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Year 1 Medicine > Week 138 - Testicular Lump > Flashcards

Week 138 - Testicular Lump Flashcards

1
Q

What is Orchidopexy?

A

Surgery for undescended testicle

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2
Q

What does the Dartos Muscle do?

A

Responsible for wrinkling scrotum when cold

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3
Q

What does the Cremaster Muscle do?

A

Draws Testicles in - cold

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4
Q

Where does the arterial supply to testicle arise?

A

Testicular Arteries from Aorta at L2

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5
Q

What is the venous drainage of testicle?

A

Pampiniform Plexi to Lt Renal Vein (Left) & IVC (right)

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6
Q

What do Sertoli Cells do?

A

Epithelial cells of tubules

Acted on by FSH –> nourish sperm through development

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7
Q

What do Leydig Cells do?

A

Secrete testosterone (in response to LH)

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8
Q

What is Rete Testis?

A

Network of tubules where fluid reabsorbed & sperm concentrated

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9
Q

What is the arterial to the scrotum?

A

It is from Internal Pudendal Artery from Internal Iliac Artery

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10
Q

What is the likely cause of an acutely painful testicle in a 17 year old?

A

Testicular torsion (if no sexual/trauma history)

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11
Q

Where is a testicular tumour likely to metastasise?

A

Para-aortic nodes

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12
Q

What is the function of the Bulbo-urethral glands of Cowper?

A

Lubricate the Urethra

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13
Q

What is the commonest malignant tumour of testis?

A

Seminoma

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14
Q

What conditions do cryptorchid testis predispose an individual to?

A

Testicular Malignancy
Testicular Torsion
Inguinal Hernias

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15
Q

What do the secretions of the seminal vesicles contain?

A

Fructose, Vit C, prostaglandins, fibrinogen and vesiculase

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16
Q

What does the Prostate Produce?

A

Citric acid, acid phosphatase, fibrinolysin

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17
Q

What three cylinders does the penis consist of?

A 
Corpora cavernosum (x2) - erectile vascular tissue
Corpus Spongiosum - surrounds penile urethra + forms glans penis
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18
Q

What are the two main types of germ cell tumours in the testis?

A 
Seminomas
Nonseminomas (5 subtypes: teratomas, yolk sac tumour)
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19
Q

At whay age are Seminomas rare?

A

Before 10

Over 60

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20
Q

What are the risk factors for Testicular Germ Cell Tumours?

A 
Cryptochidism
Testicular Atrophy
Inguinal Hernia
Hydrocoele
Syndromes with abnormal testicular development
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21
Q

What effect can mumps have on the testicles?

A

Atrophy

10% of men with germinal cell tumours have h/o mumps

22
Q

What are the tumour markers that can be tested for in testicular cancer?

A

AFP, β-hCG, LDH

23
Q

If AFP is elevated as a tumour marker, what type of tumour is that suggestive of?

A

Non-seminoma

24
Q

What tumour marker is elevated in 30% of seminomas?

A

β-hCG

25
Q

Where is β-hCG also produced?

A

Trophoblastic tissue in placenta

Upper GI, bladder and bronchial carcinomas

26
Q

Apart from NSGCTs, what can AFP be a marker for?

A

Hepatocellular carcinoma

27
Q

Are intra or extra testicular masses generally benign?

A

Intra testicular = gen. malignant

Extra testicular = gen. benign

28
Q

What secondary tumours are likely to present as intra-testicular masses?

A

Lymphoma - older men

Leukaemia - children

29
Q

What are the likely causes of Extra-testicular masses?

A 
Hydrocoele
Epididymal cysts
Spermatocoele
Varicocoele
Epididymitis/ Orchitis
30
Q

What is the chemotherapy used for the treatment of testicular cancer?

A

BEP (bleomycin, etoposide & cisplatin)

31
Q

What is the mechanism of action of Cisplatin?

A

Form adducts with DNA leading to strand breaks

32
Q

What is the mechanism of action of Etoposide?

A

Topoisomerase inhibitor

33
Q

Name a few Antimicrotubule agents

A

Taxanes (paclitaxel, docetaxel)

Alkaloids (vincristine, vinblastine)

34
Q

Name a few anthracyclines and what they do

A

Doxorubicin, Epirubicin

Intercalate in the DNA molecule -> block topoisomerase action

35
Q

Name a few anti-metabolites and what they do

A

Fluorouracil - mimic uracil

Methotrexate - inhibits enzyme in folate synthesis

36
Q

What is Trastuzumab?

A

Herceptin, acts on cErbB2 (HER2)

37
Q

What receptor does Pertuzumab act on?

A

cErbB2 (HER2)

38
Q

What receptor does Cetuximab act on?

A

EGFR

39
Q

What does Bevacizumab (Avastin) act on?

A

VEGF

40
Q

What is Imatinib?

A

TKI, BCR-Abl

41
Q

What is neo-adjuvant therapy?

A

Therapy before radical local treatment

To reduce extent of surgery/ make surgery possible

42
Q

What is adjuvant therapy?

A

After radical local treatment, to increase change of cure

43
Q

What are the common toxic effects of chemotherapy?

A

Bone Marrow Toxicity (neutropenic sepsis, anaemia)
GI toxicity
Cardiac Toxicity (antracyclines, trastuzumab)
Pulmonary, Reproductive

44
Q

What medication can be used to reduce the effects of cancer on bone?

A

Bisphosphonates (pamidronate, ibandronate, zoledronic acid)

RANK-ligand inhibitors (denosumab)

45
Q

If patient has elevated PSA, abnormal DRE or both, what is the next step in management of the patient?

A

Test urine - to rule out UTI, repeat PSA

Refer to urologist (TRUSS and Biopsy)

46
Q

What is the Gleason’s Pattern Scale useful for?

A

Staging prostate cancer (histologically)

Jelly Beans -> squashed jelly beans -> No structure

47
Q

What are the treatments available for the treatment of prostate cancer?

A

Radical prostatectomy +/- hormone ablative therapy
Radical radiotherapy +/- hormone ablative therapy
Brachytherapy (internal radiotherapy)

48
Q

What are the treatments available for men presenting with metastatic disease subsequent to prostate cancer?

A

Based on hormone dependence of prostate cancer
Orchidectomy
Anti-androgens
LHRH analogues

49
Q

What is the effect of bisphosphonates on bone?

A

Inhibit osteoclast formation, migration & osteolytic activity

50
Q

What area of the prostate does BPH arise from?

A

Transitional zone

51
Q

What area of the prostate does prostate cancer most commonly arise from?

A

Peripheral zone

Year 1 Medicine (12 decks)

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