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Unit 4 disease charts > 4.4 > Flashcards

4.4 Flashcards

1
Q

most common metastases of colon cancer

A

liver

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2
Q

most common metastases of rectal cancer

A

lungs

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3
Q

ACS recommendations for colorectal cancer screening

A

colonoscopy at 45 for average risk
For IBD - 8 years after diagnosis
teens for genetic stuff

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4
Q

most common malignancy of the urinary system

A

bladder cancer

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5
Q

most common type of bladder cancer

A

urothelial (transitional cell) carcinoma

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6
Q

common metastases for bladder cancer

A

lymph nodes
lungs
liver
bone

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7
Q

2 types of lesions that can cause bladder cancer

A

flat lesions
papillary lesions

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8
Q

gold standard of diagnosis for bladder cancer

A

cystoscopy with biopsy

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9
Q

most common type of colorectal cancer

A

adenocarcinoma arising from adenomatous polyp

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10
Q

what ethnic group has the highest rates of CRC

A

African Americans

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11
Q

genetic mutation of the APC gene

A

familial adenomatous polyposis

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12
Q

What hereditary syndrome increases risk of CRC and endometrial cancer

A

Lynch syndrome (hereditary nonpolyposis colorectal cancer)

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13
Q

hereditary syndrome that increases risk of CRC and is associated with hamartomatous polyps and mucocuteanous hyperpigmentation

A

Peutz-Jehgers syndrome

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14
Q

most common clinical manifestations of CRC on the right

A

chronic occult bleeding (iron deficiency anemia + positive Guaiac)
diarrhea

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15
Q

most common clinical manifestations of CRC on the left

A

bowel obstruction
changes in stool diameter
change in bowel habits

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16
Q

most common cancer in men after skin cancer

A

prostate cancer

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17
Q

most common type of prostate cancer

A

adenocarcinoma

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18
Q

risk factors for prostate CA

A

increasing age (> 40) – strongest risk factor
genetics
Black race
Western diet
Fhx

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19
Q

Clinical manifestations of prostate CA

A

most are asymptomatic
urethral obstruction –> urinary frequency, urgency, retention, decreased stream, hematuria
back or bone pain (associated with METS)

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20
Q

DRE for prostate CA

A

hard, indurated, nodular, enlarged asymmetrical prostate

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21
Q

what general value of PSA indicates greater probability of prostate CA

A

> 4 ng/mL

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22
Q

most accurate test for prostate CA

A

transrectal US-guided needle biopsy

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23
Q

when is a bone scan indicated to rule out METS in prostate CA

A

if PSA > 10 ng/dL

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24
Q

what determines the aggressiveness or malignant potential of prostate CA – higher grade suggests more benefit from surgical removal

A

Gleason grading system – higher grade suggests more benefit from surgical removal

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25
Q

herniation of the rectum

A

rectocele

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26
Q

common cause of rectocele

A

damage to levator ani muscle

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27
Q

in what zones does prostate hyperplasia occur in BPH

A

periurethral or transitional zones

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28
Q

hyperplasia is part of the normal aging process and is hormonally dependent on

A

DHT

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29
Q

irritative (storage) symptoms of BPH

A

urinary frequency
urgency
nocturia
incontinence

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30
Q

obstructive symptoms of BPH

A

hesitancy, weak, slow, splitting or intermittent stream force
incomplete emptying
terminal dribbling
straining to void

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31
Q

BPH findings on DRE

A

uniformly (symmetrically) enlarged, smooth, form, contender, rubbery prostate

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32
Q

from what type of cells do carcinoid tumors arise

A

enterochromaffin cells

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33
Q

carcinoid syndrome

A

diarrhea
flushing
tachycardia
bronchoconstriction

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34
Q

where do most carcinoid tumors occur

A

GI tract

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35
Q

prostate gland inflammation secondary to an ascending infection

A

prostatitis

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36
Q

most common cause of prostatitis > 35 years

A

E. coli
Proteus

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37
Q

most common cause of prostatitis < 35 years

A

chlamydia and gonorrhea

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38
Q

most common cause of prostatitis in children

A

mumps (viral)

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39
Q

Clinical manifestations in prostatitis

A

irritative voiding symptoms
obstructive symptoms

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40
Q

clinical manifestations in ACUTE prostatitis

A

spiking fever
chills
perineal pain

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41
Q

clinical manifestations in CHRONIC prostatitis

A

recurrent UTIs or intermittent dysfunction

fever not common

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42
Q

PE for ACUTE prostatitis

A

boggy and exquisitely tender

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43
Q

PE for CHRONIC prostatitis

A

boddy and nontender

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44
Q

urinalysis and urine culture in acute prostatitis

A

pyuria and bacteriuria

often negative in chronic

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45
Q

what should you avoid in acute prostatitis

A

prostatic massage

  • you can do this in chronic bc usually negative for bacteria
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46
Q

