looks like rectal, uterine, colon cancer

Answer 18

adenocarcinoma of the bladder

Question 19

signet ring cell tumor is a variant of

Answer 19

adenocarcinoma of the bladder

Question 20

tumor genetics

Answer 20

chromosome 9 monosomy or deletions of 9p and 9q

deletions or mutations of 13q, 14q, 17p

Question 21

painless hematuria in older patients

- 3 treatment options

Answer 21

urothelial carcinoma

localized low grade: transurethral resection

multifocal low grade: topical chemo

high risk: BCG

Question 22

radical cystectomy is indicated when

Answer 22

tumor invades muscularis propria

CIS or high grade papillary neoplasms refractory to BCG

CIS extending into prostatic urethra and into prostatic ducts (beyond reach of BCG)

Question 23

arthritis, conjunctivitis, urethritis

Answer 23

Reiter syndrome

Question 24

2 urethral carcinomas and locations

Answer 24

proximal urethra: urothelial carcinoma

distal urethra: squamous cell carcinoma

Question 25

urethritis caused by what bac

Answer 25

gonococcal nongonococcal: enterics, chlamydia, mycoplasma

Question 26

small, red, painful inflammatory lesion at the external urethral orifice

Answer 26

urethral caruncle

Question 27

urachal remnant has increased risk of

Answer 27

adenocarcinoma