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GEM Year 1 Part II > W139 Testes > Flashcards

W139 Testes Flashcards

1
Q

Testicular tumour symptoms

A

painless lump, irregular. late presentation can include cough and back pain

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2
Q

Testicular tumour common cancer types

A

seminomas and teratomas

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3
Q

testicular tumour investigations

A

USS testicle
serum tumour marker a-fetoprotein and b-hcg
chest xray,
CT scan of abdominal and pelvis (to stage)

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4
Q

testicular tumour management?

A

orchidectomy with histology
radiotherapy- Mets below diaphragm
chemotherapy- wide spread Mets
sperm banking

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5
Q

prostate carcinoma symptoms?

A

bladder flow obstruction
pain due to bone metastases
irregular prostate on PR
asymptomatic

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6
Q

prostate cancer type?

A

adenocarcinoma

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7
Q

prostate cancer investigation?

A

trans-rectal USS
PASS test
endo-rectal MRI for staging

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8
Q

prostate cancer management if microscopic?

A

watch and wait

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9
Q

prostate cancer management if NOT microscopic?

A

radical prostatectomy
radiotherapy
synthetic LH analogues if Mets present
bilateral orchidectomy

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10
Q

benign prostate enlargement symptoms

A

nocturnal peeing - nocturia
urine frequency
delay in urine initiation
enlarged but smooth prostate on PR

if bladder outflow obstruction- similar to adenoma

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11
Q

Benign prostate enlargement investigations?

A

serum electrolytes and renal USS to rule out renal damage

serum PSA- can be elevated but must check for adenoma

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12
Q

benign prostate enlargement mild symptom management?

A

watch and wait

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13
Q

benign prostate enlargement moderate to severe management?

A

selective a1-adrenoreceptor antagonists eg. tamulosin

or

5a reductase inhibitors

suprapubic catheter if needed

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14
Q

what does tamulosin do?

A

relax smooth muscle and helps urination

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15
Q

what do 5a reductase inhibitors do?

A

block testosterone to DHT, to slow prostatic growth

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16
Q

what is giant condylomata?

A

hideous warty growth on penis/ ball area

rare aggressive verrucous carcinoma

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17
Q

giant condylomata investigation?

A

biopsy for histology

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18
Q

giant condylomata management?

A

chemotherapy
IFN treatment
surgical excision (best choice)

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19
Q

what is balanitis?

A

inflammation of gland penis

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20
Q

symptoms of balanitis?

A 
inflamed, non retractable foreskin
ulceration
foul smelling discharge
dysuria
impotence
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21
Q

balanitis investigations?

A

blood urine test for diabetes
Swansea for.microscopy (culture and sensitivity to drugs)

if STI potential is high refer to GUM

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22
Q

balanitis treatment

A

hydrocortisone if dermatitis
antibiotics if infective
if recurrent then circumcision

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23
Q

what is phimosis?

A

foreskin of penis can’t be pulled back past glans

24
Q

phimosis investigation?

A

diagnosis on examination and history only

25
Q

phimosis treatment?

A

topical steroids (bethamethasone)
stretch foreskin with balloons
circumcision
slit in foreskin

26
Q

what on earth is ‘lichen sclerosis et atrophicus’?!

A

whitish thickening of foreskin which can’t be retracted

tbh sounds pretty similar to phimosis. blehhh

27
Q

what does lichen sclerosis et atrophicus biopsy show?

A

hyperkeratosis and sclerosis (it’s ball in the name!)

28
Q

lichen sclerosis et atrophicus management?

A

topical steroids

good hygiene

29
Q

wtf is paraphimosis? and main symptom?

A

EMERGENCY

Foreskin trapped behind glans and can’t be reduced. Stops blood flow.

PAIN

30
Q

paraphimosis causes?

A

severe malhandling of penis

also psoriasis and eczema

31
Q

paraphimosis management?

A

prevented by bringing foreskin back to normal position quickly. simples.

manual.manipulation first
then dorsal slit (ouch)
then circumcision

32
Q

what is Peyronie’s disease?

A

chronic inflammation of tunica albuginea

lol you get it from sexual trauma

33
Q

penile cancer symptoms?

A 
redness/rash
bad discharge
pain
growth/sore
bleeding
34
Q

penile cancer type?

A

95% squamous cell carcinoma

HPV, hiv and genital warts strongly related

35
Q

penile cancer investigations?

A 
biopsy
blood test (for what?)
36
Q

penile cancer treatment?

A

surgery- laser, wide, macro, circumcision
radiotherapy
chemotherapy

37
Q

what is cryptorchidism?

A

absence of one or both testes from scrotum at birth

ie. undescended testes

38
Q

crptorchidism investigation?

A

test cremaster retraction (put something cold on scrotum, does it pull up?)

pelvis USS or MRI

39
Q

cryptorchidism management?

A

watch and wait if young

orchiopexy surgery

sometimes hcg injections

40
Q

sebaceous cyst on scrotum symptoms?

A

painless or painful to touch
may or may not have pus

lol

41
Q

treatment of sebaceous ball cyst?

A

surgical removal

or watch and wait

42
Q

what is fourniers gangrene?

A

EMERGENCY

Necrotising fasciitis of the ball/ genital area

grim grim grim

43
Q

testicular torsion symptoms?

A

PAIN in groin and lower abdomen
nausea and vom
pyrexia
swelling and redness

44
Q

what is testicular torsion?

A

EMERGENCY

spermatic cord twists and cuts off blood supply

oh noooo

45
Q

testicular torsion investigations?

A

decreased cremasteric reflex
physical.exam
Doppler USS if in doubt

46
Q

treatment of testicular torsion?

A

manual rotation of simple

or

SURGERY EMERGENCY

47
Q

what is an epidydimal cyst?

A

a faux third testicle

contains serous liquid

usually painless

48
Q

what is a varicocoele?

A

enlargement of venous plexus of scrotum

49
Q

what is a varicocoele?

A

enlargement of venous plexus of scrotum

50
Q

varicocoele symptoms?

A

drag like ache

visible enlarged veins-bag of worms

51
Q

which testicle is usually affected by varicocoele of unknown cause?

A

the left due to anatomy- testicular vein and renal vein connect at 90 degrees on this side

52
Q

varicocoele treatment?

A

surgery

embolisation- obstruct gonadal vein so drainage occurs through collaterals

53
Q

what causes inguinal hernia?

A

failure of embryonic closure of the deep inguinale ring once testes has passed through

or

weakening in wall

54
Q

what is a spermatocele?

A

retention of cyst in a tubule of the rete testis with sperm in it

painless, smooth mass

55
Q

haematocoele what is it?

A

blood.in tunica vaginalis.

does NOT transilluminator apparently

56
Q

symptoms of epididymitis?

A 
pain
swelling
warmth
dysuria
discharge
pyrexia
57
Q

epidydimitis causes?

A

Chlamydia most common
then gonorrhea
also ecoli/ cmv

GEM Year 1 Part II (8 decks)

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