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NUE 325: Pathopharm I > Male Reproductive and Drugs > Flashcards

Male Reproductive and Drugs Flashcards

1
Q

testicular cancer

A
  • 1% of all male cancers
  • major cancer for men 15-34
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2
Q

risk factors testicular cancer

A
  • fam hx
  • caucasian
  • crytochirdism (empty scrotum, testicles dont distend)
  • HIV infection
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3
Q

germ cells tumors

A
  • seminomas
  • nonseminomas
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4
Q

seminomas

A
  • arise from immature germ cells
  • slow growing, non aggressive
  • easily cured with radiation
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5
Q

nonseminomas

A
  • arise from mature germ cells
  • more aggressive
  • usually treated w surgery
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6
Q

germ cell

A

sperm forming cells within the testicles

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7
Q

early clinical manifestations of testicular cancer

A
  • enlargement of testicles
  • painless mass noted
  • if discomfort present, ache in groin, sensation of heaviness
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8
Q

late clinical manifestations of testicular cancer

A
  • possible frank pain (rapid growth, hemorrhage)
    manifestations based on where its spread
  • cough, hemoptysis, swelling of lower extremities, back pain, dizziness
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9
Q

benign prostatic hyperplasia

A

nonmalignant enlargement of prostate due to inc epithelial cells or inc smooth cells

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10
Q

prostate

A

gland that surrounds the urethra and produces seminal fluids
- weighs between 4-10 gms (walnut)

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11
Q

risk factors of BPH

A
  • age
  • fam hx
  • race/ethnicity
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12
Q

symptoms of BPH

A

lower urinary tract symptoms

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13
Q

theories of cause of BPH

A
  • hormone imbalance
  • DHT accumulation
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14
Q

hormone imbalance of BPH etiology

A
  • testosterone dec w aging
  • estrogen can stimulate growth factors
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15
Q

DHT accumulation BPH etiology

A

DHT=dihydrotestosterone
- formed by testosterone + 5 alpha reductase
- inc levels inc growth factors
- DHT acts on skin, hair follicles (on chest, off scalp), stimulates growth of prostate cells

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16
Q

BPH clinical manifestations

A
  • frequency and urgency
  • delay in initiation
  • reduction in force
  • inc urination time
  • dribbling
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17
Q

complications of BPH

A
  • obstruction
  • UTI
  • renal problems
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18
Q

treatment of BPH

A
  • mild symptoms: watchful waiting
  • moderate: drug therapy
  • severe: invasive options
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19
Q

finasteride class

A

5-α-reductase inhibitors

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20
Q

finasteride indications

A

mechanical obstruction of urethra
- also helps treat male pattern baldness

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21
Q

finasteride moa

A

blocks conversion of testosterone to DHT (alpha 1 receptors)
dec epithelia tissue in prostate

22
Q

finasteride se

A
  • impotence
  • dec libido
  • gynecomastia
23
Q

finasteride nc

A
  • dec PSA levels
  • caution when handling bc teratogenic
  • only works for someone w a large prostate
  • see results w/in 6-12 mons
24
Q

dutasteride class

A

5α reductase inhibitors

25
Q

dutasteride indications

A

mechanical obstruction of urethra

26
Q

dutasteride moa

A

blocks conversion of testosterone to DHT (alpha 1 and 2 receptors)
decreases epithelial tissue in prostate

27
Q

dutasteride sd

A

similar to finasteride
- impotence
- dec libido
- gynecomastia

28
Q

tamsulosin class

A

alpha 1 adrenergic antagonist

29
Q

tamsulosin moa

A
  • relaxes smooth muscle cells
  • selective for alpha receptors in the prostate
30
Q

tamsulosin indication

A

dynamic obstruction of urethra

31
Q

tamsulosin nc

A
  • immediate results
32
Q

tamsulosin se

A
  • well tolerated
  • abnormal ejaculations
  • doen’t dec levels of PCA
33
Q

combination therapy

A

durasteride + tamsulosin
FDA approved
combining a 5-alpha- reductase inhibitor w alpha blocker is superior to either alone

34
Q

prostate cancer

A

most common cancer in males
varies among race (highest in african american, asian and native american lowest)
incidence inc rapidly after 50

35
Q

prostate cancer risk factors

A
  • age
  • familial tendency
  • high fat diet
36
Q

clinical manifestions of prostate cancer

A
  • early: asymptomatic
  • later: BPH type presentation, metastasis (bone, lungs)
  • prognosis: stage dependent, early diagnosis
37
Q

controversy w prostate cancer

A

most prostate cancer is clinically irrelevant bc it grows so slowly
- PSA screening was widely adopted before we had evidence for supporting use
- survival dec once the cancer has spread

38
Q

benefits of screening PSA

A
  • small survival benefit w PSA screening in randomized
  • use of the PSA test was associated w 50% drop in prostate deaths
39
Q

harms of screening

A
  • would take 48 diagnosis of prostate cancer to prevent 1 death
  • only 1 in 3 men w positive PSA will have prostate cancer
  • many unnecessary biopsies
  • unnecessary treatment include erectile disfunction, urinary incontinence, bowel problems
40
Q

prognosis of prostate cancer

A

does not kill everyone
- low, intermediate, high grade
- severity depends on gleason score, tumor volume, PSA levels, number of cores positive, how cancer was detected

41
Q

erectile dysfunction

A

inability to achieve or sustain an erection sufficient for satisfactory sexual intercourse

42
Q

ED classification

A
  • primary: life long inability to have a normal erection, severe psychiatric problems, early vascular trauma
  • secondary: begins to be unable
43
Q

organic causes of ED

A
  • peripheral vascular disease (arterial insufficiency, excessive venous drainage, sedentary lifestyle)
  • medication (antidepressants, antiHTN)
  • endocrine problems
  • trauma, surgery
44
Q

psychogenic causes

A
  • depression
  • low desire
  • performance
  • strained relationship
45
Q

physiology of a normal erection

A
  • sexual arousal
  • inc PNS and nitric oxide
  • activation of cGMP
  • relaxation of arteries and smooth muscles
  • inc inflow and reduced outflow
  • engorgement and erection
    PDE-5 removes cGMP
46
Q

sildenafil class

A

PDE-5 inhibitors

47
Q

sildenafil moa

A

inhibits PDE5, inc and perserves cGMP levels
- only enhances the normal response to sexual stimuli

48
Q

sildenafil indications

A

relief of ED
- pulmonary HTN
- BPH

49
Q

sildenafil se

A

headache
flushing
dyspepsia

50
Q

sildenafil nc

A
  • use up to 4 hrs before sexual activity (onset30-60 mins)
  • contraindicating if preexisiting CV disease if on nitrate or have hypotension
  • if you have chest pain during sex stop and call 911
  • sudden loss of vision or hearing
  • no more than once per day
  • priapism: painful erection or lasts more than 4 hrs = medical emergency

NUE 325: Pathopharm I (23 decks)

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