Male reproductive tract diseases Flashcards

1
Q

How do you detect prostate enlargement?

A

PR exam

Prostate Specific Antigen

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2
Q

What does PSA do normally?

A

Liquifies semen in ejaculate and allows sperm to swim

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3
Q

What is a flaw of using PSA to detect cancer?

A

High grade cancers don’t produce it

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4
Q

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

A
Big prostate
Prostatitis
PR exam
Exercise
Spironolactone
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5
Q

What investigation is used detect prostate cancer?

A

Biopsy (go through rectum)

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6
Q

What grading system is used for prostate cancer?

A

Gleason Grading System

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7
Q

What is the highest possible score on Gleason Grading System?

A

10

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8
Q

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

A

Peripheral

Central

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9
Q

What affects the central zone of the prostate?

A

BPH

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10
Q

What affects the peripheral zone of the prostate?

A

Cancer

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11
Q

What are some symptoms of prostate cancer?

A

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

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12
Q

How do you diagnose prostate cancer?

A

PSA

Biopsy

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13
Q

What is the most common form of prostate cancer?

A

Multifocal adenocarcinoma

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14
Q

Where can prostate Multifocal adenocarcinoma met to?

A

Bones

Pelvic lymph nodes

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15
Q

How do you image for prostate cancer?

A

Bone scan
MRI
CT

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16
Q

How do you treat prostate cancer?

A
Radiotherapy
Resection
Treat mets w/:
Androgen Deprivation therapy
Diethylstilbesterol/ Steroids
Cytotoxic chemotherapy
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17
Q

What main kind of conditions affect the penis?

A

Skin conditions

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18
Q

What causes papilloma/genital warts?

A

HPV

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19
Q

How does Balanitis Xerotic Obliterans/Lichen Sclerosus present?

A

White patches on penis

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20
Q

What causes Balanitis Xerotic Obliterans/Lichen Sclerosus?

A

Idiopthic

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21
Q

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

A

Cancer
Paraphimosis
Phimosis

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22
Q

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

A

Differentiated- Non-HPV

Dedifferentiated- HPV

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23
Q

What causes differentiated penile cancer?

A

Non-HPV causes

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24
Q

What causes dedifferentiated penile cancer?

A

HPV

25
Q

What is Paraphimosis?

A

Inability to replace retracted foreskin

26
Q

What can cause Paraphimosis?

A

Having foreskin retracted for too long

27
Q

What is Priapism?

A

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

28
Q

What can cause Priapism?

A
Intracorporeal injection for ED, e.g. papaverine
Trauma (penile / perineal)
Haematologic dyscrasias e.g. sickle cell
Neurological conditions
Idiopathic
29
Q

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

A

Torsion
Lumps
Orchitis
Epididymitis

30
Q

What two forms of torsion are there?

A

Testicular

Appendage

31
Q

What causes testicular torsion?

A

Bell Clapper Deformity

32
Q

What group is testicular torsion most common in?

A

Teens

33
Q

What are some symptoms of testicular torsion?

A
Excruciating pain
N+V
Referred pain to lower abdo
testis high in scrotum
transverse lie
Absence of cremasteric reflex
34
Q

How do you treat testicular torsion?

A

Surgery ASAP!!!

35
Q

What are the symptoms of appendicular torsion?

A

Variable

Blue dot sign

36
Q

How do you treat appendicular torsion?

A

Resolves by itself

37
Q

What are the symptoms of Epididymitis?

A

Similar to torsion

Hx of UTI, urethritis, catheterization/instrumentation

38
Q

How do you treat epididymitis?

A

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

39
Q

What can cause lumps in the testes/scrotum?

A

Hernia- common
Tumours
Cystocoele
Hydrocoele

40
Q

What is cystocoele?

A

Cystic change within the vas of the epididymis

41
Q

What are the symptoms of cystocoele?

A

Asymptomatic

42
Q

What is hydrocoele?

A

Accumulation of fluid around the testes

43
Q

What are the symptoms of hydrocoele?

A

Unicystic
Smooth
Fluid filled

44
Q

What two broad categories of tumour can affect the testes?

A

Seminomatous

Non-seminomatous

45
Q

In what age group are seminomatous tumours usually found?

A

40+

46
Q

What do seminomatous tumours look like?

A

Potato

47
Q

What is a risk factor for seminomatous tumours?

A

Undescended testes

48
Q

How do you treat seminomatous tumours?

A

Radiotherapy

49
Q

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

A

30ish

50
Q

Describe non-seminomatous tumours

A

Aggressive

Metastatic

51
Q

How do you treat non-seminomatous tumours?

A

Chemo

52
Q

What is Fournier’s gangrene?

A

Necrotizing fasciitis in the male genitals

53
Q

What are some risk factors for Fournier’s gangrene?

A

Diabetes
Trauma
Periurethral extravasation
Infection

54
Q

What are some symptoms of Fournier’s gangrene?

A
Starts as cellulitis 
swollen
erythematous
tender
Marked pain, fever, systemic toxicity
Swelling + crepitus of scrotum, dark purple areas
55
Q

What are the two categories of priapism?

A

Ischemic

Non-ischemic

56
Q

Describe ischemic priapism

A

Compartment syndrome of the penis. Penis often painful.

57
Q

Describe non-ischemic priapism

A

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

58
Q

How do you treat priapism?

A

Aspirate blood from penis

Give alpha agonists