Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Cancer care > Urologocial cancer > Flashcards

Urologocial cancer Flashcards

1
Q

Risk factors for prostrate cancer

A

Increasing age
Family history (4x higher risk if 1st degree relative <60)
BRCA2
Afro-Caribbean>Caucasian>Asian

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Presentation of prostate cancer

A 
Asymptomatic
LUTS - nocturia, urgency, frequency, hesitancy, straining, post micturation dribble, intermittent/weak stream
Bone pain (lower back)
Ejaculatory symptoms (very rare) - haematospermia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Diagnosis of prostate cancer

A

DRE + PSA (need both together!)
MRI pelvis can be performed pre-biopsy to decide if need a biopsy and which biopsy method is more appropriate
Prostate biopsy (transrectal or transperineal)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Describe transrectal and transperineal prostate biopsies

A

Transrectal: done under LA, 3% risk of sepsis, given high dose antibiotics beforehand (metronidazole and ciprofloxacin)

Transperineal: done under GA, lower infection risk

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Causes of raised PSA

A 
Prostate cancer
UTI
Prostatitis
BPH
Urinary retention
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

If patient has a UTI, when should you redo the PSA level

A

4-6 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Percentage of men with a normal PSA who have prostate cancer

A

15%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Treatment for metastatic prostate cancer

A

Surgical:
Orchidectomy

Hormone therapy:
LHRH agonist depot (gasorelin) with initial anti-androgen (bicalutamide) to prevent initial flare up

Add-ons:
Prednisolone
Docetaxel chemo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Palliative management of metastatic prostate cancer

A

Single dose radiotherapy

Zoledronic acid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Treatment of locally advanced prostate cancer

A

Radical radiotherapy + adjuvant hormone therapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Curative management of localised prostate cancer

A

Active Surveillance - PSA and DRE every 6 months
Radical prostatectomy (only <70)
Radiotherapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Palliative management of localised prostate cancer

A

‘Watch and wait’

Can give hormone therapy if progressing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Candidates for robotic prostatectomy

A

Age <70
Intermediate/high risk localised prostate cancer
PSA <20
BMI <35

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Describe length time and lead time bias

A

Length time bias:
Screening programme is better at picking up slow growing tumours

Lead time bias:
Screening picks up cancer much earlier than it would have been detected clinically and therefore appears to improve survival

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Differential for haematuria

A 
Urological cancer
Stones
UTI
Inflammation 
BPH
Glomerular disease
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

3 key investigations for haematuria

A

Endoscopy: flexible cystoscopy
Radiology: ultrasound of kidneys and bladder
Urine: cytology

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Investigations usually performed by GP before get to urology investigations

A

EGFR
ACR
MSU

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Investigations for painless testicular lump

A

Refer via 2ww
Urgent USS of scrotum to diagnose
If USS confirms mass - tumour markers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

When to suspect penile cancer

A

Penile lump or ulcer which:
Persists despite treatment
OR
STI has been excluded

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Describe paraphimosis

A

Can’t replace foreskin
Leads to necrosis of glans penis due to venous congestion
More common in long term catheter use

21
Q

Describe phimosis

A

Can’t retract phimosis

Occurs in recurrent balanitis e.g diabetic patients or poor hygiene

22
Q

Risk factors for bladder cancer

A

Male x3
Caucasian>other
Smoking x4
Occupational exposure - rubber, plastics, printers, crude oil, combustion

23
Q

What are the superficial and invasive bladder stages

A

Superficial: T1, Ta, Tis

Muscle invasive: T2-4

24
Q

Risk factors for RCC

A 
Male 1.5x
Caucasian>other
Smoking x2
Obesity
Dialysis
25
Q

Treatment for localised RCC

A

Surveillance
Radical nephrectomy
Partial nephrectomy if renal hilum not involved

26
Q

Treatment for metastatic RCC

A

Palliative:
Targeted therapies - TKIs to target angiogenesis
Nephrectomy + adjuvant chemo if few lung mets

27
Q

Treatment for testicular cancer

A

Inguinal orchidectomy
Single dose RT para-aortic LNs
Freeze sperm if possible
Can insert prosthesis during surgery for cosmetic reasons

28
Q

Risk factors for testicular cancer

A

History of undescended testis

Kleinfelters syndrome

29
Q

Risk factors for penile cancer

A

Phimosis

HPV 16+18 (condyloma acuminata)

30
Q

Treatment for upper urinalysis tract TCC

A

Nephrourectomy

Kidney, surrounding fat, ureter, cuff of bladder

31
Q

Treatment of metastatic bladder TCC

A

Systemic chemo - cisplatin

Immunotherapy - pembroluzimab

32
Q

Curative treatment of muscle invasive bladder TCC

A

Neoadjuvant chemo

Radical cystectomy or RT

33
Q

Palliative treatment of muscle invasive bladder TCC

A

Chemo or RT

34
Q

Methods of cystectomy

A

Ileal conduit to make a urostomy (usually R side)

Reconstructed bladder from segment of bowel connected to patients urethra

35
Q

Treatment of low risk superficial bladder TCC

A

TURBT
Check cystoscopies
Cystoscopic surveillance

36
Q

Treatment for intermediate risk superficial bladder TCC

A

TURBT
Check cystoscopies
6 doses of weekly intravesical mitomycin followed by cystoscopic surveillance

37
Q

Treatment for high risk superficial bladder TCC

A

TURBT
Check cystoscopies
BCG regimen (mycobacterium bovis) or hyperthermic mitomycin
If fails, need cystectomy

38
Q

Long term effects of hormone therapy for prostate cancer and the clinical relevance of this

A

CVS events
CVA
Osteoporosis
Decreased muscle bulk

Can give long term hormones intermittently guided by PSA

39
Q

Effectiveness of long term hormone therapy

A

80% response

>2 years responsive

40
Q

What is low risk localised prostate cancer

A

T1-T2a
PSA <10
Gleason <7

41
Q

What is intermediate localised prostate cancer

A

T2b
PSA 10-20
Gleason 7

42
Q

What is high risk localised prostate cancer

A

T2c-T3c
PSA >20
Gleason 8 or above

43
Q

What is the difference between active surveillance and watchful waiting

A

AS: PSA and DRE surveillance with intention of radical curative treatment if cancer is progressing

Watchful waiting: monitor PSA and if symptoms occur treat with palliative intent (deferred hormone therapy)

44
Q

Types of testicular tumours and most common type

A

Germ - seminoma, teratoma, choriocarcinoma, yolk sac tumour
Non germ - leydig, sertoli

Most common is seminoma

45
Q

Why can’t you biopsy a testicular tumour

A

High risk of seeding

46
Q

Features of a seminoma

A 
Normal AFP levels
Raised beta-HCG and LDH
Late metastasises 
RT sensitive 
Histology: no haemorrhage, large cells in lobules have 'fried egg appearance' I.e large cytoplasm
47
Q

Histological features of yolk sac tumour

A

Raised AFP

Schiller Duval bodies

48
Q

Tumour marker levels in teratoma

A

None are raised

49
Q

Tumour marker levels in choriocarcinoma

A

Very high beta-HCG

Cancer care (12 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions