Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Met3 > Urology: Testicular cancer > Flashcards

Urology: Testicular cancer Flashcards

1
Q

State 4 risk factors for testicular cancer [4]

A

Undescended testes
Male infertility
Family history
Increased height
Klinefelters syndrome
HIV infection
Infant hernia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Describe the difference classes of testicular cancer [4]

A

Germ cell tumours (95% of cancers):
- Seminomas
- Non-seminomas: including embryonal, yolk sac, teratoma and choriocarcinoma

Non-germ cell tumours:
- include Leydig cell tumours and sarcomas.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Describe the difference in common age of patients between seminomas and teratomas [2]

Describe the difference in aggressiveness between seminomas and teratomas [2]

A

Seminomas: 35-40 year olds; less aggressive
Teratomas: 20-35 year olds; more aggressive

Teratoma: troops; seminoma: seargents

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Describe clinical presentation of testicular cancer [4]

A
  • A painless lump is the most common presenting symptom
  • Pain may also be present in a minority of men
  • Other possible features include hydrocele, gynaecomastia (drastic level of β-hCG)
  • Haematospermia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Name 3 tumour serum markers used to investigate in testicular cancer [3]

A

AFP is elevated in around 60% of germ cell tumours
LDH is elevated in around 40% of germ cell tumours
Seminomas: hCG may be elevated in around 20%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is first line investigation for testicular cancer? [1]
What is second line investigation for testicular cancer used for staging? [1]

A

1st: USS
2nd: CT - staging

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Describe the managment for testicular cancer? [2]

A

Radical inguinal orchidectomy (remove testicle through inguinal canal; not through the scrotum; want to prevents letting cancer cells go into the para-aortic lymph nodes, which drain the testes)

Adjuvant chemotherapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

AFP is raised in which type of testicular cancer? [1]
AFP is not raised in which type of testicular cancer? [1]

BhCG is raised in which type of testicular cancer? [1]
BhCG is not raised in which type of testicular cancer?

A

Alpha-fetoprotein:
May be raised in teratomas
Not raised in pure seminomas

B-hCG:
May be raised in both

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

The common places for testicular cancer to metastasise to are? [4]

A

The common places for testicular cancer to metastasise to are:

Lymphatics
Lungs
Liver
Brain

LLLBean

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Prognosis for testicular cancer? [2]

A

The prognosis for early testicular cancer is good, with a greater than 90% cure rate.

Metastatic disease is also often curable

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Describe the treatment for metastatic testicular cancer [3]

A

Chemotherapy:
- Cisplatin & Etoposide (cornerstone)
- Bleomycin (added)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Describe 4 different stages of testicular cancer [4]

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is liquefaction time? [1]

How long should it normally take in men? []

A

Time taken for semen to liquify after ejacilation

Semen should liquefy within 20 to 30 minutes of ejaculation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Why may an increased liquify time be problematic? [1]

A

If too high, it means the sperm may be unable to make the jump to the cervix. It can be caused by infection and dehydration.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Name and explain which organ is responsible for liquefaction [2]

A

Prostate as it secretes a milky white fluid which contains prostate specific antigen (PSA). PSA is responsible for liquefaction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Label the abnormality pictured in A [1]

A

Bell clapper: (horizontal testes that lie high in scrotum),

17
Q

Describe the presentation of testicular torsion [5]

A
  • bell clapper’ position
  • sudden-onset, sharp, severe, unilateral testicular pain
  • absent cremasteric reflex
  • negative Prehn’s sign (pain that is unrelieved by elevating the affected testis)
  • swollen, tender and erythematous scrotal skin, may also be seen on examination.
18
Q

What is this testicular abnormality? [1]

A

Hydrocele

19
Q

Describe the pathophysiology of hydrocele [4]

A

collection of fluid within the tunica vaginalis that surrounds the testes due to patent processus vaginalis or secondary to trauma, torsion or infection

20
Q

How do you investigate for hydrocele? [1]

A

Transilluminated: by shining torch through the skin, into the fluid (the testicle floats within the fluid)

21
Q

Name this testicular abnormality and how it occurs [2]

A

Varicocele
- pampiniform plexus become swollen
- result of increased resistance in the testicular vein

22
Q

State a serious cause of left sided variocele [1]

A

A left-sided varicocele can indicate an obstruction of the left testicular vein caused by a renal cell carcinoma.

23
Q

State 2 implications of variocele [2]

A

testicular atrophy, reducing the size and function of the testicle

Can lead to impaired fertility (probably due to disrupting the temperature in the affected testicle)

24
Q

Explain what indicates that a variocele warrants further investigation? [1]

A

Varicoceles that do not disappear when lying down raise concerns about retroperitoneal tumours obstructing the drainage of the renal vein.

25
Q

What does this image depict? [1]

A

Epididymal Cyst

26
Q

What causes epididymo-orchitis? [4]

A

Inflammation of the epididymis and/or testicle:
- Chlamydia
- E. coli
- N. gon
- Mumps
- TB

27
Q

How do you investigate epididymo-orchitis?(

A

First catch urine sample
Consider UTI screen

28
Q

What is a positive Prehn’s sign? [1]
Which two pathologies does it help to distinguish between? [2]

A

+ve Prehn’s sign:
- the relief of pain on elevation of the testis

  • Positive: indicates epididymo-orchitis
  • Negative (i.e. the pain is not relieved) in cases of testicular torsion.
29
Q

A 45-year-old man presents with symptoms of urinary colic. In the history he has suffered from recurrent episodes of frank haematuria over the past week or so. On examination he has a left loin mass and a varicocele. The most likely diagnosis is:

Renal adenocarcinoma
Renal cortical adenoma
Squamous cell carcinoma of the renal pelvis
Retroperitoneal fibrosis
Nephroblastoma

A

A 45-year-old man presents with symptoms of urinary colic. In the history he has suffered from recurrent episodes of frank haematuria over the past week or so. On examination he has a left loin mass and a varicocele. The most likely diagnosis is:

Renal adenocarcinoma
Renal cortical adenoma
Squamous cell carcinoma of the renal pelvis
Retroperitoneal fibrosis
Nephroblastoma

30
Q

Which is a key differential when suspect appendicitis (in men)? [1]

A

testicular problems (infection and torsion).

31
Q

Describe the management of testicular torsion [3]

A

Explore with surgial exploration: if positive undergo bilateral orchidopexy:

  • the cord and testis will be untwisted and both testicles fixed to the scrotum,
  • Occurs bilaterally even if presenting with one testicle torsion is because around 90% of cases are caused by a bell-clapper deformity and most of the patients with this deformity have it bilaterally. Bilateral fixation, therefore, reduces the risk of torsion in the other testis.
32
Q

The first-line investigation of a testicular mass is []

A

The first-line investigation of a testicular mass is an ultrasound

33
Q

Describe which parameters of varicoceles determine if treatment is given [2]

A

Grade II or III varicocoele Management:
* Asymptomatic AND normal semen parameters Semen analysis every 1-2yrs
* Symptomatic OR abnormal semen parameters: Surgery

34
Q

nvestigations for suspected epididymo-orchitis are guided by age:
sexually active younger adults: []
older adults with a low-risk sexual history: []

A

nvestigations for suspected epididymo-orchitis are guided by age:
sexually active younger adults: NAAT for STIs
older adults with a low-risk sexual history: MSSU

35
Q

Label the tumour marker for each type of testicular cancer [4]

A

A: hCG & AFP
B: AFP
C: hCG
D: no rise

Met3 (52 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions