Reproductive Health & Endocrine Cases Flashcards
Tom is a 36y.o. male presenting with right testicular discomfort for 3 weeks. O/E there is a hard lump in the right testicle.
1) What is the most likely diagnosis?
2) What are some differentials and what makes them less likely?
3) What is the prognosis?
Dx:
Testicular cancer
DIFFERENTIALS AND WHAT MAKES THEM LESS LIKELY?
- Testicular torsion – very painful, tender, swollen
- Testicular infection – painful, tende
PROGNOSIS?
- Testicular cancer has very low mortality rate
- Removal of one testicle does not affect fertility
- Chemotherapy may affect future fertility
45y.o. Maggie is having heavy periods for the last 3 months. Her periods are regular but are lasting 2 weeks at a time. She’s felt a dragging sensation in her lower abdomen and has been peeing more frequently.
1) What are the red flags in this case?
2) What are the differential diagnoses?
3) What tests can help confirm the diagnosis?
Red flags
- Older age
- Change in periods
- Period >7 days abnormal
- Dragging sensation/peeing more frequently – symptoms of a mass
Dx
- Dysfunctional uterine bleeding
- Sexually transmitted infection
- Fibroid
- Endometrial cancer
- Ovarian cancer Cervical cancer
Dx Tool
Pelvic US including intravaginal views
27y. o. Lisa is pregnant at 28 weeks. She fell pregnant after trying for 1 year with her partner. She was diagnosed with polycystic ovarian syndrome.
1) What is the impact of polycystic ovarian syndrome on fertility and pregnancy?
- Decreases fertility
- Increases chances of gestational diabetes
- All pregnant women screened at 28 weeks with glucose tolerance test
- Those at higher risk (previous gestational diabetes, PCOS) are screened earlier
- Increases chances of birth complications
Terry is a 41y.o. Aboriginal male with long history of diabetes and subsequent chronic renal failure.
1) What are his health issues?
- Mainly his cardiovascular risk
- Most people with chronic renal failure likely to die from cardiac cause
- His aboriginality and diabetes increases his risk
- Need to protect his kidneys and prevent deterioration
- Need to look for and prevent complications of diabetes
70y.o. Mark is a healthy man with no medical issues. His friend of a similar age has been diagnosed with prostate cancer.
1) What are the risk factors for prostate cancer?
2) What symptoms should Mark look out for?
3) How is prostate cancer screened for in Australia?
Risk factors for prostate cancer?
- Family history
- Age
- Smoking
Look out for?
Haematuria
Prostatism
Weight loss
Prostate cancer screen
Healthy asymptomatic population is NOT screened for prostate cancer
33 y.o. Tina is feeling tired. She’s been diagnosed with iron deficiency anaemia from menorrhagia from her fibroids. You notice she is talking very slowly.
1) Could she have a thyroid condition?
2) How do thyroid conditions impact on fertility and pregnancy?
1) Could she have a thyroid condition?
- Yes
- In this case hypothyroidism and fibroids has caused significant bleeding that she has lost her iron stores leading to anaemia
- The extra clue is that she is talking slowly
2) How do thyroid conditions impact on fertility and pregnancy?
- Lowers fertility
- All women on thyroid replacement need to have their dose increased by 50% immediately when they are known to be pregnant
- Impacts on neurological development
35y.o. Tim is of Vietnamese origin but grew up in Australia. His dad was diagnosed with type 2 diabetes at aged 50, he is overweight. Tim is a gym junkie and exercises 7hours a week. He’s been noticing that he’s lost weight in the last 2 months and is increasingly thirsty and peeing a lot.
1) Could he have diabetes?
2) What increases his risk?
3) What type of diabetes does he have?
1) Could he have diabetes?
Yes, despite his healthy lifestyle his symptoms are suggestive of diabetes
2) What increases his risk?
His family history
His Vietnamese origin
3) What type of diabetes does he have?
Based on his age, type 2
Rarely late onset autoimmune diabetes exist, suspicious of this if his diabetes develops rapidly
