Male Reproductive Exam 4

Question 1

risk factors for testicular cancer

Answer 1

family history
caucasian
cryptorchidism (empty scrotum)
HIV infection

Question 2

what are germ cells

Answer 2

the sperm forming cells

Question 3

what are the two types of germ cell tumors

Answer 3

seminomas and nonseminomas

Question 4

Seminomas

Answer 4

arise from immature germ cells
slow growing, nonaggressive
easily cured with radiation

Question 5

nonseminomas

Answer 5

arise from mature germ cells
more aggressive
usually treated with surgery

Question 6

early clinical manifestations of germ cell tumors

Answer 6

enlargement of testicle 
painless mass notes
if discomfort present 
-ache in groin
-sensation of heaviness

Question 7

late clinical manifestations of germ cell tumors

Answer 7

possible flank pain
based on metastatic spread: -cough 
-hemoptysis
-swelling of lower extremities
-back pain 
-dizziness

Question 8

what is the prostate

Answer 8

gland surrounding the urethra

produces seminal fluids

Question 9

what is Benign Prostatic Hyperplasia (BPH)

Answer 9

nonmalignant enlargement of prostate

increase in epithelial cells and increase in smooth muscle cells

Question 10

what are risk factors for BPH

Answer 10

age 
family history 
race/ethnicity; 
-high - blacks
-low - asian

Question 11

BPH cause/etiology

Answer 11

hormone imbalance

DHT accumulation - high levels of DHT activate growth factors

Question 12

Clinical manifestations (S/S) for BPH

Answer 12

similar to UTI

frequency and urgency with urination, dribbling, reduction in force, increased urination time

Question 13

BPH complications

Answer 13

obstruction - can obstruct urine from getting out of kidneys
UTI
renal problems

Question 14

What are 5 alpha reductase inhibitors

Answer 14

finasteride and dutasteride

for BPH

Question 15

MOA for finasteride and dutasteride

Answer 15

acts in reproduction tissue to inhibit 5 alpha DHT

blocks conversion of testosterone to DHT and decreases epithelial tissue in prostate

Question 16

SE of finasteride and dutasteride

Answer 16

impotence (erectile disfunction)
decreased libido
gynecomastia - abnormal growth of breast tissue

Question 17

Nursing considerations for finasteride and dutasteride

Answer 17

pregnant nurses can not handle this drug

men can not give blood while talking the drug

Question 18

what are alpha1-adrenergic antagonists

Answer 18

tamsulosin

for BPH; dynamic obstruction of urethra

Question 19

MOA of tamsulosin

Answer 19

relaxes smooth muscle cells and selective for alpha receptors in the prostate

Question 20

SE of tamsulosin

Answer 20

well tolerated

abnormal ejaculation

Question 21

Prostate cancer risk factors

Answer 21

age
familial tendency
high fat diet

Question 22

prostate cancer in races

Answer 22

Highest - black/ african american

lowest - native american and asian

Question 23

what is erectile dysfunction

Answer 23

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

Question 24

Primary ED

Answer 24

rare; life-long inability to have a normal erection;
severe psychiatric problems
early vascular trauma

Question 25

secondary ED

Answer 25

most common

ED in someone with a history of normal erections

Question 26

what is the physiology of a normal erection

Answer 26

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

Question 27

what removes cGMP

Answer 27

PDE-5

Question 28

what are PDE-5 inhibitors

Answer 28

sildenafil (Viagra)

for erectile dysfunction

Question 29

MOA of sildenafil

Answer 29

inhibits PDE5, increases and preserves cGMP levels

Question 30

SE of sildenafil

Answer 30

heart attack, flushing, dyspepsia

Question 31

cautious with sildenafil

Answer 31

do not take if you are taking any nitrates - will cause significant decreased BP
no more than once per day

Question 32

what is priapism

Answer 32

erection is painful or lasts more than 4 hours