Chapter 4 Flashcards
what are the principal testicular hormones
testosterone, androstenedione and dihydrotestosterone
which hormone is responsible for male secondary sexual characteristics
testosterone
what are the 3 layers of the uterus
perimetrium (serosa), myometrium (smooth muscle) and endometrium
what are the principal female hormones
hypothalamic GnRH, pituitary FSH and LH, estrogen, progesterone (last 2 produced by ovaries)
what is function of estrogen
causes growth of reproductive organs, regulates fat deposition, lipid and calcium metabolism, hypothalamic temperature, vasomotor activity production of vaginal secretions
BPH is common starting at what age
45, prevalence increases to 50% by age 60 and over 80% by age 80
when/how does BPH occur
when the glandular tissue thickens due to stimulation by testosterone, producing nonmalignant hyperplasia, also called adenomatous hyperplasia. the extra mass of tissue sometimes compresses the bladder and urethra
what is treatment of choice for BPH
watchful waiting
what are non-invasive treatments for BPH
meds (prosper, avodart, hytrin, doxazosin, uroxatral, flomax)
what are possible side effects of BPH meds
ED
how much can finasteride and dutasteride reduce PSA (%)?
50%
what are minimally invasive treatments for BPH
TUMT, TUIP, TUNA, ILC, VLAP
what surgery can be done to treat BPH and in what scenario
TURP, for severe symptoms
what are possible complications of TURP
ED, incontinence
is PSA prostate cancer specific?
it is prostate specific, but not prostate cancer specific.
males with prostate cancer tend to have a ______ free PSA then those without prostate cancer
lower
when is inflammatory prostatitis diagnosed
when WBC are found in urine or prostatic secretions, while absence of WBCs indicates non-inflammatory prostatitis
what is the standard treatment for pathogen-associated prostatitis (bacterial)
antimicrobials
how would a prostate abscess be confirmed and how would it be treated
ultrasound for dx, surgery for treatment
what is prostatodynia and how is it treated
condition that mimics prostatitis but w/o evidence of infection or inflammation. symptomatic relief with prostatic massage, hot situ baths, analgesics
can prostate stones be underlying cause of prostatitis
yes
how are prostate stones detected
ultrasound
what are causes of prostate stones
prostatic secretions that do not leave the gland due to blockage of the glandular ducts. or products of infection that are not completely remoed
what tests are done for solitary prostate nodule
nodules detected by DRE or US. then followed with PSA, if nodules don’t disappear or PSA doesn’t drop with abs, bx must be done.
is testicular cancer highly treatable?
yes, highly treatable and curable
in what age groups does testicular cancer usually appear
young and middle aged males
what are early symptoms of testicular cancer
nonspecific, with heavy feeling in the area of testicles being most common
how is testicular cancer diagnosed
physical exam, scrotum ultrasound. if mass found then CT and CXRs
what are two histologic types of testicular cancer
seminoma and nonseminoma
are seminomas or nonseminomas more sensitive to radiation?
seminomas
what is the cur rate for seminomas
over 90%
are seminomas or nonseminomas more aggressive
nonseminoma
what are treatments for testicular cancer
orchiectomy, radiation and/or chemo.
what is a common cause of testicular atrophy
anabolic steroids
what is cryptorchism
failure of one or both tests to descend into the scritum
does crypto archaism present higher or lower risk of testicular cancer
higher
what is epididymitis and orchitis
infections of testes and supporting structures
what is hydrocele and how is it treated
mass in scrotum from excessive accumulation of fluid. can be treated with surgery aspiration, or injection of sclerotic meds
what is a spermatocele and how can it be treated
mass or cystic structure which contains sperm, tx surgery or aspiration
what is a varicoceoe
swelling in scrotum caused by varicose veins
what are possible underlying causes of ED
hormonal, psychological, vascular, neurological
what is primary underlying cause of ED
endothelial dysfunction a/w diabetes, HTN or atherosclerosis - also can be d/t MS, nerve damage from prostate surgery or spinal fx
what are contraindications for taking any ED med
hx of arrhythmia or the unstable cardiac disorder treated with nitrates
what is fibrocystic breast disease
general term for variety of conditions of breast that involve lumpiness, cysts or inflammation
what are underlying causes of fibrocystic breast disease
hormonal changes that cause swelling, infections or cysts
what are fibroadenomas
benign breast tumors that usually develop in young females
is ductal papilloma (of breast) benign or malignant and how are they diagnosed
benign, though can occasionally become malignant. dx’d with galactogram, or ductogram.
Paget’s disease of the Breast is a form of ____
DCIS
what are symptoms of Paget’s disease of breast
crusting, scaling erosion of nipple, and a discharge that can be milky or bloody
cancer is present in less than ____ % of females who have any kind of nipple discharge
10%
define endometriosis
presence of endometrial tissue outside of the uterine cavity
what is the preferred mode of dx for endometriosis
laparoscopy
what is amenorrhea
absence of menstrual periods
what is dysmenorrhea
painful periods
what is oligomenorrhea
infrequent periods
what is polymenorrhea
menstrual cycles 21 days or less
what is menorrhagia
heavy or prolonged menstrual bleeding with regular cycle
metorrhagia
bleeding between regular menstrual periods
postmenopausal bleeding
any bleeding that occurs 6 months or more after menopause
dysfunctional uterine bleeding
bleeding associated with hormone abnormalities
PCOS is associated with _____ and ____
oligomenorrhea and amenorrhea
what are the main features of PCOS
elevated male hormones (androgens), ovulatory dysfunction (oligo or anovulation), abnml menstrual cycles, obesity, hursutism (abnml facial hair), infertility, insulin resistance
what are some underlying causes of PCOS
primary hyperandrogegism, adrenal hyperplasia, hypothalamic-pituitary dysfunction
families with which syndromes (genetic) have increased risk for gynecologic tumors?
HNPCC and BRCA
what are the two types of endometrial cancer and which one tends to metastasize readily
type 1 associated with increased estrogen. type 2 not associated with increased estrogen and tends to mets readily
what are the most significant prognostic factors with endometrial cancer
degree of differentiation, depth of invasion, cervical invasion, extrauterine mets, presence or absence of progesterone
what are risk factors for type 1 endometrial cancer
unopposed estrogen treatment, have used tamoxifen, morbid obesity, diabetes and HTN, hx of ovulatory dysfunction, genetic predisopsition
do type 1 endometrial tumors tend to be low or high grade
low grade
do type 1 endometrial tumors have progesterone receptor levels that are high
yes
which women are most at risk for type 2 endometrial tumors
over age 70
what cell types are usually in grade 2 endometrial tumors? are they higher or lower grade? low or high progesterone levels?
papillary or clear cell, higher grade, lower progesterone levels
what % of ovarian cancer is in age >65
50%
do most women have widespread disease at time of ovarian cancer dx? why or why not
yes, because asxs early on usually get late dx
what tests are done for ovarian cancer dx
hcg, CEA, LDH, transvag US
which lab test is commonly elevated with normal pregnancy
alk phos
is HPV relapse frequent, requiring re-treatment?
yes
is clear cell carcinoma the most common cell type of cervical cancer
no
does cigarette smoking increase risk of CIN
yes
