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STEP 2 Cardio + Renal > Renal. Urologic cancers > Flashcards

Renal. Urologic cancers Flashcards

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1
Q

FA. Protate.
most common nonskin cancer in male

second cause of death in men

A

.

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2
Q

FA. Protate. 2 risk factors?

A

advanced age and family history

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3
Q

FA. Protate. initial symptoms? 2

A

asymptomatic, may present with obstructive urinary symptoms

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4
Q

FA. Protate. symptoms. additional?

A

Constitutional symptoms
lymphedema (from metastases obstructing lymphatic drainage) and/or black pain (bone mestastases)

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5
Q

FA. Protate. DRE?

A

palpable nodule or an area of induration.
Early carcinoma is usually not detectable

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6
Q

FA. Protate. Diagnosis. 2

A

Clinical findings and/or increased PSA (> 10 ng/ml)

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7
Q

FA. Protate. Diagnosis. most accurate test?

A

transrectal US guided biopsy

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8
Q

FA. Protate. Diagnosis. additional need to do what?

A

Look for metastases with CT of the abdomen/pelvis

and

a bone scan (metastatic lesions shows an osteoblastic or incr. bone density)

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9
Q

FA. key fact. leading causes of cancer death in men? 4

A

lung, protate, colorectal, pancreatic

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10
Q

FA. Protate. incr. in PSA can be caused by what other diseases?4

A

BPH, prostatitis, prostatic trauma, carcinoma

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11
Q

FA. Protate. treatment. older adults with low grade.?

A

watchful waiting, as many cases are slow to progress.

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12
Q

FA. Protate. treatment. radical prostatectomy assoc with what?

A

incr. risk for incontinence and/or erectile dysfunction

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13
Q

FA. Protate. treatment. radiation therapy, assoc with what?

A

incr. risk for radiation proctitis and GI symptoms.
erectile dysfunction posttreatment.

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14
Q

FA. Protate. treatment. PSA for what purpose used?

A

contraversial for screening

used to follow patient post treatment to evaluate for disease recurrence

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15
Q

FA. Protate. treatment. metastatic disease treatment?

A

androgen ablation (gonadotropin-releasing hormone agonists, orchiectomy, bicalutamide)
and
chemotherapy

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16
Q

FA. Protate. treatment. metastatic disease treatment.

Radiation therapy bone?

A

useful to manage bone pain from metastases after androgen ablation

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17
Q

FA. Protate. prevention.

A

screening guidelines contraversial :)))) THE FUCK

Males should discuss pros and cons of anual DRE and/or PSA starting at 50 y/o.

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18
Q

FA. Protate. prevention. in what patients start earlier than 50 yo?

A

black males and in those with first-degree relative with prostate cancer

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19
Q

FA. Bladder.
second most common urologic cancer and the most frequent malignant tumor of urinary tract. THE FUCK

A

.

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20
Q

FA. Bladder. what usually carcinoma?

A

transitional cell carcinoma (now called urothelial carcinoma)

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21
Q

FA. Bladder. in what age?

A

most prevalent in 60-70 decade in males

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22
Q

FA. Bladder. risk factors?

A

smoking, diet rich in meat ant fat, schistosomiasis (squamous cell carcinoma), past treatment of cyclophosphamide, ocupational exposure to anilin dye

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23
Q

FA. Bladder. symtoms.

A

Gross, painless hematuria

Terminal hematuria (end of voiding) suggests bleeding from bladder

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24
Q

FA. Bladder. other symptoms than most common?

A

frequency, urgency, dysuria can also be seen.
Most patients are asymptomatic in the early stages

