Male reproductive tract diseases

Question 1

How do you detect prostate enlargement?

Answer 1

PR exam

Prostate Specific Antigen

Question 2

What does PSA do normally?

Answer 2

Liquifies semen in ejaculate and allows sperm to swim

Question 3

What is a flaw of using PSA to detect cancer?

Answer 3

High grade cancers don’t produce it

Question 4

What are some things that can cause an increase in PSA?

Answer 4

Big prostate
Prostatitis
PR exam
Exercise
Spironolactone

Question 5

What investigation is used detect prostate cancer?

Answer 5

Biopsy (go through rectum)

Question 6

What grading system is used for prostate cancer?

Answer 6

Gleason Grading System

Question 7

What is the highest possible score on Gleason Grading System?

Answer 7

10

Question 8

What two zones of the prostate can be affected with pathology?

Answer 8

Peripheral

Central

Question 9

What affects the central zone of the prostate?

Answer 9

BPH

Question 10

What affects the peripheral zone of the prostate?

Answer 10

Cancer

Question 11

What are some symptoms of prostate cancer?

Answer 11

Asymptomatic
LUTS
Hematuria / Hematospermia
Bone pain, Anorexia, Weight loss

Question 12

How do you diagnose prostate cancer?

Answer 12

PSA

Biopsy

Question 13

What is the most common form of prostate cancer?

Answer 13

Multifocal adenocarcinoma

Question 14

Where can prostate Multifocal adenocarcinoma met to?

Answer 14

Bones

Pelvic lymph nodes

Question 15

How do you image for prostate cancer?

Answer 15

Bone scan
MRI
CT

Question 16

How do you treat prostate cancer?

Answer 16

Radiotherapy
Resection
Treat mets w/:
Androgen Deprivation therapy
Diethylstilbesterol/ Steroids
Cytotoxic chemotherapy

Question 17

What main kind of conditions affect the penis?

Answer 17

Skin conditions

Question 18

What causes papilloma/genital warts?

Answer 18

HPV

Question 19

How does Balanitis Xerotic Obliterans/Lichen Sclerosus present?

Answer 19

White patches on penis

Question 20

What causes Balanitis Xerotic Obliterans/Lichen Sclerosus?

Answer 20

Idiopthic

Question 21

What are some complications of Balanitis Xerotic Obliterans/Lichen Sclerosus?

Answer 21

Cancer
Paraphimosis
Phimosis

Question 22

What two forms of cancer can you get on the penis?

Answer 22

Differentiated- Non-HPV

Dedifferentiated- HPV

Question 23

What causes differentiated penile cancer?

Answer 23

Non-HPV causes

Question 24

What causes dedifferentiated penile cancer?

Answer 24

HPV

Question 25

What is Paraphimosis?

Answer 25

Inability to replace retracted foreskin

Question 26

What can cause Paraphimosis?

Answer 26

Having foreskin retracted for too long

Question 27

What is Priapism?

Answer 27

Prolonged erection (> 4hrs), often painful and not associated with sexual arousal

Question 28

What can cause Priapism?

Answer 28

``` Intracorporeal injection for ED, e.g. papaverine Trauma (penile / perineal) Haematologic dyscrasias e.g. sickle cell Neurological conditions Idiopathic ```

Question 29

What are the four categories of condition that can affect the testes?

Answer 29

Torsion Lumps Orchitis Epididymitis

Question 30

What two forms of torsion are there?

Answer 30

Testicular | Appendage

Question 31

What causes testicular torsion?

Answer 31

Bell Clapper Deformity

Question 32

What group is testicular torsion most common in?

Answer 32

Teens

Question 33

What are some symptoms of testicular torsion?

Answer 33

``` Excruciating pain N+V Referred pain to lower abdo testis high in scrotum transverse lie Absence of cremasteric reflex ```

Question 34

How do you treat testicular torsion?

Answer 34

Surgery ASAP!!!

Question 35

What are the symptoms of appendicular torsion?

Answer 35

Variable | Blue dot sign

Question 36

How do you treat appendicular torsion?

Answer 36

Resolves by itself

Question 37

What are the symptoms of Epididymitis?

Answer 37

Similar to torsion | Hx of UTI, urethritis, catheterization/instrumentation

Question 38

How do you treat epididymitis?

Answer 38

Analgesia + scrotal support Bed rest Ofloxacin 400mg/day for 14 days

Question 39

What can cause lumps in the testes/scrotum?

Answer 39

Hernia- common Tumours Cystocoele Hydrocoele

Question 40

What is cystocoele?

Answer 40

Cystic change within the vas of the epididymis

Question 41

What are the symptoms of cystocoele?

Answer 41

Asymptomatic

Question 42

What is hydrocoele?

Answer 42

Accumulation of fluid around the testes

Question 43

What are the symptoms of hydrocoele?

Answer 43

Unicystic Smooth Fluid filled

Question 44

What two broad categories of tumour can affect the testes?

Answer 44

Seminomatous | Non-seminomatous

Question 45

In what age group are seminomatous tumours usually found?

Answer 45

40+

Question 46

What do seminomatous tumours look like?

Answer 46

Potato

Question 47

What is a risk factor for seminomatous tumours?

Answer 47

Undescended testes

Question 48

How do you treat seminomatous tumours?

Answer 48

Radiotherapy

Question 49

At what age do non-seminomatous tumours tend to present?

Answer 49

30ish

Question 50

Describe non-seminomatous tumours

Answer 50

Aggressive | Metastatic

Question 51

How do you treat non-seminomatous tumours?

Answer 51

Chemo

Question 52

What is Fournier’s gangrene?

Answer 52

Necrotizing fasciitis in the male genitals

Question 53

What are some risk factors for Fournier's gangrene?

Answer 53

Diabetes Trauma Periurethral extravasation Infection

Question 54

What are some symptoms of Fournier's gangrene?

Answer 54

``` Starts as cellulitis swollen erythematous tender Marked pain, fever, systemic toxicity Swelling + crepitus of scrotum, dark purple areas ```

Question 55

What are the two categories of priapism?

Answer 55

Ischemic | Non-ischemic

Question 56

Describe ischemic priapism

Answer 56

Compartment syndrome of the penis. Penis often painful.

Question 57

Describe non-ischemic priapism

Answer 57

Traumatic disruption of penile vasculature results in unregulated blood entry and filling of corpora.

Question 58

How do you treat priapism?

Answer 58

Aspirate blood from penis | Give alpha agonists