Test Bank Solution Manual for Urology - Surgical Recall Already Passed
DDx of scrotal mass? - Answers Cancer, torsion, epididymitis, hydrocele, spermatocele, vericocele,
inguinal hernia, testicular appendage, trauma (swelling), paratesticular tumor
(rhabdomyo-,leiomyo-,lipo-sarcoma)
Causes of hematuria? - Answers Bladder cancer, trauma, UTI, cystitis (chemotherapy, radiation), stones,
kidney lesion, BPH
Gross hematuria with trauma or chemo/radiation? - Answers Bladder cancer
DDx for bladder outlet obstruction? - Answers BPH, stone, foreign body, urethral stricture, urethral valve
DDx for ureteral obstruction? - Answers Stone, tumor, iatrogenic (suture), stricture, gravid uterus,
radiation injury, retroperiotneal fibrosis
DDx for kidney tumor? - Answers RCC, sarcoma, adenoma, angiomyolipoma, hemangiopericytoma,
oncoytoma
What is RCC? - Answers Most common solid renal tumor (90%); proximal renal tubular epithelium origin
Epidemiology of RCC? - Answers Adults 40-60, 3:1 Male: Female, 5% of cancers overall in adults
RCC: % bilateral? - Answers 1%
RCC: Risk? - Answers Male, tobacco, VHL, PKD
RCC: symptoms? - Answers Pain, hematuria, weight loss, flank mass, HTN
RCC: classic triad? - Answers Flank pain, hematuria, palpable mass. Only in 10-15% of cases
RCC: how diagnosed? - Answers Incidentally on imaging for another reason
RCC: Radiologic tests? - Answers IVP (intravenous pyelogram), Abdominal CT w/ contrast
AJCC staging of RCC: Stage 1 - Answers Tumor <2.5 cm, no nodes/mets
AJCC staging of RCC: Stage 2 - Answers Tumor >2.5 cm limited to kidney, no nodes/mets
AJCC staging of RCC: Stage 3 - Answers Tumor into IVC or main renal vein, regional nodes but <2 cm in
diameter and no mets
AJCC staging of RCC: Stage 4 - Answers Distant mets or nodes >2cm in diameter, tumor past Gerota's
fascia
RCC metastatic workup? - Answers CXR, IVP, CT, LFT, Calcium
RCC sites of mets? - Answers Lung, liver, brain, bone; tumor thrombus in renal vein or IVC
, RCC: unique route of spread? - Answers Tumor thrombus through IVC
RCC treatment? - Answers Radical nephrectomy (kidney, adrenal, Gerota's), stages I through IV
What gland is included in a radical nephrectomy? - Answers Adrenal
RCC: Unique treatment for metastatic spread? - Answers 1. alpha interferon
2. LAK cells (lymphokine-activated killer) and IL-2
RCC + liver disease? - Answers Stauffer's syndrome
Concern in an adult with new onset left varicocele? - Answers Left RCC - left gonadal vein drains into left
renal vein
Bladder cancer: incidence? - Answers Second most common urologic malignancy, M:F 3:1, White > AA
Bladder cancer: most common histology? - Answers Transitional/urothelial cell carcinoma (TCC)>>
squamous, adenocarcinoma
Bladder ca: risk factors? - Answers Smoking >> industrial carciogens (aromatic amines), schisto, truck
drivers, petroleum workers, cyclophosphamide
Bladder ca: symptoms? - Answers Hematuria +/- irritation (dysuria), frequency
Bladder ca: classic presentation? - Answers Painless hematuria
Bladder ca: workup? - Answers Urinalysis, culture, IVP, cystoscopy + cytology, biopsy
Bladder ca TCC: Stage 0 - Answers Superficial, CIS
Bladder ca TCC: Stage 1 - Answers Invades subepithelial connective tissue, no nodes/mets
Bladder ca TCC: Stage 2 - Answers Invades superficial or deep muscularis propria, no nodes/mets
Bladder ca TCC: Stage 3 - Answers Invades perivesical tissues, no nodes/mets
Bladder ca TCC: Stage 4 - Answers Nodal spread with distant mets and/or invades abdominal/pelvic wall
Bladder ca TCC: Stage 0 Treatment - Answers TURB, intravesical chemotherapy
Bladder ca TCC: Stage 1 Treatment - Answers TURB
Bladder ca TCC: Stage 2/3 Treatment - Answers Radical cystectomy, lymph node dissection, removal of
prostate/uterus/ovaries/anterior vaginal wall, urinary diversion (ileal conduit) +/- chemo
Bladder ca TCC: Stage 4 Treatment - Answers +/- Cystectomy and systemic chemo
