Renal - Surgery, Prostate, Penis, Testes

Front 1

Normal growth of prostate under control of _____, made by:

Which Zone?
Chronic prostatis, PCa:
BPH:
Strictures, fibromuscular stroma:

Back 1

Testosterone, DHT
Leydig cells

Chronic prostatis, PCa = peripheral
BPH = transitional
strictures = anterior

Front 2

Bacteria that cause ABP?

S/S?

Abx to treat ABP?

Chronic bacterial prostatis S/S?

Back 2

G-, usually E. coli

perineal pain, fever, urinary pain, frequency

fluoroquinolones, Bactrim, Doxy

chronic: suprapubic pain, low back pain

Front 3

BPH:

T/F: Androgens cause BPH.

T/F: big prostate always means BPH.

Changes in bladder fxn?

Back 3

False

False - inside grows, outside doesn't, or vice versa

more detrusor pressure --> blader can't store --> trabeculations --> weakened detrusor tone --> stream weakness, more residual urine

Front 4

BPH incidence in age 50, 80?

Tx of BPH:
a-blockers?

SE = orthostatic hypotension

SE = retrograde ejaculation, rhinitits, less hypotension:

Less SE's than others, less efficacy:

Back 4

50 = 50%, 80 = 80%

foxazosin, terazosin, tamsulosin, alfuzosin

orthostatic = dox/tera

retrograde = tamsulosin

less = alfuzosin

Front 5

5a-reductase inhibitors:

decreases prostate volume in what time?

SE's?

What supplement makes symptoms worse?

Back 5

finasteride, dutasteride

3-6 mo.

decreased libido, impotence

Zinc - accumulates in prostate

Front 6

Gold standard of BPH?

Indications? (5)

hyponatremia, bradycardia, HTN, confusion:

Back 6

TURP - Transurethral resection of prostate

Pt that fails medical therapy
bladder stones
renal failure
recurrent hematuria
acute urinary retention

TURP syndrome

Front 7

Function of PSA?

How long from PCa dx to detectable mets?

____ male cancer, ____ male ca death

Lifetime risk is 1 in ____.

Annual PSA/DRE should start at age ____.

Back 7

PSA = liquefies semen

10-13 yrs - slow growing

#1 cancer, #2 death

1 in 5

50 y/o

Front 8

Common complication of PCa?

Tx of PCa, low risk?

SE of Tx that's always there post surgery?

Back 8

osteoblastic disease, lytic lesions

Low risk: active surveillance, radical prostatectomy, androgen deprivation therapy (castration)

infertility/aspermia

Front 9

SE's of androgen deprivation?

Prostate Ca risk factors?

What % is sporadic?

T/F: Vasectomy/smoking are risk-related.

Back 9

male menopause

family hx
black ethnicity
high fat diet (?)

90%

False

Front 10

uncircumcised men, can't retract the prepuce:

turtleneck syndrome, prepuce behind glans:

Fibrous induration of penis, causes curvature, painful erection:

angiofibromas, normal:

Back 10

phimosis

paraphimosis

Peyronie's disease

Pearly penile purpura

Front 11

Viral-related derm lesions, which viruses?

Histologic carcinoma in situ, but clinically benign, HPV 16 associated:

Mitotic figures on path, keratinocytes, cytological atypia:

Back 11

HPV 6,11

Bowenoid papulosis

SCC in situ

Front 12

erythematous plaque on penis:

erythematous plaque on scrotum, adjacent skin:

verrucous carcinoma, doesn't mets, local invasion, CAN'T USE RADIATION THERAPY:

Risk factors include HPV 16 infection, # of partners, smoking, UV light to genitalia:

Back 12

Bowen's disease

Queyrat's disease

Buschke-Lowenstein tumor

SCC

Front 13

Make androgens, stimulated by LH:

Make MIS, stimulated by FSH:

Varicocele more likely on which renal vein?

Varicocele on R side, not L:

Back 13

Leydig cells

Sertoli cells

L renal vein

kidney cancer

Front 14

cryptorchidism incidence by age 1:

surgical emergency, deficient affixation of testicle to scrotum:

solid gray/white tumor, normal AFP, large polygonal cells, distinct cell borders (fried egg):

Back 14

1%

testicular torsion, fix within 6 hrs

seminoma

Front 15

infants/children, yellow/pale, Schiller-Duval bodies:

only HCG, never AFP, 20-30 y/o, extensive necrosis, worst prognosis:

25-35 y/o, >1 germ cell layer involved, no AFP/HCG, resistant to chemo/radiation:

Back 15

yolk sac tumors

choriocarcinoma

teratoma

Front 16

10% malignant, secretes andogens, estrogens; Reinke crystals:

effect on pre-pubertal boys, adults?

Tumor markers?

if suspected tumor, which surgery?

Complication of trans-scrotal orchiectomy?

Back 16

Leydig tumors

pre-pubertal = growth
adults = feminization

bHCG, AFP, LDH

radical inguinal orchiectomy

changes lymphatic drainage