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Pathology II Exam II > MALE Genital I > Flashcards

Flashcards in MALE Genital I Deck (24):
1

What is the differential diagnosis of hematuria? 3

cystitis
urolithiasis
neoplasms

2

What is the most common cause of cystitis?

Gram negative bacteria (E. coli)

3

What is the symptoms triad of cystitis?

frequency, dysuria, and lower abdominal pain

+/- hematuria

4

What is granulomatous cystitis secondary to? where is it mostly found?

1. Renal tuberculosis
2. trigone- ureteral orifices

5

What is BCG- induced granulomas? Are the necrotizing?

1. intravesicular administration of bacillus calmette-guerin (BCG) used for the Tx: of superficial bladder carcinoma
2. No

6

What is malakoplakia due to? what do they look like grossly? What do we see microscopically?

1. defects of phagocytic functions of macrophages
2. 3-4 cm, soft, yellow, raised plaques
3. PAS+ granules in large foamy macro., giant cells, lymphocytes, basophilic remnants in macrophages (michaelis-gutmann bodies)

7

What is the symptom of small stones passing into ureter?

Renal colic

8

Large stones may remain silent within the renal pelvis or give rise to what? 2

1. hematuria
2. superimposed infections
by obstruction and trauma

9

Is urinary bladder cancer more common in men or women?

men 3:1 50-80 years old

10

Review the epidemiology of bladder cancer

tobacco
arylamines- anilines
cyclophosphamide
analgesic abuse
bladder radiation
schistosoma hematobium

11

What is the most common type of bladder cancer? 2nd?

Urothelial carcinoma
squamous cell carcinoma

12

What is an infectious cause of squamous cell carcinoma of the bladder?

schistosoma hematobium

13

What does urothelial carcinoma in situ look like grossly? what happens due to lack of cell cohesiveness? what happens if untreated?

1. flat, reddened, thickened/granular
2. Shedding into urine
3. 50-75% progress to muscle invasive disease

14

What do we see microscopically in urothelial carcinoma in situ?

flat lesion, atypical cells with large, irregular hyper chromatic nuclei and mitoses

15

How many of bladder cancers are low grade papillary urothelial carcinoma? What does low stage mean? does it have a high recurrence rate? very progressive? What chromosome is involved?

1. 2/3
2. <10% invade
3. yes
4. No
5. 9

16

What does low grade papillary urothelial carcinomas look like microscopically?

IS mitosis frequently seen?

1. -fragile branching papillae
-covered by orderly urothelial cells with min. crowding or loss of polarity, round oval nuclei, mild variation,

2. Mitosis is infrequent

17

How many high grade papillary urothelial carcinomas invade? progressive?

1. 80%
2. very progressive and high mortality

18

What does high grade urothelial carcinomas look like microscopically?

1.-delicate branching or fused papillae
- covered by disorderly urothelial cells, loss of polarity, pleomorphic, nucleoli and mitoses.

19

What is the biggest prognostic factor in bladder cancer?

depth of invasion (stage)

others include- grade, multifocality, prior recurrence rate

20

In bladder cancer what stage corresponds to the following depths- muscular is propria? perivesical tissue? lamina propria? pelvic wall?

II
III
I
IV

21

What is the main clinical finding of urothelial carcinoma?

1. painless hematuria

others include- frequency, urgency and dysuria
- obstruction of orifice, multiple recurrences, metastases

22

How do we treat bladder cancer if it is small, localized and low grade? What if it is multifocal?

1. transurethral resection
2. resection then topical chemo

23

How do we treat high risk patients with high grade tumors etc.?

1. Resection then topical immunotherapy- BCG bacillus calmette-guerin

24

Review the following indications for radical cystectomy

-invading muscularis propria
- CIS or high grade papillary cancer refractory to BCG
- extension into prostate