Term
| A 60yo man with a 35 pack year smoking history presents with pink colored urine. UA reveals macrohematuria. CT urogram reveals no abnormalities of the kidneys or ureters. what is the diagnostic test of choice? |
|
Definition
| Cystoscopy with possible biopsy. |
|
|
Term
| What kind of cancer is typical for urinary tract? |
|
Definition
| transitional cell carcimoma |
|
|
Term
| What are the risk factors for urinary tract cancer? |
|
Definition
| smoking, exposure to aniline dyes, and chronic bladder infections |
|
|
Term
| What are the signs/symptoms of bladder cancer? |
|
Definition
| Gross hematuria. Urinary frequency, urgency, and dysuria may also be seen. |
|
|
Term
| How do you diagnose bladder cancer? |
|
Definition
UA; with lack of dysmorphic RBCs help to distinguis from glomerular source. Cytology may show dysplastic cells.
CT urograhy or IVP
Cystoscopy with biopsy is diagnostic |
|
|
Term
| What is the treatment for bladder cancer? |
|
Definition
Carcinoma in situ: intravesicular chemotherapy
Invasive cancers wo mets: aggressive surgery, radiation, or both
Distant mets: chemotherapy alone |
|
|
Term
| What are the symptoms of prostate cancer? |
|
Definition
| most are asymptomatic and are incidentally diagnosed by DRE or PSa. May present with urinary frequency, urgency, hesitancy, anemia, hematuria, or low back pain. |
|
|
Term
|
Definition
| (2-10) best predictor of tumor biology. Sums the scores of the two most dysplastic biopsy samples. |
|
|
Term
| How do you diagnose prostate cancer? |
|
Definition
| US guided needle biopsy of the prostate allows for diagnosis and staging. |
|
|
Term
| How do you treat prostate cancer |
|
Definition
Watchful waiting for elderly with low Gleason scores.
Consider radical prostatectomy or radiation therapy for node (-) dz. Treat node (+) dz with androgen ablation (GnRH agonist, orchiectomy flutamide) +/- chemotherapy. |
|
|
Term
| What are the signs/symptoms of testicular cancer? |
|
Definition
| Unilateral scrotal mass is testicular cancer until proven otherwise. Can present with unilateral discomfort or swelling suggestive of orchitis or epididymitis. |
|
|
Term
| What are the risk factors for testicular cancer? |
|
Definition
| men age 20-35, cryptorchid testis and kleinfelter's syndrome. |
|
|
Term
| How do you diagnose testicular cancer? |
|
Definition
Labs: alpha-fetoprotein, LDH, and Beta-hCG levels
Scrotal US will help differentiate hydrocele, spermaticele, or infection)
Definitive diagnosis is made by radical inguinal orchiectomy. |
|
|
Term
| How do you stage testicular cancer? |
|
Definition
| TNM, LDH, AFP, Beta-hCG, CT of abd/pelvis |
|
|
Term
| How do you treat testicular cancer? |
|
Definition
| Radical inguinal orchiectomy +/- chemotherapy/RT |
|
|
Term
| What are the risk factors for renal cell carcinoma? |
|
Definition
| smoking, von-Hippel-Lindau dz, tuberous sclerosis, and cystic kidney disease. |
|
|
Term
| What are the symptoms of RCC? |
|
Definition
| hematuria, flank pain, palpable mass, fevers, night sweats, anemia, or disseminated disease may present with dyspnea and bone pain. |
|
|
Term
| what paraneoplastic effects are seen in RCC? |
|
Definition
| erythrocytosis, hypercalcemia, and hypertension. |
|
|
Term
|
Definition
| CT with contrast is the choice for dx and operative planning. |
|
|
Term
| How do you treat RCC with local dz? |
|
Definition
| Partial vs. radical nephrectomy vs. cryoablation/radiofrequency ablation. |
|
|
Term
| How do you treat disseminated RCC? |
|
Definition
| chemotherapy (sorafenib, sunitinib) or biologic response modifiers (IL-2, IFN-alpha) +/- nephrectomy. |
|
|
Term
| What are the risk factors for ovarian cancer? |
|
Definition
| Age, use of infertility drugs, and familial cancer syndromes (BRCA-1, BRCA-2). |
|
|
Term
| What are some protective factors for ovarian cancer? |
|
Definition
| long term use of OCPs, having children, breast-feeding, TAH-BSO. |
|
|
Term
| What are the presenting symptoms of ovarian cancer? |
|
Definition
Usually asymptomatic until reached advanced stage.
Abdominal pain, bloating, pelvic pressure, urinary frequency, early satiety, constipation, vaginal bleeding, and systemic symptoms (fatigue, malaise, wt loss) |
|
|
Term
| What are the exam findings for ovarian cancer? |
|
Definition
| Palpable solid, fixed nodular pelvic mass; ascites; pleural effusions (Meigs' syndrome). An ovarian mass in postmenopausal women is ovarian cancer until proven otherwise. |
|
|
Term
| How do you diagnose ovarian cancer? |
|
Definition
| pelvic US and possibly CT or MRI; get serum CA-125 and CXR. |
|
|
Term
| How do you treat ovarian cancer? |
|
Definition
| TAH-BSO, omentectomy, and tumor debulking |
|
|
Term
| A 25 yo woman is noted to have dysplastic cells on a routine screening Pap smear. What test is required to confirm a diagnosis of cervical cancer? |
|
Definition
|
|
Term
| What are the risk factors for cervical cancer? |
|
Definition
| HPV infection, tobacco use, early onset of sexual activity, multiple sexual partners, immune compromise, and STDs. |
|
|
Term
| What are the symptoms of cervical cancer? |
|
Definition
| post coital bleeding, pelvic pain, vaginal discharge, menorrhagia and/or metrorrhagia. |
|
|
Term
| How do you diagnose cervical cancer? |
|
Definition
| Colposcopy and biopsy in pts with an abnormal Pap or visible lesion. |
|
|
Term
| How do you treat cervical cancer? |
|
Definition
CIN I:colposcopy every three months for one year.
CIN II-III: cryosurgery, laser surgery, or LEEP
Invasive cancer: Early state with radical hysterectomy and lymph node dissection. Advanced - radiation and chemotherapy. |
|
|
