urology Flashcards
(29 cards)
what are RF for TCC of bladder
aromatic amines (dyes), smoking, increasing age
what is the 2WW for haematuria
age 45 + with either 1) unexplained visible haematuria or 2) visible haematuria that persists after UTI
or age > 60 with non visible haematuria and dysuria or raised WCC on bloods
-firstline investigation - urine dip, bloods (FBC, U+E, clotting), also do DRE on examination and PSA
-firstline imaging - cystoscopy
-if visible haematuria - CT urogram
-if non visible haematuria - US
what is the staging of a bladder cancer
Tis
T1 - through LP
T2 - through muscular mucosa (so this is muscle invasive
T3
T4
for what cancer is TURBT used for
Tis / T1
when is BCG vaccine given into the bladder
2 weeks after TURBT if you have a high risk bladder cancer
what is the treatment option for a muscle invasive bladder cancer
radical cystectomy with urodiversion
what are some options for urine diversion
1) neobladder - where a new bladder is made from a section of the bowel
2) ileal conduit (urostomy) - section of ileum taken to make a stoma
3) continent urinary diversion - a pouch is made from bowel so you do not have a stoma bag but drain with a catheter through the stomach periodically.
what kind of chemo is used for bladder cancer
cisplatin based
if a low grade non invasive bladder cancer what is given into the bladder after TURBT
intravesicular chemo
what is the risk with superficial bladder cancers
they have a high rate of recurrence
where else can you get TCC
upper urinary tract (ureters and renal pelvis) although this is rare
complications of bladder cancer
1) Haematuria –> anaemia
2) Recurrent UTIS due to obstruction of urinary flow
3) Obstructive uropathy –> hydronephrosis
4) radiation cystitis if treated with radiotherapy
what’s the most common type of renal cancer
adenocarcinoma
common presentations of renal cell carcinoma
1) haematuria 2) loin pain 3) palpable mass 4) left varicocele 5) pyrexia
RF of RCC
dialysis, smoking, obesity, HTN, black, age
what kind of mets do you get in RCC
cannonball (spread with direct invasion around the kidney to gerotas fascia)
how big is a T1 RCC
<7cm
when is a partial nephrectomy appropriate for RCC
if T1
what can you not use to treat RCC
chemo!
what is Stauffer’s syndrome
hepatic dysfunction (raised AST and ALT) which then goes following nephrectomy
RF for prostate cancer
FHX, BRCA2, age, obesity
late symptoms of prostate cancer
problems urinating, poor stream, blood in semen, ED, bone pain
what should PSA be
<4
following an MRI, how can a biopsy be taken for protstae cancer
TRUS or transperineal US guided biopsy
