Male Gu

Front 1

In what zone of the prostate are the majority of adenocarcinomas?

Back 1

Peripheral zone

Front 2

In what zones of the prostate does BPH arise? (2)

Back 2

Transitional & periurethral zones

Front 3

Normal glands in the prostate are lined by ___ layers of cells.

Prostatic adenocarcinoma glands in the prostate are lined by ___ layers of cells

Back 3

2

1

Front 4

Growth and differentiation in the prostate is controlled by what hormone, produced from testosterone by what enzyme?

Back 4

Hormone: dihydrotestosterone (DHT)

Enzyme: 5-alpha reductase

Front 5

Patient presents with dysuria, fever, chills, perineal pain. Prostate is tender and soft, neutrophils in prostatic secretions

Back 5

Acute bacterial prostatitis (usu E.coli)

Front 6

Patient is asymptomatic or presents with dysruia, pelvic discomfort, and lower back pain. History of recurrent UTIs. Histology: plasma cells, lymphocytes, macrophages, & neutrophils

Back 6

Chronic bacterial prostatitis

Front 7

Most common form of prostatitis, seen in sexually active men

Back 7

Nonbacterial chronic prostatitis

Front 8

Vague symptoms, may be secondary to surgical manipulation of prostate; may mimic prostatic carcinoma

Back 8

Granulomatous prostatitis

Front 9

Enlargement of the prostate due to proliferation of glands and stroma

Back 9

BPH

or Nodular hyperplasia

Front 10

Prostatic caliculi are seen in...

Back 10

BPH

Front 11

Enlarged, firm-rubbery nodular prostate

Back 11

BPH

Front 12

Prostatic adenocarcinoma that is not clinically significant is called:

Back 12

latent carcinoma

Front 13

Highest incidence of prostatic adenocarcinoma occurs in what race?

Back 13

African-American men

Front 14

2 things that, interestingly, do not contribute to prostatic adenocarcinoma

Back 14

Alcoholism (they have lower testosterone)

Smoking

Front 15

Histologic features of prostatic adenocarcinoma

Back 15

Prominent nucleoli, prostatic crystalloids, blue mucin, and peri-neural invasion

Front 16

What system is used to grade prostatic cancer?

Back 16

Gleason Grade

2 scores, 1-5 each, added together

Front 17

What is the doubling time of prostatic cancer?

Back 17

4 years

Front 18

Men with benign prostatic disease have a free PSA % ______

Men with prostatic adenocarcinoma have a free PSA % ______

Back 18

Benign: greater than 23

Adenocarcinoma: less than 6

Front 19

Screening for prostate cancer begins at age...

Back 19

40 in African Americans

50 in others

Front 20

A precursor of prostatic malignancy

Back 20

prostatic intraepithelial neoplasia (PIN)

Front 21

Most common sarcoma of prostate is.....

Most common prostatic sarcoma of adults (greater than 20 years) is...

Back 21

Overall/under 20: rhabdomyosarcoma

Over 20: leiomyocarcoma

Front 22

Case: sudden onset of right flank pain, radiated to groin, cramps, 10/10

Construction worker

Back 22

Kidney stone!

Front 23

What do you expect to see with a kidney stone in terms of blood/urine?

Symptoms?

Back 23

Hematuria

Possibly high calcium

Normal/high BUN & creatinine

Sx: pain and nausea, vomiting (vagus nerve)

Front 24

How do you adjust blood calcium for albumin level?

Back 24

For every gram% albumin below 4 (4 is normal), you add 0.8 to the calcium

Front 25

Most kidney stones contain ______

80% of those are ________

Back 25

calcium

CaOxalate

Front 26

Stones larger than ____ must be surgically removed

Back 26

9mm

Front 27

A struvite/ ammonium magnesium stone is often seen in ______ and caused by _______

Back 27

Women, proteus mirabellus UTI

Front 28

Bent penis is....

Can be caused by: (3)

The plaques are in which layer?

Treated by?

Back 28

Peyronie's disease

Beta blockers, genetics, trauma

Tunica albuginea

Xiaflex

Front 29

Erection for longer than 4/6 hours is....

Tx?

Back 29

priapism

Tx: surgical intervention or sympathomimetic agent (alpha 1 to decrease blood flow into penis)

Front 30

Scrotum that transilluminates

Back 30

Hydrocele, usually due to trauma, will go away on its own

Front 31

Nursing home patient complaining of "swelling"

Rash with serpiginous edge

Back 31

Yeast infection

Front 32

Whole-body edema

Back 32

anasarca

Front 33

1. Swelling of the glans

2. Swelling of the foreskin that traps the glans inside

3. Swelling of the foreskin that traps it in a retracted position

Back 33

1.Balanitis

2. Phimosis

3. Paraphimosis

Front 34

Firm, painless swelling in one testicle

Most common age/race?

Risks?

Back 34

Testicular cancer

Ages: 20-39

Caucasians

Mumps orchitis, undescended testicle

Front 35

25 y/o HTN

Aching back pain, bilateral, with blood in urine, occasional fever

Back 35

Polycystic kidney disease

Front 36

Back 36

Renal ultrasound of polycystic kidney disease

Front 37

Adolescent boy

Acute testicular pain, precipitated by cold

What test do you use?

What is wrong?

90% cases caused by

Back 37

Testicular torsion

Doppler ultrasound to check for blood flow

Twisted spermatic cord

Caused by congenital malformation of the tunica vaginalis

Front 38

What hurts more when you raise the testicle?

Less?

Back 38

More: testicular torsion

Less: epididymitis

Front 39

45 y/o with painful nut, especially in right superior area

Green discharge, mild dysuria

Back 39

Epididymitis

caused by chlamydia or gonorrhea

Front 40

Warts ...proper name

Caused by?

Back 40

Condyloma accuminata

HPV

Front 41

Back 41

Chlamydia

Front 42

Back 42

Gonorrhea

Gram negative intracellular diplococci

Front 43

Burning rash on genitalia with blisters

Back 43

Genital herpes

Front 44

Painless sore on penis

Back 44

Syphilis (chancre)

Front 45

How to test for primary syphilis?

Secondary?

Tertiary?

Back 45

1: scraping of chancre w/ dark field microscopy

2: VLDR

3: CSF VLDR

Front 46

What is a common manifestation of secondary syphilis? (2)

Tertiary? (5)

Back 46

2: maculopapular rash, especially on palms and feet & flu-like symptoms

3: syphlitic gummas, thoracic aortic aneurism, gait problems, memory problems, pupillary dysfunction

Front 47

Extreme itching

Back 47

Can be uremia from kidney failure

Front 48

What common OTC drug can cause kidney problems?

Back 48

NSAIDS!

Front 49

What lab value changes would you expect to see with worsened kidney failure?

Back 49

Low bicarb (not reabsorbed)

Low calcium

High potassium

High BUN/creatinine

Front 50

Painless hematuria, no accompanying symptoms

Back 50

Renal cell carcinoma

(EVEN if urine screen for malignant cells is negative)

Front 51

What is a normal BUN to creatinine ratio?

Elevated suggests?

Back 51

15:1

Elevated: hypoperfusion, acute kidney injury (pre renal)