Male Reproductive System

Question 1

What is the most common type of prostate cancer?

Answer 1

Adenocarcinoma

Question 2

Which tumours are associated with a raised AFP?

Answer 2

1) - Hepatocellular carcinoma
- Mets affecting liver
2) Non-seminoma germ cell
3) Yolk cell tumour
4) Embryonal Ca

Question 3

Which tumours are associated with a raised bHCG?

Answer 3

1) Seminoma
2) Teratoma
3) Choriocarcinoma
4) Germ cell tumours - good for monitoring
5) Breast Ca
6) Bladder, liver, pancreas, stomach, lung, kidney Ca

Question 4

What other conditions are associated with a raised AFP?

Answer 4

Liver related pathology
Gastric, biliary & pancreatic Ca
Bronchial Ca
Antiepileptics & anesthetics

Question 5

Which other conditions are associated with a raised bHCG?

Answer 5

Marijuana Use
Hypogonadism
Hydatidiform mole
Heterophile antibodies

Question 6

Complications of TURP

Answer 6

1) Bleeding: helped by finasteride
2) Clot retention & clot colic
3) Intra/extraperitoneal rupture of bladder
4) Bladder neck stenosis
5) Urinary incontinence - injury to external sphincter
6) TURP syndrome

Question 7

What is TURP syndrome?

Answer 7

Hyponatraemia & water intoxication caused by XS fluid absorption from open prostatic sinusoids

Makes the body go into:

1) Transient hypertension
2) Bradycardia
3) Confusion
4) Altered mental state
5) Vomiting
6) Nausea
7) Coma

Question 8

TURP syndrome prevention?

Answer 8

1) Limit procedure to <1hr
2) Height of container to irrigate must be low - to reduce hydrostatic pressure going into prostatic veins
3) Prevent blood loss/hypotension/capsular perforation during procedure
4) Use glycine for irrigation (hypoosmolar)

Question 9

Differentials for testicular swellings you can’t get above?

Answer 9

1) Indirect hernia

2) Varicocele

Question 10

Which conditions can you not feel a separate testes?

Answer 10

1) Testicular tumour - craggy swelling
2) Hydrocele
3) Torsion
4) Orchitis

Question 11

Which condition is most likely to be transilluminant?

Answer 11

Hydrocele

Question 12

Which conditions are more likely to have a “dragging sensation”?

Answer 12

1) Varicocele

2) Indirect hernia

Question 13

Which nerves are responsible for the cremasteric reflex?

Answer 13

AFFERENT - Ilioinguinal nerve (L1)

EFFERENT - Genital branch of genitofemoral nerve (L1,2)*

Question 14

What supplies the sensation to the anterior aspect of male genitalia?

Answer 14

Ilioinguinal nerve

Question 15

What supplies the sensation to the lateral aspect of male genitalia?

Answer 15

Genital branch of genitofemoral nerve

Question 16

What supplies the sensation to the inferior aspect of male genitalia?

Answer 16

Perineal nerve