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25
FA. Bladder. diagnosis. methods?
Sceening - not recommended UA - hematuria (microscopic or macroscopic) cystoscopy + biopsy is diagnostic urine cytology - dysplastic cells MRI, CT, bone scan - for muscle invasion and metastases
26
FA. Bladder. diagnosis. which method is diagnostic?
cystoscopy + biopsy
27
FA. Bladder. diagnosis. when recommended cysto+ biopsy?
in adults > 35 yo with unexplained hematuria
28
FA. Bladder. treatment. depends on what?
extent of spread beyond the bladded mucosa
29
FA. Bladder. treatment. Carcinoma in situ?
intravesicular chemotherapy or transuretheral resection.
30
FA. Bladder. treatment. superficial cancers?
Complete transuretheral resection or intravesicular chemotherapy with mitomycin C or BCG (TB vaccine)
31
FA. Bladder. treatment. Large, high grade recurrent lesions.
intravesicular chemotherapy
32
FA. Bladder. treatment. invasive cancer without metastases.
radical cystectomy or radiation therapy for patients who are deemed poor candidates for radical cystectomy and for those with unresectable local disease. Nonadjuvant systemic therapy and radiosensitization is often considered.
33
FA. Bladder. treatment. invasive cancer with distant metastases.
Chemotherapy, immunotherapy, novel targeted agents are considered.
34
FA. key fact. key step for diagnosis in an adult with unexplained hematuria is cystoscopy to evaluate for bladder cancer.
.
35
FA. RCC. origin?
Adenocarcinoma from tubular epithelial cells
36
FA. RCC. spread way?
spread along the renal vein the the IVC and metastasize to other sites (lungs, bone, brain, liver)
37
FA. RCC. Risk factors?
male, smoking, obesity, acquired cystic kidney disease in ESRD, genetic conditions eg von Hippel Lindau disease.
38
FA. RCC. symptoms?
gross hematuria, flank pain, scrotal varicoceles, palpable flank mass.
39
FA. RCC. metastatic disease symtoms?
weight loss, malaise, symptoms according to metastases site
40
FA. RCC. paraneoplastic symptoms? gali isskirti EPO
anemia, erythropoiesis, thrombocytosis, fever, cachexia, hypercalcemia, polymyalgia rheumatica
41
FA. RCC. best initial test?
Diagnosed via CT. allow to characterize renal mass and stage for lymp nodes/metastases.
42
FA. RCC. how confirmed diagnosis?
after CT --> histology on nephrectomy specimen
43
FA. RCC. what about UG?
rarely used
44
FA. RCC. treatment. 2
surgical resection OR thermal ablation may be curative in localized disease.
45
FA. RCC. treatment. metastases?
metastasectomy may improve survival in metastatic disease.
46
FA. RCC. key fact. triad? same UW
hematuria, flank pain, palpable flank mass these all 3 occur in only 5-10proc. patients.
47
FA. RCC. response to radiation therapy/chemo?
15-30 proc. only
48
FA. RCC. newer tyrosine kinase inhibitors (axitinib, lenvatnib, cabozatonib) for treatment?
it shows promising results. it decrease tumor angiogenesis and cell proliferation
49
FA. RCC. key fact. what typical scenario?
middle age individual with a history of smoking and left sided varicocele ---> CONSIDER RCC.
50
UW. RCC. in what proc. seen hematuria?
40 proc.
51
UW. RCC. left varicocele. in what percent and what position?
10 proc. do not empty when patient is recumbent - this failure shows that there is secondary cause of varicocele (eg tumor mass obstructing venous flow)
52
UW. RCC. Constitutional symptoms? 20 proc.
fever, night sweats, anorexia, weight loss, easy fatigabilty
53
UW. RCC. diagnosis?
CT scan
54
UW. RCC. paraneoplastic symptoms?
If ectopic EPO production --> polycytemia Thrombocytosis hypercalcemia cachexia, fever
55
FA. Testicular cancer. origin of 95 proc.?
germ cells and virtually all are malignant.
56
FA. Testicular cancer. risk factors?
cryptochidism, Kleinfelter syndrome, family history
57
FA. Testicular cancer. in what age?
15-34 y/o
58
FA. Testicular cancer. symptoms?
painless enlargement of the testes firm ovoid mass with possible nodules dull abdominal pain metastatic symptoms
59
