Bladder Cancer Definition  Malignancy arising from the bladder urothelium Most common type is urothelial carcinoma Often presents with painless hematuria  Risk Factors  Cigarette smoking Occupational chemical exposures such as dyes and rubber 

Bladder Cancer 
Definition 
<ul> 
<li>Malignancy arising from the bladder urothelium</li> 
<li>Most common type is urothelial carcinoma</li> 
<li>Often presents with painless hematuria</li> 
</ul> 
Risk Factors 
<ul> 
<li>Cigarette smoking</li> 
<li>Occupational chemical exposures such as dyes and rubber</li> 
<li>Chronic bladder irritation or infection</li> 
<li>Cyclophosphamide therapy (chemotherapy agent)</li> 
</ul> 
Clinical Presentation 
<ul> 
<li>Painless gross hematuria is classic</li> 
<li>Irritative voiding symptoms such as frequency or urgency</li> 
<li>Flank pain if obstruction occurs</li> 
<li>The question stem would likely describe an older smoker with painless blood in the urine</li> 
</ul> 
Diagnostics 
<ul> 
<li>Urinalysis: hematuria</li> 
<li>Urine cytology: may detect malignant cells</li> 
<li>Cystoscopy with biopsy: diagnostic test of choice</li> 
<li>CT urography or renal ultrasound: evaluate upper tracts for masses or obstruction</li> 
</ul> 
Treatment 
<ul> 
<li>Transurethral resection of bladder tumor for diagnosis and initial management</li> 
<li>Urology referral for cystoscopy</li> 
<li>Advanced disease may require more extensive surgery or systemic therapy</li> 
<li>Ongoing surveillance cystoscopy due to high recurrence</li> 
</ul> 
Exam Keys 
<ul> 
<li>Painless hematuria in older patient = bladder cancer</li> 
<li>Smoking is strongest risk factor</li> 
<li>Cystoscopy with biopsy is required for diagnosis</li> 
<li>High recurrence rate requires surveillance</li> 
</ul> 
Penile Cancer 
Definition 
<ul> 
<li>Malignancy of the penis, usually squamous cell carcinoma</li> 
<li>Rare in the United States</li> 
</ul> 
Risk Factors 
<ul> 
<li>HPV infection</li> 
<li>Lack of circumcision with chronic smegma accumulation</li> 
<li>Phimosis</li> 
<li>Smoking</li> 
<li>Poor hygiene</li> 
</ul> 
Clinical Presentation 
<ul> 
<li>Painless penile mass, ulcer, or lesion</li> 
<li>May bleed or become foul smelling</li> 
<li>Inguinal lymphadenopathy in advanced cases</li> 
<li>The question stem would likely describe an uncircumcised man with a persistent penile lesion or ulcer</li> 
</ul> 
Diagnostics 
<ul> 
<li>Clinical exam and biopsy of the lesion</li> 
<li>HPV testing may be supportive but not required</li> 
<li>Imaging (CT or MRI) if concerned for nodal or metastatic spread</li> 
</ul> 
Treatment 
<ul> 
<li>Surgical excision is mainstay</li> 
<li>Topical or laser therapy for very superficial lesions</li> 
<li>Partial or total penectomy for invasive disease</li> 
<li>Radiation or chemotherapy for advanced or metastatic cases</li> 
</ul> 
Exam Keys 
<ul> 
<li>Uncircumcised male with chronic lesion = think penile cancer</li> 
<li>Strongly associated with HPV and poor hygiene</li> 
<li>Diagnosis requires biopsy</li> 
<li>Treatment is surgical excision</li> 
</ul> 
Prostate Cancer 
Definition 
<ul> 
<li>Malignancy of prostate gland, usually adenocarcinoma</li> 
<li>Most common non-skin cancer in men</li> 
<li>Often slow growing and asymptomatic early</li> 
</ul> 
Risk Factors 
<ul> 
<li>Age over 50</li> 
<li>African American race</li> 
<li>Family history</li> 
<li>BRCA mutations</li> 
</ul> 
Clinical Presentation 
<ul> 
<li>Often asymptomatic</li> 
<li>May have urinary hesitancy, weak stream, or nocturia</li> 
<li>Bone pain suggests metastasis</li> 
<li>The question stem would likely describe an older man with urinary obstructive symptoms or elevated PSA</li> 
</ul> 
Diagnostics 
<ul>

Physician Assistant Exam Review

145 GU Neoplasms. Only the pieces you need to pass.

145 GU Neoplasms. Only the pieces you need to pass.

Description