Urology Testing Flashcards
Which cells produce testosterone?
Leydig cells stimulated by LH
Single most important test for male hypogonadism
testosterone
Serum total testosterone
Free and protein bound testosterone
Normal 300 - 800
Obesity causes decreased binding
When should testosterone sample be obtained?
8am
If abnormal, repeat 1-2 times to comfirm
If testosterone is low x2
Check LH and FSH
High = primary
Low = secondary
What elevates PSA?
BPH
Prostate CA
Prostatic inflammation or infxn
Perineal trauma
PSA is directly proportional to prostate _____.
Size
Larger in older men and blacks
Meds that reduce PSA
5-alpha-reductase inhibitors (50%)
NSAIDS
Statins (17%)
Thiazides (26%)
PSA Density (PSAD)
Higher in men with BPH
not considered to be specific
PSA Velocity (PSAV)
PSA rate of change over time
Quickly rising suspicious of ca
free/total PSA (PSAII)
Percentage of free PSA decreases as total PSA increases in men with prostate CA
If free PSA is elevated in respect to bound PSA, it is probably being caused by?
BPH
If there is a high level of bound PSA it is likely to be?
Prostate CA
Screening guidelines
50 with no risk
45 with moderate risk (african americans)
40 with higher risk (family hx)
Retested every 2 years if 2.5
Gold standard for significant bacteriuria
Urine culture and sensitivity
