Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Urology > Bladder Pathology > Flashcards

Bladder Pathology Flashcards

1
Q

What are the risk factors to developing bladder TCC?

A

SMOKING, aromatic amines (rubber), B-naphthylamine, benzidine, chronic cystitis, schistosomiasis (squamous type), pelvic irradiation, drugs (phenacetin, cyclophosphamide)

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

Non-papillary type bladder TCC is p53…

A

dependent (mutation)

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

Papillary type bladder TCC is p53…

A

independent

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

What is the pathophysiology of papillary type bladder TCC?

A

grow outwards from urothelium = can become malignant

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

What is the pathophysiology of non-papillary type bladder TCC?

A

grows horizontally and downwards = always malignant

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

what is the spread of bladder TCC?

A

local – to pelvic structures
lymphatic – to iliac and para-aortic nodes
haematogenous – to liver and lungs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what are the clinical features of bladder TCC?

A
  • Painless haematuria
  • Frequency
  • Urgency
  • Dysuria
  • Urinary tract obstruction
  • Pain from local nerve involvement or TCC of the kidney and ureter
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what is the gold standard investigation for bladder TCC?

A

Cystoscopy with biopsy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what are the investigations for bladder TCC?

A
  • Cystoscopy with biopsy
  • Urine: microscopy/cytology for malignant cells
  • Ct Urogram
  • Bimanual EUA
  • MRI or lymphangiography
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what is the criteria for T0 bladder TCC?

A

No evidence of tumour

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what is the criteria for Ta bladder TCC?

A

Non invasive papillary carcinoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what is the criteria for T1 bladder TCC?

A

Tumour invades sub epithelial connective tissue

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

what is the criteria for T2a bladder TCC?

A

Tumor invades superficial muscularis propria (inner half)

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

what is the criteria for T2b bladder TCC?

A

Tumor invades deep muscularis propria (outer half)

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

what is the criteria for T3 bladder TCC?

A

Tumour extends to perivesical fat

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what is the criteria for T4 bladder TCC?

A

Tumor invades any of the following: prostatic stroma, seminal vesicles, uterus, vagina

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what is the criteria for T4a bladder TCC?

A

Invasion of uterus, prostate or bowel

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what is the criteria for T bl4badder TCC?

A

Invasion of pelvic sidewall or abdominal wall

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what is the criteria for N0 bladder TCC?

A

No nodal disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what is the criteria for N1 bladder TCC?

A

Single regional lymph node metastasis in the true pelvis (hypogastric, obturator, external iliac, or presacral lymph node)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what is the criteria for N2 bladder TCC?

A

Multiple regional lymph node metastasis in the true pelvis (hypogastric, obturator, external iliac, or presacral lymph node metastasis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

what is the criteria for N3 bladder TCC?

A

Lymph node metastasis to the common iliac lymph nodes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

what is the criteria for M0 bladder TCC?

A

No distant metastasis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

what is the criteria for M1 bladder TCC?

