male reproductive

Question 1

testicular cancer

Answer 1

rf = fam hx, white, cryptochordism (x descend w/n 3 mo), HIV (AIDS)
cause sterility
germ cell tumors: seminomas (arise from immature nerve cells, slow growing, non aggressive, easily cured with radiation) and non seminomas (arise form mature germ cells, more aggressive, usually need sx

Question 2

testicular cancer: cm

Answer 2

early: testes enlarge, painless mass noted or ache in groin, sensation of heaviness
late: frank pain, based on metastatic spread (hemoptysis, cough, swelling of LE, back pain, dizzy

Question 3

benign prostatic hyperplasia

Answer 3

prostate: gland around urethra, produce seminal fluids, 4-20g
nonmalignant enlarrgement of prostate: more epithelial cells (mechanical obstruction), more SM cells (dynamic obstruction), stromal cells
rf: age, fam hx, race/ethnicity
LUTs = lower UT s

Question 4

BPH: etiology

Answer 4

hormone imbalance = testosterone (go down with age) and estrogen (stay same with age - may stim growth factors to enlarge)
DHT accumulation: test + 5 alpha reductase, activate growth factors, levels increase with age, acne, hair on chest and off scalp, stim growth of prostate cells

Question 5

BPH: cm

Answer 5

freq and urgency, delay in initiation, decrease in force, increase urination time, dribbling

Question 6

BPH: complications

Answer 6

obstruction (P change in kidneys and impairs function, stones), UTI, renal problems

Question 7

BPH: tm

Answer 7

mild s = watchful waiting
mod s = 5 alpha reductase I, alpha 1 adrenergic antagonist
severe = invasive options (sx and microwave)

Question 8

prostate cancer: rf

Answer 8

age, familial tendency, high fat diet

Question 9

prostate cancer: cm

Answer 9

early: mostly asymptomatic
late: BPH type presentation, metastasis (bone - pain, lung - cough, hemoptysis, sputum)

Question 10

prostate cancer: controversy

Answer 10

most grow so slow that men die of other causes
100% survival if not spread -> falls drastically (screening - may be more harm if cancer found and treatment provided than doing nothing)

Question 11

prostate cancer: prognosis

Answer 11

low, intermediate, high grade cancer
severity depends on: gleason score (higher = worse), tumor volume - PSA level (higher and rapid rise = worse) and number of cores + (more = worse)
how was cancer detected? PSA (early stage) vs DRE (low risk pops, digital rectal exam)

Question 12

prostate cancer: tm

Answer 12

no meds
can remove prostate
chemo
radiation

Question 13

ED

Answer 13

inability to achieve or sustain an erection sufficient for satisfactory sex
impotence, associated with chronic illness
primary = rare, lifelong inability -> psychologic, early vascular trauma
secondary = hx of normal erections,

Question 14

ED: secondary - etiology

Answer 14

peripheral vascular disease: arterial insufficiency, excessive venous drainage, sedentary lifestyle
meds: antiD, antihtn
endocrine issues -> low testosterone
trauma, sx (radical prostatectomy)
depression, low desire, performance anx, strained relationship

Question 15

ED: phys of normal erection

Answer 15

arousal -> increased PNS to penis, and nitric oxide release -> activation of cGMP -> relaxation of arteries and SM -> increase inflow and decreased outflow -> engorgement and erection
PDE5 removes cGMP