GU Flashcards
which hormone causes enlargement of the prostate from boy > man?
dihydrotestosterone
is cancer, or benign prostate enlargement more likely to push on the urethra?
benign
[benign - transitional zone
cancer - outer zone]
what is PSA?
prostate specific antigen
non-specific blood test for prostate cancer
[liquefaction of semen, small leakage into blood]
2 most common areas of mets in prostate cancer
lymph nodes
bone
what are paraneoplastic sydromes?
rare
triggered by altered immune response to neoplasm
non-mets systemic effects w/ malignant neoplasm
non-spec systemic symptoms of cancer
weight loss
fever
normocytic anaemia
specific constitutional symptoms in cancer caused by hypercalcaemia
anorexia
thirst
confusion
collapse
why does cancer cause hypercalcaemia?
bone breakdown
dehydration (vomiting) > kidney fn. impaired
parathyroid hormone related protein secreted by tumour > bone resorption & tubules
specific constitutional symptoms in cancer caused by marrow replacement
purpura
anaemia
immune suppression
examples of paraneoplastic syndromes
cushing's disease dementia cerebellar degeneration peripheral neuropathy acanthosis nigricans erythrocytosis
what type of cancer is prostate?
adenocarcinoma
[prostate GLAND]
Which zone of the prostate is affected by adenocarcinoma?
peripheral zone
5 cancers that tend to metastasise to bone
breast lung prostate thyroid kidney
what is an androgen?
male sex hormone e.g. testosterone
prostate cancer genetics - oncogene that links with TMPRSS2 gene, leading to disruption of androgen receptor signalling
ERG
reasons for elevated PSA other than prostate cancer
benign prostate enlargement
UTI
prostatitis
recent ejaculation
how does prostate cancer grading [Gleason] differ from norm?
looks a TISSUE not cell
grading not related to cellular differentiation. How close/far from normal tissue?
describe T1 stage in prostate cancer
no palpable tumour on DRE
describe T2 stage in prostate cancer
palpable tumour confined to prostate
describe T3 stage in prostate cancer
palpable tumour extending beyond prostate
treatment for localised prostate cancer
surgery
radiotherapy
observation
arguments against radical prostatectomy
erectile & sexual dysfn.
urinary incontinence
most die WITH not OF it
what is the purpose of the wider diameter of the afferent arteriole than the efferent in the kidney?
increases blood pressure within glomerulus
forces water and solutes into bowman’s capsule
most common disease of kidney/urinary tract in men?
benign prostatic hypertrophy
most common disease of kidney/urinary tract in women?
UTI
what is dysuria?
pain on micturition
structural and functional abnormalities in which glomerular cell leads to nephrotic syndrome?
podocytes
management of nephrotic syndrome
oedema: dietary salt restriction, thiazide diuretic
proteinuria: ACE inhibitors, angio2 rec. blockers
severe: cyclophosphamide/prednisolone
[treat underlying disease]
how do ACE inhibitors/ angiotensin2 receptor blockers decrease proteinuria?
decrease BP in glomerulus so less forced filtration
complications of nephrotic syndrome
venous thrombosis
sepsis
AKI
how can nephrotic syndrome lead to sepsis?
loss of immunoglobulin in urine
^ infections
how can nephrotic syndrome lead to venous thrombosis?
loss of clotting factors in urine
what causes acute nephritic syndrome/ acute glomerulonephritis?
immune response triggered by infection e.g. post strep pharyngitis
bacterial antigen trapped in glomerulus
clinical features of acute glomerulonephritis/ acute nephritic syndrome
haematuria proteinuria hypertension oedema oliguria uraemia
Tx of acute glomerulonephritis
HTN: salt restriction, loop diuretics, vasodilators
oedema: fluid restriction
if SLE/vasculitis: prednisolone, cyclophosphamide..
