24- Upper GIT Explains Flashcards
What is the prevalence of BPH in men over the age of 60?
BPH is present in 50% of men over the age of 60.
Where does hyperplasia occur in the prostate gland in BPH?
Hyperplasia occurs in the periurethral glands in the transitional zone of the prostate.
What role do androgens play in the development and progression of BPH?
Androgens, such as testosterone, stimulate the growth and proliferation of prostatic and stromal cells, leading to BPH.
What is the end result of androgen stimulation in prostatic stromal cells?
Androgen stimulation leads to proliferation and growth of these cells.
What are the clinical features used to diagnose BPH?
Clinical diagnosis of BPH involves lower urinary tract symptoms (LUTS), palpable prostatic enlargement, and evidence of impaired voiding on urodynamic assessment.
What are the two main groups of LUTS in BPH?
LUTS in BPH can be divided into obstructive symptoms (hesitancy, poor stream, straining) and irritation symptoms (pain during bladder filling, frequency, urgency, nocturia).
What are the conservative management options for BPH?
Conservative management options include alpha-adrenergic antagonists and 5-alpha reductase inhibitors.
What is the gold standard surgical treatment for BPH?
Transurethral resection of the prostate (TURP) is the gold standard surgical treatment for BPH.
When might an open retropubic prostatectomy be considered for BPH?
An open retropubic prostatectomy may be considered for BPH in cases of a large gland.
What are the two main types of germ cell tumors in testicular cancer?
Seminoma and nonseminomatous germ cell tumors
What is the most common malignancy in men aged 20-30 years?
Testicular cancer
What percentage of testicular cancer cases are germ-cell tumors?
Around 95%
What are the key features of seminoma, the most common subtype of germ cell tumor?
Average age at diagnosis is 40, even advanced disease has a 5-year survival rate of 73%
What tumor markers are associated with seminomas?
HCG (elevated in 10% of cases) and lactate dehydrogenase (elevated in 10-20% of cases)
What tumor markers are commonly elevated in nonseminomatous germ cell tumors?
They include teratoma, yolk sac tumor, choriocarcinoma, and mixed germ cell tumors. They present at a younger age (20-30 years) and advanced disease has a worse prognosis (48% at 5 years).
What are the key features of nonseminomatous germ cell tumors?
They include teratoma, yolk sac tumor, choriocarcinoma, and mixed germ cell tumors. They present at a younger age (20-30 years) and advanced disease has a worse prognosis (48% at 5 years).
What tumor markers are commonly elevated in nonseminomatous germ cell tumors?
AFP (elevated in up to 70% of cases) and HCG (elevated in up to 40% of cases)
What is the characteristic texture of nonseminomatous germ cell tumors?
They have a heterogeneous texture with occasional ectopic tissue, such as hair.
What are the risk factors for testicular cancer?
Cryptorchidism, infertility, family history, Klinefelter’s syndrome, and mumps orchitis
What is the most common presenting symptom of testicular cancer?
A painless lump
What is the first-line diagnostic test for testicular cancer?
Ultrasound
What are other possible features of testicular cancer?
Pain (in a minority of men), hydrocele, and gynecomastia
What imaging is used for staging testicular cancer?
CT scanning of the chest, abdomen, and pelvis
What should be measured as tumor markers in testicular cancer?
HCG, AFP, and lactate dehydrogenase