Urinary Bladder Carcinoma

Description

Mind Map on Urinary Bladder Carcinoma, created by yousaf alabrash on 04/04/2018.
yousaf alabrash
Mind Map by yousaf alabrash, updated more than 1 year ago
yousaf alabrash
Created by yousaf alabrash almost 7 years ago
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Resource summary

Urinary Bladder Carcinoma
  1. signs and symptoms
    1. hematuria
      1. physiology of hematuria
        1. initial
          1. Urethra
          2. total
            1. bladder or upper UT
            2. end
              1. Bladder neck or prostate urethra
              2. causes: differential diagnosis
                1. pain
                  1. UTI
                    1. stones
                    2. without pain
                      1. glomerulonephritis
                        1. schistosomiasis
                        2. either
                          1. UTI
                            1. APCKD
                            2. Grading
                        3. urgency
                          1. frequency
                            1. weight loss and fatigue
                              1. peripheral swelling
                              2. causes
                                1. schistosoma
                                  1. chronic cystitis
                                    1. HPV
                                  2. smoking
                                  3. risk factors
                                    1. occupational
                                      1. aniline
                                        1. Taxi drivers
                                      2. Past exposure to radiation
                                        1. type 2 diabetes treatment
                                      3. prognosis (5 year)
                                        1. stage 0
                                          1. 98%
                                            1. stage 2
                                              1. 63%
                                                1. stage 4
                                                  1. 15%
                                                    1. overall survival
                                                      1. 5 year: 77%
                                                        1. 10 year: 70%
                                                          1. 15 year: 65%
                                                        2. ALWAYS follow up with transurethral removal of bladder tumor (TURBT)
                                            2. stage 1
                                              1. 88%
                                                1. stage 3
                                                  1. 46%
                                            3. diagnosis
                                              1. imaging
                                                1. US
                                                    1. Cytoscopy
                                                  1. histopathology
                                                    1. grading
                                                      1. high grade
                                                        1. well differentiated
                                                          1. low grade
                                                            1. poorly differnentiated
                                                      2. staging
                                                        1. stage 0
                                                          1. cis
                                                            1. flat on the mucosal linning
                                                            2. Papillary 0a
                                                              1. Papillary on mucosal linning
                                                              2. stage 1
                                                                1. invades the submucosa
                                                                  1. stage 2
                                                                    1. invade the muscle layer
                                                                      1. stage 3
                                                                        1. invades the surrounding fat
                                                                          1. stage 4
                                                                            1. invade the surrounding tissues
                                                                  2. cytology
                                                                    1. Detect highly malignant cells (like CIS)
                                                                      1. schistoma hematobium egges
                                                                      2. Papillary varient
                                                                    2. lab investigations
                                                                      1. PSA
                                                                        1. test for prostatic cancer and BPH
                                                                          1. can cause UTI symptoms
                                                                            1. normal level: up to 4ng/ml of blood
                                                                              1. other investigations were disscussed in details in previous PBL's
                                                                        2. management
                                                                          1. stage 0
                                                                            1. a(papillary)
                                                                              1. mitomyocin
                                                                              2. in situ
                                                                                1. BCG
                                                                                2. stage 1
                                                                                  1. low grade
                                                                                    1. BCG
                                                                                    2. high grade
                                                                                      1. radical cystectomy
                                                                                      2. stage 2 & 3
                                                                                        1. radical cystectomy
                                                                                          1. stage 4
                                                                                            1. chemotherapy
                                                                                    3. Physiology of micturation
                                                                                      1. during bladder filling
                                                                                        1. sympathetic (L1-L3) dominate
                                                                                          1. Relax detrusor muscle
                                                                                            1. stimulate the internal sphincter
                                                                                              1. during bladder emptying
                                                                                                1. parasympthatic (S2-S4) dominate
                                                                                                  1. contract detrusor muscle
                                                                                                    1. inhibit the internal sphincter
                                                                                                      1. there must be somatic relaxation of external sphincter in order of voiding to happen
                                                                                                        1. by pudendal nerve (S3-S4)
                                                                                              2. epidemiology
                                                                                                1. MC malignancy in UTI
                                                                                                  1. 9th MC malignancy
                                                                                                    1. types
                                                                                                      1. urothelial
                                                                                                        1. in america and europe
                                                                                                          1. MC risk factor: smoking
                                                                                                        2. non-urothelial
                                                                                                          1. in middle east
                                                                                                            1. MC risk fsctor: schistosoma hemabotium
                                                                                                              1. A cestode parasitic infection
                                                                                                                1. increases carcinogen-metabolizing enzymes
                                                                                                                  1. +++N-nitrosamines
                                                                                                                    1. alkylating DNA damage
                                                                                                                      1. metaplasia and carcinoma
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