021215 male clinical cases Flashcards
lower urinary tract symptoms–divided into what symptom categories?
obstructive (obstruction of prostate)-decreased force of stream, hesitancy, incomplete emptying, nocturia, straining
irritative (dysfxn of bladder)-urgency, frequency, dysuria
hyperplastic prostate glands are lined by what
two cell layers: inner columnar and outer layer of flattened basal cells
meds for BPH?
alpha blocker therapy (to relax sm musc)
5alpha reductase inhibitors
surgery (decreases gland size)
when does prostate cancer start causing obstruction?
not until it gets to PSA in 50-100 range
can US detect prostate cancer?
no, it’s not very good for imaging prostate cancer.
would need to do US with biopsy (US is used to guide biopsy
tx options for low risk prostate cancer
active surveillance radical prostectomy external beam radiation brachytherapy cryosurgery
you never do a partial prostectomy
scrotal swelling-differential?
epididymo-orchitis, orchitis, hydrocele, spermatocele, varicocele, torsion, hematoma, hernia, tumor (need to rule out tumor!)
average age for testicular cancer
34
90% of testicular tumors are
germ cell tumors
prognosis for testicular cancer
5 yr survival is 96%
alpha feto protein (AFP) is NOT present in
pure seminomas or choriocarcinomas
beta hCG is present in
choriocarcinomas, embryonal and some seminomas
LDH
non specific
correlates with volume of testicular tumor
risk factors for testicular cancer
undescended testes hx
history of atrophy
DES exposure
HIV/AIDS-increased risk of seminoma
60s-age-what kind of testicular tumor should you think of?
seminoma (can hv mildly elevated hCG)