FA. Testicular cancer. what age for seminomas?
40-50 y/o
60
FA. Testicular cancer. diagnosis? 2 instrumental
testicular UG xray and CT of abdomen/pelvis for metastases
61
FA. Testicular cancer. whats about screening?
tumor markers are useful for diagnosis and in monitoring treatment response
62
FA. Testicular cancer. biopsy?
contraindicated due to risk of spillage of cancer
63
FA. Testicular cancer. treatment. 2
radical orchiectomy + classification as seminoma or nonseminomatous germ cell turmor
64
FA. Testicular cancer. treatment. Seminoma?
chemotherapy or radiation for low stage disease
65
FA. Testicular cancer. treatment. non-seminoma?
retroperitoneal lymph node dissection for low-stage disease
66
FA. Testicular cancer. treatment. what chemo for advanced disease?
platinum based for advanced disease of either type (seminoma or non-seminoma)
67
FA. Testicular cancer markers. what are germ cell tumors? 95 proc.
Seminoma (most common) yolk sac choriocarcinoma teratoma
68
FA. Testicular cancer markers. what are non- germ cell tumors? 5 proc.
leydig cell, sertoli cells, testicular lymphoma
69
FA. Testicular cancer markers. Seminoma?
usually negative; beta-hCG in some cases
70
FA. Testicular cancer markers. Yolk sac?
inc. alfa-fetoprotein (AFP)
71
FA. Testicular cancer markers. Choriocarcinoma?
incr. beta-hCG
72
FA. Testicular cancer markers. Teratoma?
AFP and/or beta-HCG
73
usually negative; beta-hCG in some cases?
Seminoma
74
inc. alfa-fetoprotein (AFP)?
Yolk sac (endodermal sinus tumor)
75
AFP and/or beta-HCG?
Teratoma
76
incr. beta-hCG?
Choriocarcinoma
77
FA. Testicular cancer markers. leydig cells?
incr. testosterone and estrogen (causing dec. LH and FSH)
78
FA. Testicular cancer markers. sertoli?
none
79
FA. Testicular cancer markers. testicular lymphoma?
none. arises from metastasis to testes
80
incr. testosterone and estrogen (causing dec. LH and FSH)?
leydig
81
none marker in what testicular cancer?
sertoli
82
testicular markers? none. arises from metastasis to testes
testicular lymphoma
83
UW. Bladder cancer. risk factors. age, family history. what chronic exposure?3
smoking - carcinogens workplace - aromatic amines or aluminum well water - arsenic
84
UW. Bladder cancer. why screening is not recommended? 3
Current tests have lowe sensitivity/specificity most of them are detected at an early stage anyway generally have good prognosis, hence early diagnosis really doesnt help us much
85
UW. RCC. origin of what part shows worst prognosis?
collecting duct
86
UW. RCC. spread to 2 most common places?
lungs and bones
87
UW. RCC. spread route?
hematogenous. --> DVT or piece of tumor in renal vein
88
UW. RCC. thrombus in liver (hepatic vein), what syndrome?
Budd Chiari
89
UW. RCC. Diagnosis?3
CT scan or US CT thorax and bone scan for stagin DO NOT BIOPSY
90
UW. RCC. Treatment?
Resection --> nephrectomy
91
UW. Bladder cancer. Increased risk in what patients? 2
smokers and exposure to industrial carcinogens
92
UW. Bladder cancer. manifestation?
Painless hematuria Irritative voiding symptoms Regional pain
93
UW. Bladder cancer. Diagnosis?2 what gold standard?
gold - Flexible cystoscopy with biopsy Urine cytology
94
UW. Bladder cancer. staging, what methods?
TURBT Upper urinary tract imaging (IVP, MRI, CT)
95
UW. Bladder cancer. Treatment. 1. no muscle invasion. methods? 2
TURBP and itravesical immunotherapy
96
UW. Bladder cancer. Treatment. 2. muscle invasion. methods? 2
radical cystectomy and systemic chemotherapy
97
UW. Bladder cancer. Treatment. 3. metastatic? 2
Systemic chemotherapy and immunotherapy
98
UW. indications for cystoscopy. 5.
Gross hematuria with no evidence of glomerual disease or infection microscopic hematuria with no evidence of glomerual disease or infection BUT increased risk for malignancy Recurrent UTI Obstructive symptoms with suspicion for stricture, stone Irritative symptoms without UTI Abnormal bladder imaging or urine cytology
99

STEP 2 Cardio + Renal (55 decks)

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