A

Distant metastasis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
what is the management of pTa stage bladder TCC?
transurethral resection. and cystoscopy monitoring
26
what is the management of pT1 stage bladder TCC?
o Intravesical BCG –as a form of immunotherapy.  Given after the main tumour has been removed by surgery.  The vaccine is left in place in the bladder for 2 hours.
27
what is the management of pT2 stage and above bladder TCC?
o <70 = radical cystectomy “gold standard” + Post-Op Chemo – M-VAC or neoadjuvant chemo - CMV o >70, treatment is with radiotherapy
28
what is frank haematuria?
presence of blood on macroscopic investigation (i.e. looking at the blood)
29
what is microscopic haematuria?
where you can only see RBC’s on microscopic investigation
30
what is Haemoglobinurea?
presence of free haemoglobin in the urine
31
what is initial haematuria?
presence of blood in the urine when you first start micturating – this implies urethral damage
32
what is terminal haematuria?
presence of blood in the urine at the end of the stream, and this suggests a problem with the prostate or bladder base.
33
what do ribbon clots suggest?
suggest a ureteric cause
34
what are kidney bleeds?
can mimic renal colic as the clot passes down the ureter.
35
what are the kidney causes of haematuria?
``` Trauma Tumours RCC Calculus Glomerulonephritis Pyelonephritis Renal TB Polycystic disease Renal infarction TCC ```
36
what is the ureter cause of haematuria?
Calculus
37
what are the bladder causes of haematuria?
Calculus TCC Acute cystitis Interstitial Cystitis
38
what are the prostate causes of haematuria?
BPH | Carcinoma
39
what are the urethra causes of haematuria?
Trauma Calculus Urethritis
40
what is a bladder prolapse/cystocele?
womens bladder bulges into her vagina
41
what are the causes of cystocele?
age, heavy lifting, pregnancy, childbirth, chronic lung disease/smoking, FH, ethnicity, pelvic floor trauma, CTD, hysterectomy, cancer of pelvic organs
42
what is the underlying mechanism of a cystocele?
• Occurs when the muscles, fascia, tendons and connective tissues between a woman's bladder and vagina weaken, or detach.
43
what are the different types of bladder prolapse?
midline defect, paravaginal defect, transverse defect, apical cystocele, medial cystocele, lateral cystocele
44
what is a midline defect bladder prolapse?
cystocele caused by the overstretching of the vaginal wall
45
what is a paravaginal defect bladder prolapse?
separation of the vaginal connective tissue at the arcus tendineus fascia pelvis
46
what is a transverse defect bladder prolapse?
when the pubocervical fascia becomes detached from the top (apex) of the vagina.
47
what is a apical cystocele?
located upper third of the vagina. The structures involved are the endopelvic fascia and ligaments. The cystocele in this region of the vagina is thought to be due to a cardinal ligament defect.
48
what is a medial cystocele?
forms in the mid-vagina and is related to a defect in the suspension provided by to a sagittal suspension system defect in the uterosacral ligaments and pubocervical fascia.
49
what is a lateral cystocele?
when both the pelviperineal muscle and its ligamentous–fascial develop a defect.
50
what are the clinical of a cystocele?
a vaginal bulge, pelvic heaviness or fullness, hesitancy, incomplete urination, frequency, urgency, faecal incontinence, frequent UTI, back and pelvic pain, fatigue, painful intercourse, bleeding
51
what investigations are used in diagnosis of cystocele?
* pelvic exam * US * Voiding cystourethrogram * Urine culture * Grading – POP-Q
52
what is the preventative management of cystoceles?
smoking cessation, losing weight, pelvic floor strengthening, treatment of chronic cough, maintaining heathy bowel habits – high fibre food, avoid constipation
53
what is the non-surgical management of cystocele?
pessary, pelvic floor muscle therapy, dietary changes, oestrogen
54
what is the surgical management of cystocele?
wall repair
55
what are the causes of interstitial cystitis?
* An antiproliferative factor * PAND * Associated with: IBS, Fibromyalgia, Chronic fatigue, Allergies, Sjogren
56
what is the pathophysiology of interstitial cystitis?
Unknown Several theories: autoimmune theory, nerve theory, mast cell theory, leaky lining theory, infection theory, and a theory of production of a toxic substance in the urine, neurologic, allergic, genetic, and stress-psychological
57
what are the clinical features of interstitial cystitis?
Suprapubic pain, frequency, Painful intercourse, dysuria, Hesitancy, Pelvic pain worsen with filling of bladder, and improve with urination, Hunners Ulcers
58
how is interstitial cystitis diagnosed?
Exclusion tests plus hydrodistention during cystoscopy with biopsy.
59
what is the 1st line management of interstitial cystitis?
education, self care (diet modification), stress management
60
what is the 2nd line management of interstitial cystitis?
physical therapy, oral medications (amitriptyline, cimetidine or hydroxyzine, pentosan polysulfate), bladder instillations (DMSO, heparin, or lidocaine)
61
what is the 3rd line management of interstitial cystitis?
treatment of Hunner's ulcers (laser, fulguration or triamcinolone injection), hydrodistention (low pressure, short duration)
62
what is the 4th line management of interstitial cystitis?
neuromodulation (sacral or pudendal nerve)
63
what is the 5th line management of interstitial cystitis?
cyclosporine A, botulinum toxin (BTX-A)
64
what is the 6th line management of interstitial cystitis?
surgical intervention (urinary diversion, augmentation, cystectomy)

Urology (10 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions