If smoking fucking the patient over is a choice, its right. NBME loves smoking cessation!
This was in NBME 20 as well. Its painless hematuria + papillary growth is showing transitional cell carcinoma This is associated with "Pee SAC": phenacetin, smoking, aniline dyes, and cyclophosphamide.
Mixed up cytoscopy with culposcopy so I put HPV. Insert upsidedownsmileyface.jpg
I'm sorry but... where in the cytoscopy are the fibrovascular cores demonstrated? Are they visible?
submitted by โmadojo(212)
This is transitional cell carcinoma aka urothelial carcinoma which is the most common urinary tract system tumor. On histo you expect to see fibrovascular core in a papillary tumor and dysplastic urothelium. It occurs with painless hematuria with no casts.
Predisposing risk factors: Pee Sac Phenacetin (NSAID), smoking, aniline dyes, and cyclophosphamide (alkylating agent that cross links DNA).
Vinyl chloride is incorrect because thats associated with angiosarcoma of the liver, because vinyl chloride is whats in PVC pipes (plumber). Schistosoma is a trematode fluke that is associated with squamous cell carcinoma of the bladder in which you would also see painless bleeding but see squamos cell and not really the papillary growth we see here.