Bladder Cancer Quiz

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Bladder Cancer Quiz

Created by Connor Bohlken and Chris Galbraith
Edited by Dr. Paris Ingledew

The most common form of bladder cancer in North America is ____________, and it arises from ____________.

1 point

Urothelial Carcinoma, arises from the Lamina Propria of the bladder.

Urothelial Carcinoma, arises from the Muscularis Propria of the bladder.

Squamous Cell Carcinoma, arises from the Epithelium of the bladder.

Urothelial Carcinoma, arises from the Epithelium of the bladder.

Adenocarcinoma, arises from the Epithelium of the bladder.

Clear selection

Which of the following are routine screening tests for Bladder Cancer that are recommended in the general population?

1 point

Urinalysis / Urine Microscopy every 2 years or Cystoscopy every 5 years.

Bladder Ultrasound every 3 years

Alpha fetoprotein (AFP)

There are no routine screening tests for bladder cancer recommended for the general population.

Prostate Specific Antigen (PSA)

Carcinoembryonic Antigen (CEA)

Clear selection

You are a 3rd year medical student on your last rotation of the year: Urology. Today your attending is Dr. Anna Line. Your first procedure of the day is a cystoscopy for new onset gross hematuria. As the patient is getting surgically prepped, Dr. Anna Line asks you what risk factor accounts for most bladder cancer in Western countries. You answer:

1 point

Smoking

Pelvic Irradiation and Cyclophosphamide

Aromatic Amines

Schistosoma Haematobium Infection

Chronic Bladder Irritation

Clear selection

You are about to see Mrs. Owchwhenipee, a 64 year old female with a history of recurrent uric acid stones. As a learning opportunity, Dr. Lisa Stone, your attending Urologist, asks you to take a focused history and physical targeting your top differential diagnoses only! You walk into the room and introduce yourself, and begin taking the history. Mrs. O reports that she noticed that her urine started appearing pink about 2 weeks ago and has progressively become slightly more red. However, she states that she has had no pain. She has previously worked in a hair salon, and smoked a pack of cigarettes a day for 40 years. She began menopause at the age of 57. Which of the following presentation is most associated with bladder cancer:

1 point

Urinary Frequency, Urgency, and Dysuria.

Flank Pain.

Painless Gross Hematuria.

Fever and Chills.

Constitutional Symptoms.

Clear selection

You are on your outpatient rotation in Urology, when a 65 year male comes in who has been referred for painless gross hematuria. The patient has a 30 pack year history of smoking, and worked as a lead miner for 20 years. The patient indicates that they don’t regularly go into the doctor's office, but got concerned once their urine changed to pink about 3 months ago. Otherwise, they have no surgical history and are not on any medications. Physical exam, including a DRE is non-contributory. You report the case back to you attending. They ask you what the best diagnostic test is for suspected bladder cancer. You answer:

1 point

PSA

Urinalysis and Cytology

Cystoscopy

CT Imaging

Percutaneous Biopsy

Clear selection

Mrs. Ingles is a 74 year old female who is presenting today for treatment of her bladder cancer. Previous diagnostic tests have indicated that she has non-muscle invasive bladder cancer, stage T1N0M0. What is the best treatment modality?

1 point

Transurethral Resection of the Prostate (TURP)

Cystectomy

Intravesical Therapy with BCG

Cisplatin-Based Chemotherapy

Transurethral Resection of Bladder Tumor (TURBT)

Clear selection

You are a third year medical student who has just started their third year clinical rotation in Oncology. Today you will be working with Dr. Flow, a medical oncologist who sees a lot of Bladder Malignancy. Dr. Flow warmly welcomes you to the rotation and you begin the day with a quick review of TNM Staging. To gauge your knowledge she asks the following: If a patient with known bladder cancer had the following disease characteristics which stage would it be? The following are the tumor characteristics: Tumor invades into the inner half of the muscularis propria, there are multiple regional lymph nodes involved but no extension to the common iliac nodes, no known metastasis to other organs.

1 point

T2a, N1, M1a

T3a, N1, M0

T2a, N2, M0

T2b, N1, M1b

T4a, N1, M0

Clear selection

Of the following patients with non-metastatic muscle invasive bladder cancer, which combination of patient and treatment is ‘“optimal” acknowledging the fact that management of muscle invasive disease is often much more nuanced?

1 point

Mrs. A a 55 year old female with no known medical comorbidities opting for a radical cystectomy with neo-adjuvant platinum based chemotherapy and subsequent creation of a Neobladder.

Mrs. B a 89 year old female, with diabetes and a coagulation disorder opting to be treated with radical cystectomy with neo-adjuvant platinum based chemotherapy and subsequent creation of a Neobladder.

Mrs. C a 97 year old female with a 2 month life expectancy opting to be treated with high dose chemotherapy and several courses of radiation.

None of the above are optimal.

Clear selection

You are a first year family doctor resident on your family medicine rotation. Today you are alone in the office as your attending left to go get some coffee. Your next patient is a 78 year old male named Cal Geurin. You do a quick chart review and note that Mr. Geurin recently had a TURBT and is being maintained on a course of intravesical BCG. Which of the following is NOT a common toxicity associated with intravesical BCG?

1 point

Chemical Cystitis

Gross Hematuria

Fever

Epididymo-orchitis

Malaise

Clear selection

Which of the following two are used in the routine follow-up of a patient of any AUA risk class of Non-muscle invasive bladder cancer.

1 point

Urothelial tumor markers and cystoscopy

Urinary tract and abdomen/pelvis imaging and urothelial tumor markers

Urinalysis/ urine microscopy and cystoscopy

Urinary tract and abdomen/pelvis imaging and urinalysis/ urine microscopy

Cystoscopy and urinary tract and abdomen/pelvis imaging

Clear selection

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