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Urology Topics > Topic List 2 - Urooncology > Flashcards

Topic List 2 - Urooncology Flashcards

(37 cards)

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1
Q

Groups of antineoplastic drugs - Kidney tumors

A

Not sensitive to chemotherapy
Immunotherapy: Interferon alpha2, IL-2
Targeted therapy: VEGF blocking drugs

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2
Q

Groups of antineoplastic drugs - tumors of pyelon and ureter

A

Gemzar-cisplatin
M-VAC: Methotrexate, Vinblastine, Adriamycin, Cisplatin

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3
Q

Groups of antineoplastic drugs - Bladder

A

Superficial bladder cancer
- Mitomycin C, Epirubicin, Doxorubicin

Invasive bladder cancer
- M-VAC: Methotrexate Vinblastine, Adriamycin, Cisplatin
- Gemzar- cisplatin

Immunotherapy after TURB: BCG vaccine (Super weird, but makes it memorable)

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4
Q

Groups of antineoplastic drugs - Prostate

A

Advanced Disease:
Hormonal therapy:
1. Antiandrogens: Flutamide
2. LHRH agonist: Triptorelin

Chemotherapy:
3. Docetaxel/Cabazitaxel

Secondary hormonal therapy:
4. Abiraterone
5. Enzalutamide

Bone metastasis:
6. Alpharadin irradiation
7. Bisphosphonates

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5
Q

Groups of antineoplastic drugs - Testes

A

Chemotherapy if vascular or lymphatic invasion:
- BEP: Bleomycin, Etoposide, Cisplatin
- PVB: Cisplatin, Vinblastine, Bleomycin

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6
Q

Groups of antineoplastic drugs - Penis

A

Chemotherapy:
- Vincristine, MTX, Bleomycin, 5-FU, Cisplatin

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7
Q

Groups of antineoplastic drugs - Alkylating agents

A
  1. Bleomycin - intercalating
  2. Cisplatin - platinum
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8
Q

Groups of antineoplastic drugs - Antimetabolites

A
  1. Methotrexate - Folate
  2. 5-FU - Pyrimidine analogues
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9
Q

Groups of antineoplastic drugs - Topoisomerase inhibitors

A
  1. Doxorubicin
  2. Epirubicin
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10
Q

Groups of antineoplastic drugs - Mitotic spindle inhibitors

A
  1. Vincristine/Vinblastine - Vinca alkaloids
  2. Docetaxel - Taxanes
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11
Q

What are benign tumors of the kidney

A
  1. Angiomyolipoma
  2. Adenoma
  3. Oncocytoma
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12
Q

What are malignant tumors of the kidney

A
  1. Adenocarcinoma (82%)
    - Clear cell, papillary, chromophobe, bellini tumor
  2. Sarcoma
  3. Lymphoma
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13
Q

What is the classic triad of Renal cell carcinoma?

A
  1. Hematuria
  2. Flank pain
  3. Palpable abdominal mass
    Only 10-15% of the patients present like this though
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14
Q

Kidney tumors - Treatment

A
  1. Surgery (first choice) Most important by far
  2. Immune therapy: Alpha2 interferon, IL-2
  3. Chemotherapy: Vinblastine, 5-FU
  4. Bisphosphonate therapy
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15
Q

Kidney tumors - typical areas of metastasis

A

Lung, liver, brain, bone

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16
Q

Kidney tumor specific - classifications

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A

Robson’s
Fuhrmann

17
Q

Tumors of the pyelon and ureter

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A

10% of renal tumors and 5% of urothelial tumors
Peak incidence: 70-90 years old; smoking
Hereditary: HNPCC
60% are invasive

18
Q

Superficial bladder cancer - types (histology)

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A
  1. Transitional cell carcinoma (90%)
  2. Adenocarcinoma (3-4%)
  3. SCC (2-3%)
  4. Rhabdomyosarcome, leiomyosarcome, lymphoma, melanoma (<1%)
19
Q

Bladder cancer diagnosis

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A
  1. History: Painless hematuria, irritative symptoms (frequency, urgency, dysuria)
  2. Physical: Nothing unless super advanced
  3. Labs: Urinalysis, Anemia, SeCr/SeUr increased
  4. US
  5. Cystoscopy
  6. CT
  7. MRI
    8.Urine cytology
20
Q

