Bladder Cancer

09/03/2010

Transitional cell carcinoma (also called urothelial carcinoma)

  • urothelial cells that line the bladder
  • noninvasive flat carcinoma and noninvasive papillary carcinoma

Squamous cell carcinoma

  • 1-2% of bladder cancers
  • originate from cells that line the bladder
  • invasive

 

Adenocarcinoma

  • less than 1% of bladder cancers
  • originating from duct or gland-like tissues
  • invasive

 

Small cell carcinomas

  • less than 1% of bladder cancers
  • rare and highly aggressive

 

Manifestations

  1. gross and microscopic hematuria
  2. Urinary frequency
  3. Urinary Urgency
  4. Dysuria

Treatment:

  1. Edoscopic resection for superficial lesions
  2. Cystectomy and resection of pelvic lymph nodes
  3. Electrocautery – Diathermy
  4. radiation
  5. chemotherapy
  6. immunotherapy – instilled directly in the bladder
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Where do we go?

08/03/2010

 

We go where

the light of the candle goes

after you blow it out…

The smoke lingers

intensifies

then dissipates.

What is this journey we call life?

I don’t know

A journey of the heart,

full of greetings and departures.

Death,

the end of the journey,

Birth,

the start.

Of laughter,

our sense of humor

our heart’s defense

against the misery we face.

What of sorrow?

Someone wise once said:

it opens the heart,

it softens it,

so we love more deeply than before

Of our time here,

of this I am certain:

There is no rewind,

no fast forward,

no repeat.

This is your life

your time,

what will you do with it?

 


Progressive Supranuclear Palsy (PSP) or Steele-Richardson-Olszewski syndrome

08/03/2010
  • a rare degenerative disease.
  • involves degernatation and death of areas of the  brain.
  • causes serious and permanent problems with control of gait and balance.
  • The most obvious sign of the disease is compromised eye movement, occuring due to lesions in the area of the brain that coordinates eye movements.

Manifestations:

  1. loss of balance
  2. lunging forward when mobilsing
  3. speed-walking
  4. knocking into objects and people
  5. falls.
  6. personality changes
  7. general slowing of movement

 

Later manifestations:

  1. dementia – loss of inhibition and ability to organize information
  2.  slurring of speech
  3. dysphagia
  4. difficulty moving the eyes, particularly in the vertical direction (accounts for some of the falls experienced by these patients as they are unable to look up or down)
  5. poor eyelid function
  6. contracture of the facial muscles
  7. a backward tilt of the head with stiffening of the neck muscles
  8. sleep disruption

Treatment and Management:

  • symptom management
  • The average age at symptoms onset is 63 and survival from onset averages 7 years with a wide variance.

In life –

07/03/2010

“It must be borne in mind that the tragedy of life doesn’t lie in not reaching your goal.
The tragedy lies in having no goal to reach.

It is not a calamity to die with dreams unfulfilled.
But it is a calamity not to dream.

It is not a disaster to be unable to capture your ideal,
But it is a disaster to no ideal to capture.

It is not a disgrace not to reach the stars.
But it is a disgrace not to have stars to reach for. ”
.
-Dr Benjamin Elijah Mays


Breast Cancer

07/03/2010

 

Ductal carcinoma in situ

  • 20% of breast cancers
  • malignant cancer of the breast ducts
  • in situ – indicative of remaining in area of origin
  • tumor originates from duct epithelium
  • stage 0 – precancerous
  • will progress to infiltrating form
  • progressing to infiltrating carcinoma

 

Lobular Carcinoma in situ

any cancer that begins in the tissues that line or cover the lactation glands of the breast that produce milk.

Infiltrating Carcinoma

  • 70-80%
  • hard mass
  • metastasizes readily to auxiliary lymph nodes

 

 Medullary Carcinoma – 6% of breast cancers

  • neoplasm grows in a capsule inside a duct

 Mucinous Cancer – 3% of breast cancers

  • mucin producing
  • slow-growing/favorable prognosis

 Tubular Ductal Cancer – 2%

  • axillary metastases uncommon
  • excellent prognosis

 Inflammatory Carcinoma

  • localized tumor
  • tender (differs from other mnfs)
  • red dusky skin over area
  • breast is abnormally firm and enlarged
  • edema and nipple retraction occur
  • spread rapidly

 Paget’s Disease of the breast – 1%

  • scaly lesion, burning, itching present around nipple
  • ductal neoplasm
  • tumor mass often not palpable under nipple
  • Dx: mammography

Azotemia

06/03/2010

Condition where the body retains nitrogenous waste products and levels of creatinine, urea and nitrogen containing compounds increase in the blood.

Etiology:

Acute or chronic renal failure

condition may result in death if left untreated


Akathisia

05/03/2010

from the greek meaning without sitting.

is a syndrome characterized by unpleasant sensations of “inner” restlessness that manifests itself with an inability to sit still or remain motionless.

etiology:

  • as a side effect of medications:
  • neuroleptic antipsychotics eg phenothiazines
  • antispasmodics
  • antidepressants.
  • to a lesser extent, be caused by Parkinson’s disease and Parkinsonian-like syndromes.