Breast & Urology Flashcards
(42 cards)
1
Q
National Breast Screening Programme
A
- every 3 years
- 50-70yrs
2
Q
Stag Horn Calculus
A
Struvite
- urease producing bacteria
- slightly radio-opaque
3
Q
THP (uromodulin)
A
Inhibits stones
Binds to crystals and prevent binding to renal epithelium
4
Q
Dx for renal colic
A
- ureteric colic
- bowel colic
- leaking AAA
- ectopic
- MI
- pancreatitis
- pneumonia
- biliary colic (RUQ -> shoulder)
- pyelonephritis
- bleeding RCC
5
Q
Ix for renal colic
A
- CT KUB
- low dose
- urate lucent
- urine dip for infection
- MSU
- FBC
- CRP
- U&E
6
Q
Tx for renal colic
A
- analgesia = NSAIDs
- Tamsulosin
- removal
- hydration (2L/d)
- urate = allopurinol
- calcium = thiazides
7
Q
Renal Clear Cell Carcinoma
A
- VHL
- polycythaemia
8
Q
Renal Cancer Triad
A
- palpable mass
- flank pain
- macrohaematuria
9
Q
Renal - transitional cell carcinoma
A
- occupational dyes and rubber
10
Q
Renal Cancer Treatment
A
- TKI (sutinib, pazopanib sorafenib)
- IL2 (not if anaemic)
- mTORI (sirolimus, everolimus)
- nephrectomy if not metastatic
11
Q
Bladder Cancer
A
- 2-Naphthylemene dye/paint
- smoking
- TCC
- SCC = schistosomiasis and smoking RF only not dye
12
Q
Bladder Cancer Chemo
A
Cisplatin & Gentamycin
Cisplatin & Methotrexate
13
Q
PSA Norm
A
<4
14
Q
Prostate Cancer Tx
A
- bilateral orchidectomy
- gosrelein (GnRH agonist) with flutamide before
- if castration resistant = peripheral androgen receptor antagonist = bicalutamide
- Enzalutamide x 5 affinity overcoming bicalutamide resistance
- Cyp17 inhibitor and dexamethasone and oestradiol
15
Q
Prostate Cancer Palliative Tx
A
- bone bisphosphonates, RANKL inhibitor (denosumab)
- Anaemia blood
- analgesia
- radiotherapy
16
Q
Prostate Cancer Chemo
A
TAXANES
Docetaxel
Carbataxel
17
Q
Testicular vs Prostate RF
A
Testicular = Caucasian Prostate = Afro-Caribbean
18
Q
Testicular germ cell Tx
A
- chemo = cisplatin and etoposide and bleomycin
- stem cell rescue if relapse
19
Q
Testicular cancer serum tumour markers
A
- LDH
- AFP
- BHCG
20
Q
Penile Cancer Tx
A
- removal and nodal block dissection
- radiotherapy and drain inguinal nodes
- chemo = cisplatin, fluorouracil, docetaxel
21
Q
Epididymo-orchitis
A
- infection of epididymis and testes
- pain and swelling
- chlam and gonorr of genital tract or bladder
- amiodorone causes
- ceftriaxone and doxycycline
- urethral discharge
22
Q
Testicular torsion
A
- urethral stricture
- medical emergency to prevent ischaemia
- severe pain
- surgical exploration of both
- if cremasteric reflex present = torsion affects testicular appendage only
- elevation of testes does not alleviate pain
- if do not fix both = bell clapper testes
23
Q
Hydronephrosis
A
- from obstruction
- children = from patent processus vaginalis
- remove obstruction and drain urine = nephrostomy tube if acute and ureteric stent if chronic
24
Q
Breast Tx
A
- Surgery first line
- if <4cm = wide local excision (and if peripheral tumour)
- if >4cm = mastectomy (and if central tumour)
- radio after wide local to reduce recurrence
- radio after mastectomy if high stage tumour and >4 axillary nodes affected
- Hormonal if receptors positive
- biological = traztuzumab (Herceptin) only for HER2 positive tumours (not if heart disorders)
- chemo
25
Breast Hormonal Tx
- tamoxifen for pre and peri menopausal women
| - aromatase inhibitors if post menopause = anastrozole
26
SE of tamoxifen
endometrial cancer
VTE
menopausal symp
27
Pagets
- nipple crusty lesion
- no areolar affect
- lymphadenopathy
- invasive carcinoma liekly
28
Breast Abscess
- mastitis from breast feeding = recommended to keep breastfeeding
- S. aureus
- tender, fluctulant
- AB and US
- overlying skin necrosis
- mammary duct fistula
29
Duct Ectasia
- discharge from single or multiple ducts
- thick and green
- NDI
- common during menopausal breast involution
30
Intraductal Papilloma
- single duct
| - clear or bloody discharge
31
TB
- child bearing women
- chronic breast or axillary sinuses
- biopsy, culture, histology
32
Fibroadenoma
- from lobule
- mobile, firm
- 2yrs get smaller
- if >3cm surgery
- phyllodes widely excised
33
Cyst
- smooth, disceret
- increased risk of cancer if young
- aspirate and biopsy
34
Sclerosing adenosis
- lump, pain
- mimic carcinoma on mammography
- lobular distortion
- ANDI
- biopsy
35
Epithelial hyperplasia
- variable lumpiness
- FH
- conservative if no atypical features
36
Fat necrosis
- mimic carcinoma
- increases in mass and size
- core biopsy and image
- skin tethering
37
Cause of ED
- vascular
- SSRI
- Beta blockers
38
Renal Colic Management
- If <5nm = spontaneously pass in 4w
- if obstructing = nephrostomy tube, ureteric catheter, ureteric stent
- shockwave lithotripsy first (analgesia need, organ injury, obstruction)
- ureteroscopy (ureter-> pelvis, pregnancy, when lithotripsy not possible, complex stone, left with stent)
- percutaneous nephrolithotomy (remove via renal collecting system)
39
Calcium oxalate
- hypercalciuria
| - radio-opaque
40
Cystine
- inherited metabolic disorder
- malabsorption of cysteine
- multiple stones
- radiodense as contain sulphur
41
Urate
- product of purine metabolism
- radiolucent
- low urine pH
- excessive tissue breakdown = malignancy
- children inborn errors of metabolism
42
Calcium phosphate
- renal tubular acidosis
- high urine pH
- radio-opaque
