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reproductive > diseases of the prostate, testis, and penis > Flashcards

diseases of the prostate, testis, and penis Flashcards

1
Q

BPH

A

very frequent disorder with 70% at age 60 but only half of them would have clinical diagnostically enlargement and only have of these have symptoms

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2
Q

BPH more common

A

in blacks

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3
Q

LUTS (lower urinary tract symptoms) are result of (2)

A

BPH and age-related detrusor dysfunction

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4
Q

why is there BPH occuring

A

there is an increase in epithelial and stromal cell in the periurethral area due to an impaired apoptosis thought to be due to androgen and estrogens inhibiting that leads to an increase cellular accumulation

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5
Q

Type 1 5alpha

A

found in the blood

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6
Q

Type 2 5alpha

A

reductase predominantly prostatic and it is critical in normal development of prostate and hyperplastic growth

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7
Q

Presence of __________ is required for development of prostate and BPH

A

androgens

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8
Q

90% of prostatic andorgen is

A

DHT which has a higher affinity to androgen receptors

this is a target that might reverse BPH by allowing apoptotsis to occur again

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9
Q

why are we seeing BPH more now?

A

more people are living longer and there is a correlation between increase in estrogen (this increase in adrogen receptors) and aging

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10
Q

bladder function undergo obstruction leads to induction 2 changes

A
  1. decrease in compliance/ detrusor instability- frequency and urgency
  2. decrease in contractility- leading to decrease in flow rate, hesitancy and increase in PVR … detrusor failure
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11
Q

BPH occurs mainly in the

A

transition zone

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12
Q

focal atrophy of the prostate occurs in the

A

peripheral zone

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13
Q

complication of BPH (2)

A
  1. bladder stones due to urinary stasis
  2. UTI/Urosepsis which is a main indicator of surgical intervention
  3. bladder decompensation- fibrosis that is irreversible
  4. urinary incotinence
  5. renal insufficiency
  6. hematuria
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14
Q

2 end point of BPH

A
  1. acute urinary retention

2. surgery- TURP

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15
Q

international prostate symptom score

A

symptom score that classifies as either mild, moderate or severe and is a primary determinant of treatment response or disease progression

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16
Q

medical therapy for BPH (4)

A
  1. alpha-adrenergic blockers
  2. 5alpha-reductase inhibitors
  3. aromatase inhibitors
  4. plant extracts
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17
Q

98% alpha-ARs are localized in

A

prostatic stroma

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18
Q

BOO associated with alpha-AR in prostate

A

smooth muscle

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19
Q

Suppression of DHT synthesis through a 5alpha reductase inhibitor leads to

A

decrease in prostate size

  • pts. with larger size of prostate have greater effect
20
Q

prostate cancer

A

most common cause of cancer in men

  • 1/6 lifetime probability but only 3% lifetime risk of death
21
Q

what is a main goal for prostate cancer

A

prevent the development of metastatic disease due to its higher risk of death

22
Q

overall PSA has done what?

A

improvements for screening with overall declining age at diagnosis, shifts to earlier stages, decreased tumor volumes and increased treatment rates

23
Q

There is no safe PSA value below which reassure patient he does not have CaP

A

yep

24
Q

the only way to diagnosis cancer of the prostate

A

biopsy duhhhh

25
Q

Remains the gold standard for long term control of clinically localized CaP in young healthy man

Goals:

  1. Cure of disease
  2. Urinary control
  3. Preservation of erectile function
A

radical prostatectomy

26
Q

5-10% of prostatitis causes that can be treated effectively is

A

bacterial infections

27
Q

symptoms of prostatitis

A

related to pain or discomfort in the pelvic region with problems with urination and ejaculation

28
Q

treatment of prostatitis

A
  1. alpha blockers
  2. pain relievers
  3. prostatic massage
  4. lifestyle changes/home remedies
  5. alternative therapies
29
Q

testicular cancer

A

most common solid tumor in young adults where most of them are germ cell cancer such as seminoma or non-seminoma

30
Q

most common testicular tumor in >50 is

A

lymphoma

31
Q

testicular cancer met spreads usually via

A

lymphatic but yol sac tumor (choriocarcinoma) may met hematogenously

32
Q

most common lymph node affected in met in testicular cancer

A

retroperitoneal lymph node

33
Q

most common testicular tumor in 0-10

A

yolk sac tumor

34
Q

most common testicular tumor in 20-30

A

choriocarcinoma

35
Q

____________is the primary management for all solid testicular tumors

A

Radical inguinal orchiectomy

36
Q

twisting of the spermatic cord leading to sudden onset of severe pain in one testicle w/ or w/0 previous event and immediate surgery is required to to chance of infarction of the blood supply being cut

A

testicular torsion

37
Q

2 premalignant penile lesions

A
  1. bowenoid papulosis

2. carcinoma in situ

38
Q

Bowenoid Papulosis vs. Carcinoma in situ

  1. age at diagnosis
  2. usual foreskin status
  3. HPV has been detected
  4. risk of developing SCC
A
  1. age at diagnosis: 20-30 vs 50-60
  2. usual foreskin status: circumcised vs. uncircumcised
  3. HPV has been detected: yes for both
  4. risk of developing SCC: rare vs. 10%
39
Q

Inflammatory lesion due to chronic infection, trauma, and inflammation. it rarely undergoes malignant transformation but presents with flat white patches son the glans and prepuce

A

balantis xerotica obliterans (BXO)

40
Q

penile carcinoma

A

squamous cell carcinoma in >95%

with increased risk due to

  1. uncircumcised
  2. premalignant lesions
  3. tobacco
41
Q

gold standard for penile carcinoma treatment

A

partial or total penectomy

42
Q

penile carcinoma lymph node spread

A

inguinal lymph node

43
Q

_______ is a condition in which the foreskin is tight and narrow, making it impossible or painful to retract

A

Phimosis

44
Q

Persistent erection for over 4 hour’s duration

2 types

  1. ischemic low flow and
  2. non ischemic with high flow
A

priapism

45
Q

treatment of ischemic slow flow priapism

A
  1. corporal aspiration and irrigation

2. penile corporal shunts

46
Q

Inelastic scar (plaque) in tunica albuginea of the corpora with cause unknown. Present with penile pain (esp. with erection), shortening, deformity, or induration/plaque

A

peyronie’s disease

47
Q

treatmet of peyronie’s

A
  1. medical therapy-
  2. intracorporal injection
  3. surgery

reproductive (27 decks)

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