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Medicine > Prostate and Testicular > Flashcards

Prostate and Testicular Flashcards

1
Q

What is the most commonly diagnosed cancer in males in the UK?

A

Prostate cancer

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2
Q

What is the peak age to be diagnosed with prostate cancer?

A

60-80

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3
Q

What are the definite risk factors for developing prostate cancer?

A

Age
Race
Family history

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4
Q

What are the probable and potential risk factors for developing prostate cancer?

A 
Dietary fat intake
Hormones
Vasectomy
Environment
Diet
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5
Q

Which ethnicities have a higher risk for developing prostate cancer?

A

Caucasian and black males

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6
Q

What are the symptoms of local disease of prostate cancer?

A

Obstructive voiding symptoms
Irritative symptoms
Blocked ejaculatory ducts
Impotence

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7
Q

What are the symptoms of advanced/metastatic prostate cancer?

A

Bone pain
Anaemia
Lymphoedema
Renal failure

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8
Q

What are the indications for performing a PSA test?

A

Lower urinary tract symptoms suggestive of BPH
Abnormal prostate on DRE
Patient concerned about prostate cancer

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9
Q

When should a PSA test not be performed?

A

In presence of retention or infection
Less than 10-year life expectancy
After instrumentation to lower urinary tract (e.g. catheter)

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10
Q

What three methods can be used to detect prostate cancer?

A

DRE
PSA test
Transurethral ultrasound scan

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11
Q

What factors determine treatment of prostate cancer?

A

Gleason grade
TNM stage
PSA level

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12
Q

What can be used to treat skeletal complications in hormone refractory prostate cancer?

A

Bisphosphonates

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13
Q

What do bisphosphonates do?

A

Inhibit osteoclast formation, migration and osteolytic activity
Modulate signalling from osteoblasts to osteoclasts

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14
Q

What are the subtypes of testicular cancer?

A

Germ cell tumours (95%)

Non-germ cell tumours (5%)

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15
Q

What are the two main types of testicular germ cell tumour?

A

Seminoma

Non-seminoma (eg teratoma)

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16
Q

What is the age range of diagnosis of testicular germ cell tumours?

A

15-35

17
Q

What do testicular tumours of older men tend to be?

A

Spermatocytic seminomas

Testicular lymphomas

18
Q

What are the risk factors for testicular germ cell tumours?

A 
Cryptorchidism
Testicular atrophy
Inguinal hernia
Hydrocoele
Syndromes with abnormal testicular development
19
Q

Testicular cancer is associated with being exposed to high levels of what hormone?

A

Oestrogen

20
Q

What is testicular carcinoma in situ?

A

Testicular intraepithelial neoplasia

A precursor for testicular cancer

21
Q

What is the typical symptom that presents with testicular cancer?

A

Painless swelling of the testis

22
Q

10% of testicular germ cell tumours present with metastases. What symptoms would you see with this?

A 
Respiratory symptoms: Haemoptysis, cough
GI: nausea, haemorrhage
Neurological: CNS, PNS
Lumbar back pain
Lower limb swelling
23
Q

How would you investigate a testicular cancer?

A

Physical examination
Scrotal ultrasound
Serum tumour marker blood tests

24
Q

What are the serum tumour marker blood tests that should be done for testicular cancer?

A

Alpha-fetoprotein
Beta-human chorionic gonadotropin
Lactate dehydrogenase

25
Q

Which serum tumour markers are normally elevated in non-seminoma germ cell tumours?

A

Either AFP or beta-hCG, or both

26
Q

Which serum tumour marker is normally elevated in seminomas?

A

LDH

27
Q

What is the treatment for a testicular cancer/tumour?

A

Radical orchidectomy

28
Q

When should a contralateral biopsy be offered?

A

Testicular volume less than 12cc
History of cryptorchidism
Age under 30

29
Q

What are the subclassifications of testicular masses?

A

Intra-testicular

Extra-testicular

30
Q

Which of the two subclassifications of testicular masses tend to be benign?

A

Extra-testicular

31
Q

What can intra-testicular masses be due to?

A 
Malignant primary or secondary tumours
Benign tumours
Infection
Trauma
Torsion
32
Q

What can extra-testicular masses be due to?

A 
Hydrocoele
Epididymal cyst
Spermatocoeles
Varicocoele
Epididymitis/orchitis
33
Q

Why should undescended testes be treated promptly?

A

Prevent atrophy

Maintain fertility

34
Q

What risk do small atrophic testicles carry?

A

Increased risk of malignancy

Medicine (19 decks)

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