Superficial Bladder cancer - Treatment

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A
  1. TURB
  2. Adjuvant treatment - intravesical instillation
    - indications: Rapid tumor recurrence, multicentricity, invasion, presence of carcinoma in-situ
  3. Chemotherapy - Mitomycin C, Epirubicin, Doxorubicin
21
Q

Invasive Bladder Cancer (T2 and up) - Treatment

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A
  1. Radical cystectomy
    -Males: Bladder + prostate + vesicles + parailiac lymph are removed
    -Females: Bladder + uterus + upper third of vagina are removed
  2. Urinary deviation: Percutaneous nephrostomy or ureterocutaneostomy
  3. Chemotherapy:
    -M-VAC (methotrexate, vinblastine, adriamycin, cisplatin)
    -Gemzar-cisplatin
22
Q

Prostate cancer - Epidemiology and Etiology

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A

Epidemiology:
-Hungary 4500 each year, 1400 die

Etiology:
-Genetics
-Hormonal
-Environmental

23
Q

Prostate cancer scoring system

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A

Gleason score: Based on histology glandular formation
Well differentiated 1-3
Medium 4-7
Poor differentiation 8-10

24
Q

Prostate cancer diagnosis

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A
  1. DRE
  2. PSA
  3. Transrectal US (80% nothing can be seen on US)
  4. Biopsy (6 samples each lobe, 12 total)
  5. MRI
  6. PCA3 (prostate cancer antigen 3)
25
Where does prostate cancer normally metastasize?
Lungs and Bones
26
Localized prostate cancer (T1-T2) treatment
1. Radical prostatectomy (prostate, lymph, seminal vesicles) -Perineal -Retropubic -Laparoscopic -SE: incontinence, ED, loss of libido, Urethral anastomosis stricture 2. Irradiation -Extracorporeal irradiation/teletherapy -Brachytherapy: if PSA<10 and Gleason<6; can be interstitial or intracavital -SE: Irradiation cystitis and proctitis (rectum); ED, loss of libido
27
Advance Prostate Cancer (T3-T4) Treatment
Total androgen blockade 1. Antiandrogens (Flutamide): to decrease flare-up phenomenon 2. LHRH agonist: Triptorelin This works for first few years then resistance builds Follow-up is done every 3 months for PSA, 6 months for CT and bone scintigraphy Next Chemotherapy: 3. Docetaxel (first line) Cabazitaxel (2nd line) 4. Abiraterone or Enzalutamide (Secondary hormone therapy)
28
Penile tumors - Clinicopathology
Primary tumors: 1. Squamous cell carcinoma (95%) 2. Sarcoma, Kaposi, BCC, Melanoma (5%) Location: 1. Glans (48%) 2. Prepuce (21%) 3. Both (9%) 4. Coronary sulcus (6%)
29
Penile tumors - Lymphatic spread
Superficial and deep inguinal lymph nodes then to iliac nodes Sentinel node = pubic tubercle and superficial epigastric vein
30
Penile low risk precancerous lesions
1. Balanitis xerotica 2. Cornu cutaneum 3. Bowenoid papulosis
31
Penile high risk precancerous lesions
1. Lichen sclerosis 2. Erythroplasia glandis 3. Zoon balanitis 4. Bowen disease 5. Buschke lowenstein tumor
32
Penile tumor treatment
1. Surgery/excision 2. Lymphadenectomy 3. Chemo: 5-FU, Bleomycin, MTX 4. Radiotherapy
33
Testicular tumor - epidemiology and etiology
20-45 years old 95% of all testicular tumors are germ cell Associated with undescended testes, cryptorchid testes, family and personal history
34
Testicular tumors - Germ cell
Seminomas Non-seminomatous: -Embryonal -Teratoma -Choriocarcinoma -Mixed
35
What are some chemical markers of testicular tumors?
α-Fetoprotein: elevated in yolk sac tumor β-HCG: elevated in choriocarcinoma LDH: elevated in seminoma and embryonal carcinoma
36
Testicular tumors - Non-germ cell
1. Leydig cell tumors (Reinke crystals on histology) 2. Sertoli cell tumors
37
Testicular tumor - staging
Stage 1: local Stage 2: retroperitoneal lymph node involvement Stage 3: distant metastasis

Urology Topics (2 decks)

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