Male Reproductive Flashcards

1
Q

Testicular Cancer

A

-Major cancer in men 15-34

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2
Q

Testicular Cancer: Risk factors

A

Family history

Caucasian

Cryptorchidism (major) (10% of all cancers) (Testes do not descend) (Higher it is located –> higher chance for cancer)

HIV infection

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3
Q

Teste Cancer: Germ cell tumors

A

Make up 95% of all teste cancers

Serminomas

Nonseminomas

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4
Q

Serminomas

A

-arise from immature germ cells

-slow growing, non aggressive

-easily cured with radiations

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5
Q

Nonseminomas

A

-Airse from mature germ cells

-More aggressive

-Usually treated with surgery

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6
Q

Early Clinical Manifestations of Teste Cancers

A

-Enlargement of testicle with painless mass noted

-If discomfort is present usually ache in groin or sensation of heaviness

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7
Q

Late clinical manifestations of testicle cancer

A

Frank pain

PAIN BASED ON METASTATIC SPREAD
Cough and hemoptysis

Swelling of lower extremities

Back pain

Dizziness

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8
Q

BPH

A

Begning prostatic hyperplasia

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9
Q

The Prostate

A

Gland surrounding the urethra

Produces seminal fluids

Weigh 4-20 gm

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10
Q

Mechanical BPH

A

Increase of epithelial cells

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11
Q

Dynamic BPH

A

Increase smooth muscle cells

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12
Q

Risk factors for BPH

A

Age

Family history

Race/ethnicity

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13
Q

BPH Symptoms

A

Lower urinary tract symptoms

Frequency - Sudden urge - Pain - Dribbling

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14
Q

BPH Etiology: Two Theories

A
  1. Hormone imbalance
    -testosterone and estrogen (estradiol) (increase of estrogen levels)
  2. DHT accumulation
    -What is DHT and where is it formed?
    -Testosterone + 5 alpha reductase –> DHT
    -Why is it important in development of BPH?
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15
Q

Hormone imbalance BPH theory

A

-testosterone and estrogen (estradiol) (increase of estrogen levels)

As we age test decrease while estrogen increase. Creates a disbalance and increase the size of the prostate

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16
Q

DHT imbalance BPH theory

A

DHT formed by testosterone and 5 alpha reductase

DHT is a growth factors that accumulates as we age

17
Q

DHT accumulation works as a growth factors that causes

A

Acts on skin: acne

Acts on hair on chest but off scalp

Stimulate growth of prostate cells

18
Q

BPH: Clinical Manifestations

A

-Frequency and urgency

-Delay in initiation

-Reduction in force

-Increase urination time

-Dribbling

19
Q

BPH: complications

A

Obstruction (impair kidney fuction)

UTI

Renal problems

20
Q

Treatment of mild BPH

A

Mild symptoms = Watchful waiting

21
Q

Treatment of moderate BPH

A

Drugs

5-alpha-reductase

Alpha1-adrenergic antagonists

22
Q

Treatment of severe BPH

A

Invasive surgery

23
Q

Prostate Cancer

A

Most common know cancer in the US

2nd to lung cancer is cancer related deaths

Increases rapidly after age 50

24
Q

Prostate Cancer: RF’s

A

Age

Familial tendency (1st or 2nd degree increases risk 8 fold)

High fat diet

25
Prostate Cancer Clinical Manifestations
Late only: BHP type presentation Bone pain (most common) Lungs (coughing up blood)
26
Prostate Cancer: Progonosis
-Stage dependent -Early diagnosis
27
Prostate CA prognosis
Does not kill everyone Low, intermediate, and high grade CA
28
Severity of prostate cancer depends on
Gleason score: (higher = worse) Tumor volume: PSA level and number of cores
29
Erectile Dysfunction is known as _______ and is the _________…
Impotence Inability to achieve or sustain an erection sufficient for satisfactory sexual intercourse
30
ED is associated with
chronic illness
31
Primary ED
Rare Life long inability to have a normal erection
32
Primary ED RF's
Severe psychiatric problems Early vascular trauma
33
Secondary ED
Most common History of normal erections and then is unable to get it up
34
Secondary ED: Organic Cause
PVD Medications Endocrine problems Trauma - surgery (radical prostatectomy)
35
Secondary ED: Psychogenic Cause
Depression Low desire Performance anxiety Strained relationship
36
Physiology of Normal Erection
Sexual arousal leads to increase in the parasympathetic nervous system and nitric oxide release. This activates cGMP which relaxes arteries and smooth muscles which increases the inflow to the penis and reduces the outflow from the penis.
37
What enzyme is responsible for activates an erection
cGMP
38
What enzymes is responsible for inhibiting the erection
PDE-5