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aa Step 2CK: Internal & Peds > Heme/Onc- Male reproductive > Flashcards

Heme/Onc- Male reproductive Flashcards

1
Q

Diagnosis: 65yo male, hematuria, no pain, 30-pack year. UA + only RBCs

A

Bladder cancer.

Advanced age, history of tobacco, painless hematuria, absence of infection or casts raise suspicion for bladder cancer

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2
Q

Bladder cancer

A

malignant transformation of the bladder surface epithelium (urothelium) due to chronic exposure. to chemical carcinogens (tobacco smoke and industrial chemicals).

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3
Q

Differential diagnosis anterior mediastinal masses

A

4 Ts:

Thymoma
Teratoma
“Terrible” Lymphoma
Thyroid neoplasm

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4
Q

Types of malignant germ cell tumors (teratoma)

A

Seminoma (↑ B-HCG, normal AFP)

(↑AFP and/or B-HCG):
Nonseminomatous GCT
Mixed GCT

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5
Q

Differentiated a benign mediastinal teratoma

A

Normal AFP and B-HCG

Imaging: Fat bone or fluid

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6
Q

Next steps possible malignant mediastinum teratoma

A
  1. Biopsy (confirm diagnosis)

2. Testicular ultrasound (determine is primary of mets)

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7
Q

S&S bladder cancer

A

painless hematuria (gross or microscopic)
voiding symptoms (frequency, urgency, dysuria )
suprapubic pain
Smoking history/ chemical exposure
age >40
RBC on UA and nothing else

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8
Q

Tx bladder cancer

A

No muscle invasion: Transurethral reaction & intravesical immunotherapy

muscle invasion: radical cystectomy & sys. chemo

mets: sys. chemo & immunotherapy

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9
Q

gynecomastia and ↑hCG

A

Testicular or gonadal germ-cell tumor

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10
Q

gynecomastia and ↓/normal LH ↓Testosterone

A

Central hypogonadism

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11
Q

gynecomastia and ↑LH ↓ Testosterone

A

Primary hypogonadism

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12
Q

gynecomastia and ↑LH ↑Testosterone

A

Possible thyrotoxicosis

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13
Q

gynecomastia and ↑ estradoil

A

testicular or adrenal tumor

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14
Q

Mechanism of gynecomastia with germ cell tumors

A

Xs hCG suppresses testoerone productiona nd increases armature activity and conversion of androgens to estrogens

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15
Q

Management of gynecomastia with ↑hCG

A

Testicular ultrasound to exclude occult mass

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16
Q

Varicocele

A

dilation of the pampiniform plexus surrounding the spermatic cord and testis

17
Q

S&S primary varicocele

A

Bag of worms/ coiled
Pubertal onset
Left-sided
Decompresses when supine

18
Q

Management of primary varicocele

A

Reassurance and observation

19
Q

S&S secondary varicocele

A

Bag of worms/ coiled
Prepubertal onset
Right sided
Persists when supine

20
Q

Management of secondary varicocele

A

abdominal ultrasound (rule out a tumor compressing IVC)

any varicocele that persists when laying down is treated was is a secondary cause

aa Step 2CK: Internal & Peds (71 decks)

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