Male Reproductive Exam 4 Flashcards
risk factors for testicular cancer
family history
caucasian
cryptorchidism (empty scrotum)
HIV infection
what are germ cells
the sperm forming cells
what are the two types of germ cell tumors
seminomas and nonseminomas
Seminomas
arise from immature germ cells
slow growing, nonaggressive
easily cured with radiation
nonseminomas
arise from mature germ cells
more aggressive
usually treated with surgery
early clinical manifestations of germ cell tumors
enlargement of testicle painless mass notes if discomfort present -ache in groin -sensation of heaviness
late clinical manifestations of germ cell tumors
possible flank pain based on metastatic spread: -cough -hemoptysis -swelling of lower extremities -back pain -dizziness
what is the prostate
gland surrounding the urethra
produces seminal fluids
what is Benign Prostatic Hyperplasia (BPH)
nonmalignant enlargement of prostate
increase in epithelial cells and increase in smooth muscle cells
what are risk factors for BPH
age family history race/ethnicity; -high - blacks -low - asian
BPH cause/etiology
hormone imbalance
DHT accumulation - high levels of DHT activate growth factors
Clinical manifestations (S/S) for BPH
similar to UTI
frequency and urgency with urination, dribbling, reduction in force, increased urination time
BPH complications
obstruction - can obstruct urine from getting out of kidneys
UTI
renal problems
What are 5 alpha reductase inhibitors
finasteride and dutasteride
for BPH
MOA for finasteride and dutasteride
acts in reproduction tissue to inhibit 5 alpha DHT
blocks conversion of testosterone to DHT and decreases epithelial tissue in prostate
SE of finasteride and dutasteride
impotence (erectile disfunction)
decreased libido
gynecomastia - abnormal growth of breast tissue
Nursing considerations for finasteride and dutasteride
pregnant nurses can not handle this drug
men can not give blood while talking the drug
what are alpha1-adrenergic antagonists
tamsulosin
for BPH; dynamic obstruction of urethra
MOA of tamsulosin
relaxes smooth muscle cells and selective for alpha receptors in the prostate
SE of tamsulosin
well tolerated
abnormal ejaculation
Prostate cancer risk factors
age
familial tendency
high fat diet
prostate cancer in races
Highest - black/ african american
lowest - native american and asian
what is erectile dysfunction
impotence; inability to achieve or sustain an erection sufficient for satisfactory sexual intercourse
Primary ED
rare; life-long inability to have a normal erection;
severe psychiatric problems
early vascular trauma
secondary ED
most common
ED in someone with a history of normal erections
what is the physiology of a normal erection
sexual arousal –> increased parasympathetic nervous system and nitric oxide release –> activation of cGMP –> relaxation of arteries and smooth muscles –> increased inflow and reduced outflow –> engorgement and erection
what removes cGMP
PDE-5
what are PDE-5 inhibitors
sildenafil (Viagra)
for erectile dysfunction
MOA of sildenafil
inhibits PDE5, increases and preserves cGMP levels
SE of sildenafil
heart attack, flushing, dyspepsia
cautious with sildenafil
do not take if you are taking any nitrates - will cause significant decreased BP
no more than once per day
what is priapism
erection is painful or lasts more than 4 hours
