Packet 3

Question 1

malignant cells withing the testicular tissue; germ cell

Answer 1

testicular cancer

Question 2

age prevalence of testicular cancer

Answer 2

20-35 years

Question 3

risk factors of testicular cancer

Answer 3

cryptorchidism, FHx, PMhx

Question 4

symptoms of testicular cancer

Answer 4

a small painless less on testicle (unilateral)
heavy sensation to scrotum
secondary hydrocele
metastasis symptoms: fever, cough, bone pain, weight loss, night sweats

Question 5

PE testicular cancer

Answer 5

nontender mass on testicle
diffuse enlargement of testicle with changes to shape or consistency
inguinal lymphadenopathy
signs consistent of hydrocele

Question 6

Dx tests testicular cancer

Answer 6

serum markers: hcG, alpha fetoprotein, LDH
imaging: scrotal US
surgical evaluation (biopsy) and subsequent staging

Question 7

Treatment testicular cancer

Answer 7

orchiectomy
chemotherapy
radiation
radical surgical intervention (remove lymph nodes and spermatic cord)

Question 8

complications with orchiectomy

Answer 8

infertility and erectile dysfunction

Question 9

testicular self exam

Answer 9

recommended to adolescents (15)

Question 10

benign tumor of the prostate gland resulting in enlargement

Answer 10

benign prostate hypertrophy

Question 11

BPH cause

Answer 11

increased DHT and testosterone causes proliferation of cells

Question 12

BPH risk factors

Answer 12

aging, FHx, african american

Question 13

obstructive sx of BPH

Answer 13

changes in stream
urinary hesitancy
incomplete emptying
straining

Question 14

irritative sx of BPH

Answer 14

nocturia
urgency
frequency

Question 15

PE BPH

Answer 15

DRE- nontender, homogenous enlargement with rubbery consistency
abd exam
external genitalia exam
neuro exam

Question 16

what is and what causes neurogenic bladder

Answer 16

nerves don’t communicate with the bladder
stroke
diabetes

Question 17

Dx Tests BPH

Answer 17

Urinalysis
Labs: PSA, BUN/Creatinine
Transurethral US
biopsy

Question 18

Tx BPH pharmacological

Answer 18

alpha blockers- terazosin (Hytrin), doxazosin (Cardura), tamsulosin (Flomax)
alpha reductase inhibitors- finasteride (Proscar), dutasteride (Avodart)

Question 19

side effects of alpha blockers and alpha reductase inhibitors

Answer 19

alpha blockers: dizziness
alpha reductase inhibitors: erectile dysfunction and decreased libido

Question 20

Tx of BPH nonpharmocological

Answer 20

transurethral prostate resection

Question 21

malignant cells within the prostate gland
most common cancer in men

Answer 21

prostate cancer

Question 22

type 1 of prostate cancer

Answer 22

adenocarcinoma and androgen dependent

Question 23

risk factors of prostate cancer

Answer 23

age, Fhx, Pmhx, African Americans

Question 24

Sx prostate cancer

Answer 24

asymptomatic–found incidentally on PSA or DRE
urinary complaints- hematuria, retention
back pain
metastasis- bone pain, cough, fever, night sweats, weight loss

Question 25

PSA screening

Answer 25

PSA > 4ng/mL: further workup of prostate cancer PSA >10 ng/mL: indicative of prostate cancer screening age 55-69: grade C (certain populations) screening age >70: grade D (don't recommend)

Question 26

Dx tests prostate cancer

Answer 26

urinalysis: RBCs transrectal ultrasound guided prostate biopsy- multiple samples: complications of UTI, bleeding, ED metastasis: CT/MRI/PET

Question 27

prostate cancer staging system

Answer 27

gleason grading system: based on cell differentiation on biopsy results TNM: tumor depth, number of nodes, and metastasis

Question 28

prostate cancer treatment

Answer 28

watchful waiting radiation prostatectomy metastasis: palliative care and symptomatic tx (GnRH agonists: leuprolide acetate (Lupron) or radiation

Question 29

inability to obtain or maintain an erection

Answer 29

erectile dysfunction

Question 30

causes of ED

Answer 30

physical: obesity, DM, HTN, high cholesterol, neurogenic, BPH psychological: stress, depression, anxiety, loss of interest, ED meds

Question 31

Dx tests erectile dysfunction

Answer 31

Labs: lipids, HBA1C, testosterone, LH prostaglandin E1 injection imaging: US or angiography

Question 32

pharmacological tx erectile dysfunction

Answer 32

phosphodiesterase 5 inhibitors: sildenafil (Viagra), tadalafil (Cialis) androgen replacement tx- in hypogonadism intracavernosal injection of prostaglandin E1

Question 33

nonpharmacological tx erectile dysfunction

Answer 33

counseling implants facilitating devices smoking cessation diet and exercise