Exam 3 - Male Reproductive Flashcards
1
Q
risk factors for testicular cancer
A
- family history
- Caucasian
- cryptorchidism
- HIV infection
2
Q
germ cell tumors
A
- seminomas
- noseminomas
3
Q
seminomas
A
- arise from immature germ cells
- slow growing, nonaggressive
- easily cured with radiation
4
Q
nonseminomas
A
- arise from mature germ cells
- more aggressive
- usually treated with surgery
5
Q
early clinical manifestations of testicular cancer
A
- enlargement of testicle
- painless mass noted
- ache in groin
- sensation of heaviness
6
Q
late clinical manifestations of testicular cancer
A
- possible frank pain
- manifestations based on metastatic spread:
- cough
- hemoptysis
- swelling of lower extremities
- back pain
- dizziness
7
Q
the prostate
A
- gland surrounding the urethra
- produces seminal fluids
- weighs between 4-20 gm
8
Q
definition of benign prostatic hyperplasia (BPH)
A
- nonmalignant enlargement of prostate
- increase of epithelial cells
- increase of smooth muscle cells
- stroll cells
- LUTS: lower urinary tract symptoms
9
Q
risk factors of BPH
A
- age
- family history
- race/ethnicity
10
Q
BPH etiology - two theories
A
- hormone imbalance
- testosterone and estrogen - DHT accumulation
11
Q
DHT accumulation
A
- dihydrotestosterone
- acts on skin: acne
- acts on hair follicles: hair on chest BUT off scalp
- stimulates growth of prostate cells
12
Q
BPH clinical manifestations
A
- frequency and urgency
- delay in initiation
- reduction in force
- increased urination time
- dribbling
13
Q
BPH complications
A
- obstruction
- UTI
- renal problems
14
Q
where is DHT formed
A
- testosteron + 5 alpha-reductase
15
Q
mild treatment of BPH
A
- watchful waiting
16
Q
moderate treatment of BPH
A
- 5-alpha reductase inhibitors
- alpha1-adrenergic antagonists
17
Q
severe treatment of BPH
A
- invasive options
18
Q
5-a-reductase inhibitor drugs
A
- finasteride
- dutasteride
19
Q
MOA of finasteride
A
- blocks conversion of testosterone to DHT (alpha 1 receptors)
- decreases epithelial tissue in prostate
20
Q
indication of finasteride
A
- mechanical obstruction of urethra
21
Q
does finasteride work on someone with a smaller prostate
A
it typically works best on someone with a large prostate
22
Q
when will patients see results of finasteride
A
- 6-12 months
- take for rest of life
23
Q
side effects of finasteride
A
- impotence
- decreased libido
- gynecomastia (great tissue)
24
Q
side notes of finasteride
A
- decreases prostate specific antigen (PSA) levels
- used for male-pattern baldness
- men can’t donate blood on this
- pregnant women should not handle
25
dutasteride indication
- mechanical obstruction of urethra
26
MOA of dutasteride
- blocks conversation of testosterone to DHT (alpha 1 and 2 receptors)
- decreases epithelial tissue in prostate
27
alpha1-adrenergic antagonist drug
tamsulosin
28
MOA of tamsulosin
- relaxes smooth muscle cells
- selective for alpha receptors in the prostate
29
indication of tamsulosin
- dynamic obstruction of urethra
30
side effects of tamsulosin
- well tolerated
- abnormal ejaculation
31
combination therapy for BPH
- dutasteride + tamsulosin = jayln
- combining a 5-alpha-reducatse inhibitor with an alpha blocker is superior to either agent alone
32
what is the most common male cancer in US
prostate cancer
33
risk factors for prostate cancer
- age
- familial tendency
- high fat diet
- (African american most common)
34
what does severity of prostate cancer depend on
- Gleason score (higher = worse)
- tumor level
- how the cancer was detected
35
erectile dysfunction (ED) definition
- also known as impotence
- inability to achieve or sustain an erection sufficient for satisfactory sexual intercourse
36
erectile dysfunction primary classification
- rare
- life-long inability to have a normal erection
- severe psychiatric problems
- early vascular trauma
37
erectile dysfunction secondary classification
- most common
- someone with a history of normal erections
38
PDE-5 inhibitor drug
sildenafil
39
MOA of sildenafil
- inhibits PDE5
- increases and preserves cGMP levels
- only enhances the normal response to sexual stimuli
40
indications of sildenafil
- relief of ED
- pulmonary arterial hypertension
- BPH
41
timing of sildenafil
- up to 4 hours before sexual activity
- onset: 30-60 minutes
42
side effects of sildenafil
- HA
- flushing
- dyspepsia
43
cautions of sildenafil
- preexisting CV disease, if on nitrate Rx
- hypotension
44
safety issues for a patient on sildenafil
- don't take if you are on any nitrates
- if you have chest pain or other signs of a heart attack during sex, stop and call 911
- sudden loss of vision or hearing
- no more than once per day
- priapism
45
what is priapism
- erection that is painful or lasts more than 4 hours
- medical emergency