Why should you avoid prostatic massage in prostatitis

A

could cause bacteremia

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47
Q

how should you treat refractory chronic prostatitis

A

transurethral resection of the prostate

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48
Q

From what vein do internal hemorrhoids originate from

A

superior hemorrhoid vein

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49
Q

where are internal hemorrhoids located in terms of the dentate line

A

proximal to the dentate line (above the dentate line)

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50
Q

clinical manifestations of internal hemorrhoids

A

intermittent rectal bleeding
PAINLESS

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51
Q

most common renal cell carcinoma

A

clear cell

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52
Q

risk factors for renal cell carcinoma

A

smoking
HTN
obesity
men
dialysis

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53
Q

classic triad of renal cell carcinoma

A

hematuria
flank or abdominal pain
palpable abdominal or flank mass

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54
Q

other common finding in renal cell carcinoma

A

left-sided varicocele

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55
Q

METS for renal cell carcinoma

A

cannon ball metastases to the lungs

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56
Q

initial test for diagnosis of renal cell carcinoma

A

CT scan

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57
Q

epididymal cyst that contains sperm

A

spermatocele

58
Q

when is an epididymal cyst considered a spermatocele

A

if > 2 cm

59
Q

are spermatoceles painful

A

no

60
Q

does spermatocele transilluminate

A

yes

61
Q

treatment for spermatocele

A

none

62
Q

most common cause of painless scrotal swelling

A

hydrocele

63
Q

two different type of hydrocele

A

communicating versus noncommunicating

64
Q

is hydrocele painful

A

no

65
Q

does hydrocele transilluminate

A

yes

66
Q

initial test of choice for spermatocele and hydrocele

A

testicular US

67
Q

management of hydrocele

A

no management; watchful waiting

68
Q

cystic testicular mass of varicose veins

A

varicocele

69
Q

what is the most common surgically correctable cause of male fertility

A

varicocele

70
Q

on what side are most varicoceles

A

on the left

71
Q

what does varicocele feel like

A

bag of worms

72
Q

when does dilation worsen with varicocele

A

when patient is upright or with valsalva

73
Q

initial test of choice for varicocele

A

testicular US

74
Q

will varicocele transilluminate

A

no

75
Q

right sided varicocele may be due to

A

retroperitoneal or abdominal malignancy

76
Q

left sided varicocele may be due to

A

renal cell carcinoma

77
Q

most common cause of erectile dysfunction

A

vascular (DM, atherosclerosis)

78
Q

abrupt onset in erectile dysfunction indicates

A

psychological cause

79
Q

gradual onset in erectile dysfunction indicates

A

systemic cause

80
Q

first line therapy for erectile dysfunction

A

PDE5 inhibitors

81
Q

spermatic cord twists and cuts off testicular blood supply

A

testicular torsion

82
Q

what age groups are at the highest risk for testicular torsion

A

adolescents (10-20 years), neonates

83
Q

pathophysiology of testicular torsion

A

insufficient fixation of the testes to the tunica vaginalis

84
Q

name of the deformity in testicular torsion

A

bell-clapper deformity

85
Q

clinical manifestations of testicular torsion

A

abrupt onset of moderate to severe scrotal, inguinal, or lower abdominal pain

86
Q

when should you def suspect torsion

A

if nausea or vomiting are present

87
Q

what will you see on PE for testicular torsion

A

swollen, tender, retracted (high-riding) testicule

88
Q

prehn sign for testicular torsion

A

NEGATIVE –> holding it up doesn’t help

89
Q

cremesteric reflex for testicular torsion

A

NEGATIVE

90
Q

definitive diagnosis for testicular torsion

A

emergency surgical exploration

91
Q

most commonly used imaging modality for testicular torsion

A

testicular US

92
Q

management of testicular torsion

A

surgical exploration with urgent detorsion and orchiopexy (fixation of the testes)

93
Q

within how many hours should testicular torsion be treated

A

Within 6 hours

94
Q

most common solid tumor in young men

A

testicular cancer

95
Q

average range of men with testicular cancer

A

15-35 (average = 32)

