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Clin Med GU > GU neoplasms > Flashcards

GU neoplasms Flashcards

1
Q

What is the biggest environmental risk factor for RCC

A

Smoking

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2
Q

What type of cancer is RCC

what are the subtypes

A

adenocarcinoma

clear cell, papillary, chromophobe

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3
Q

Where do adenocarcinomas originate within the kidney

A

proximal renal tubular epithelium

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4
Q

How do RCC proliferate

A

through VEGF stimulating angiogenesis = overexpression of RCC

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5
Q

What is the most common area of metastesis for RCC

A

Lungs

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6
Q

What is the classic triad for RCC presentation

A

Hematuria
flank / abdominal pain
Flank/abdominal mass

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7
Q

If someone has bilateral RCC, what should you think of

A

von Hippel-Lindau

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8
Q

How is RCC often diagnosed

A

incidentally on CT / US

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9
Q

Is RCC biopsied for diagnosis

why

A

No, needle tends to seed the tumor in other tissue with a bx

Technically needed for definitive dx but rarely preformed

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10
Q

How large is the tumor in stage 2 RCC

A

> 7cm but limited to the kindey

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11
Q

What is the most common urologic cancer in females

Which gender is more effected by bladder carcinoma

mean age at diagnosis?

A

bladder carcinoma

Men

73

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12
Q

What is the greatest risk factor for bladder carcinoma

what type of cancer is it

A

smoking

epithelial

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13
Q

How much have bladder carcinomas typically progressed to once it is diagnosed

A

Stage one
in-situ

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14
Q

What are the different types of bladder carcinoma

A

papillary
flat inasive
carcinoma in situ

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15
Q

What is the most common presenting symptom of bladder carcinoma

A

gross/microscopic hematuria

*any painless hematuria is cancer until proven otherwise

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16
Q

What is the study of choice for bladder carcinoma workup

A

cystoscopy

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17
Q

How does a low grade bladder tumor present

A

well differentiated

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17
Q
A
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18
Q

How does a high grade bladder tumor present

A

poorly differentiated, more likely to grow and recur

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19
Q

What is the first line and gold standard treatment for bladder carcinoma

What if the patient is immunocompromised

A

Bacille Calmette-Guerin (BCG)

endoscopic resection and intravesical chemotherapy

treat with anti TB agents

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20
Q

how frequently do cystoscopy need to be preformed with bladder cancer

A

Every 3months x 1year
every 6 months x 1 year
annually thereafter

21
Q

How do you treat someone with bladder cancer that is invading the muscle (MIBC)

A

Radical cystectomy & pelvic lymphnode dissection + systemic chemo

22
Q

What is the most common cancer in American men

Race?

A

Prostate cancer

Black

23
Q

what type of cancer is prostate cancer

Where does it occur

A

adenocarcinoma

arising primarily in peripheral zone

24
Q

What are some protective factors with prostate cancer

A

not smoking
healthy weight
physical activity
more frequent ejaculation

25
Q

what is the most common site of mets associated with prostate cancer

A

axial skeleton, generally lumbar spine

26
Q

What test can identify prostate cancer

A

PSA

27
Q

What screening techniques are used for prostate cancer screening

A

DRE
PSA

28
Q

When do avg risk patients get screened for prostate cancer

What about high risk prostate cancer

A

45-50

40-45

29
Q

When is PSA most useful for prostate cancer screening

What is normal

A

better for detecting high grade tumors
more predicitve when levels are higher

<4

30
Q

What gives a difinitive dx of prostate cancer

how many samples are needed

A

transrectal US guided bx

around 12

31
Q

at what stage can prostate cancer be felt

A

Stage 2
*hasnt spread outside the prostate

32
Q

At what stage has prostate cancer invaded local organs such as the bladder

A

Stage 4

33
Q

What is the treatment for localized prostate cancer

What about metastatic disease

A

radical prostatectomy + radiation

Palliative tx (androgen blocking therapy (LHRH))

34
Q

which LHRH agonists for prostate cancer do NOT require an orchiectomy

A

Leuprolide
Goserelin

35
Q

What prostate cancer tx is used when spinal cord compression, DIC, or bilat ureteral obstruction is present

A

Ketoconazole

36
Q

What is the most common cancer in men age 20-35

What is the avg age of diagnosis

A

Testicular cancer

33

37
Q

What will significantly increase someones risk for testicular cancer

A

cryptorchidism

The higher up the testical, the higher the risk of cancer

38
Q

What are the catagories of testicular cancer

A

Non-seminomas
Seminomas

39
Q

What type of cancers make up non-seminoma testicular cancer

What are seminomas and what do they secrete

A
  • embryonic cell carcinoma- agressive secrete HCG and AFP
  • teratoma- resistant to chemo/rad
  • choriocarcinoma- agressive, secretes HCG
  • Mixed (m/c)

slow growing germ cell tumor and only secrete HCG

*spermatocytic seminoma in older men

40
Q

What type of tumors are stromal tumors

A

leydig cells
sertoli cells

non-germ cell tumor with excellent prognosis

41
Q

Which testical is most commonly effected

A

R

42
Q

What is the most common symptoms of testicular cancer

A

painless mass or diffuse enlargement of the testicle

*sensation of heaviness

43
Q

What tumor markers will be elevated with testicular cancer

A

AFP
hCG
LDH

44
Q

What is the imaging of choice for testicular cancer

What test is for a definitive dx?

A

Scrotal US

Histology

45
Q

What is the gold standard tx for testicular cancer

A

inguinal orchiectomy

46
Q

What age group is penile cancer most common

A

50-70y/o

*generally uncircumsized men

47
Q

What type of cells make up penile cancer most commonly

Where on the penis do they generally begin

Where do they generally metastesize to

A

Epithelial
*squamous cell carcinoma most common

Foreskin / glans

Superficial / deep inguinal nodes

48
Q

What is the most common complaint at presentation for penile cancer

A

lesion itself

Ulcer, small nodule, exophytic growth, induartion/erythema

49
Q

What is mandatory to establish a dx of malignancy

A

bx

50
Q

What treatment for penile cancer can be used with small, noninfiltrating lesions

A

5-FU cream
radiation
Mohs surgery
laser ablation

51
Q
A

Clin Med GU (11 decks)

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