96
Q

what is one of the most curable cancers

A

testicular cancer

97
Q

most significant risk factor for testicular cancer

A

cryptorchidism

98
Q

most common type of tumor in testicular cancer

A

germinal cell tumor

99
Q

REMEMBER TO WRITE YOUR OWN LI ON TESTICULAR CANCER AND COME BACK TO THIS

A

:)

100
Q

most common type of penile cancer

A

squamous cell carcinoma

101
Q

what is penile cancer commonly associated with

A

HPV 16, 18, smoking, lack of circumcision, HIV

102
Q

disease with leukoplakia on the shaft and penis or scrotum and some progress to squamous cell carcinoma of the penis

A

Bowen’s disease

103
Q

most common cause of epididymitis in males 14-35

A

chlamydia trachomatis (mc) and neisseria gonorrhoeae

104
Q

most common cause of epididymitis in males > 35

A

e coli

105
Q

clinical manifestations of epididymitis

A

gradual onset (over a few hours to days) of localized testicular pain and swelling

106
Q

prehn sign in epididymitis

A

POSITIVE –> lifting it up relieves pain

107
Q

cremasteric reflex in epididymitis

A

POSITIVE (elevation of the testicule after stroking the inner thigh)

108
Q

most common cause of orchitis

A

viral – mumps

keep in mind that epididymitis is usually bacterial while this is viral

109
Q

what is spared in orchitis

A

the epididymis

110
Q

management of orchitis

A

symptomatic – bc this is a viral illness

111
Q

type of inguinal hernia with bowel protrusion at the internal inguinal ring

A

indirect inguinal hernia

112
Q

origin of the sac in indirect hernia

A

lateral to the inferior epigastric artery

113
Q

most common type of hernia in both sexes, young children, and young adults

A

indirect inguinal hernia

114
Q

pathophysiology of indirect hernia

A

due to a persistent patent processus vaginalis

115
Q

clinical manifestations of incarcerated indirect hernia

A

painful, enlargement of an irreducible hernia

same for direct

116
Q

clinical manifestations of strangulated indirect hernia

A

ischemic incarcerated hernias with systemic toxicity

may refrain from defecation due to increased pain

same for direct

117
Q

origin of the sac in direct inguinal hernia

A

medial to the inferior epigastric artery within Hesselbach’s triangle

118
Q

Hesselbach’s triangle

A

RIP

Rectus abdominis muscle
Inferior epigastric artery
Poupart ligament (inguinal ligament)

119
Q

pathophysiology of direct inguinal hernia

A

result of weakness in the floor of the inguinal canal

120
Q

urge incontinence is due to

A

detrusor muscle overactivity

121
Q

urge incontinence is also called

A

overactive bladder

122
Q

overflow urinary incontinence is caused by

A

bladder detrusor muscle underactivity or bladder outlet obstruction (BPH for example)

123
Q

what type of incontinence would people with BPH likely experience

A

overflow incontinence

124
Q

do people with overflow incontinence get an “urge” before they urinate

A

no– they just do it

125
Q

diagnosis of overflow incontinence

A

post void residual > 200 mL

126
Q

stress incontinence is due to

A

increased abdominal pressure

127
Q

what type of incontinence do I have ):

A

stress incontinence

128
Q

what is hydronephrosis

A

urinary tract obstruction –> dilation of the collecting system in one or both kidneys

129
Q

enlargement of glandular breast tissue and adipose tissue in males due to increased effective estrogen or decreased androgens

A

gynecomastia

130
Q

first line med for gynecomastia if med is indicated

A

tamoxifen

131
Q

prolonged painful erection without sexual stimulation

A

priapism

132
Q

decreased VENOUS outflow

A

ischemic priapism

133
Q

increased ARTERIAL flow

A

nonischemic priapism

134
Q

most common type of priapism

A

ischemic

135
Q

nonischemic priapism is primarily associated with

A

trauma

136
Q

is ischemic priapism painful

A

YES

137
Q

is nonischemic priapism painful

A

NO

138
Q

most common testicular cancer in young boys 10 or younger

A

yolk sac nonseminomas germinal cell

139
Q

which testicular cancer type has the worst prognosis

A

choriocarcinoma nonseminomas germinal cell

140
Q

nonseminomas germinal cell tumors are associated with

A

increased serum alpha fetoprotein and beta-hCG and resistance to radiation

141
Q

the 4 S’s of seminomas

A

Simple - lacks tumor maker alpha-fetoprotein
Sensitive - sensitive to radiation
Slower growing
Stepwise spread

142
Q

Most common non-germinal cell tumors for testicular cancer

A

leydig cell tumors
Sertoli cell tumors

both may be benign and both may secrete hormones

Unit 4 disease charts (9 decks)

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