its raining men

Question 1

BPH

Answer 1

• men > 50
• HYPERPLASIA
• smooth, elastic, firm nodular enlargment of the periurethral (lateral and middle) loves which compress the urethra into a vertical slit

Question 2

BPH symptoms

Answer 2

• increased frequency of urination, nocturne, difficulty starting and stopping the stream of urine and dysuria
• may lead to distention and hypertrophy of the bladder, hydronephrosis and UTI

-increased free PSA

Question 3

treat BPH

Answer 3

a1-antagonists terazosin and tamsulosin

5alpha reductase inhibitor - finesteride

Question 4

Prostatic adenocarcinoma

Answer 4

• > 50 years male
• posterior lobe (peripheral zone)
• increase PSA and needle core biopsy to determine
• Prostatic acid phosphatase PAP and PSA are useful tumor markers
• osteoblastic metastaes in bone may develop in late stages, as indicated by lower back pain and an increase in serum ALP and PSA.

Question 5

Cryptochidism (undescended testis)

Answer 5

• one or both
• impaied spermatogensis (due to temperature too warm)
• can have normal Testosteron (leydig cells are no affected by temp)
• assoc increase risk of germ cell tumors
• assoc prematurity
• decreased inhibin (sertoli cells are sad in the heat), increase FSH and LH,
• testosterone will decrease in bilateral but normal if unilateral

Question 6

variococele

Answer 6

• dilated veins in pampiniform plexus as a result of increased venous pressure.
• most common cause of scrotal enlargment in adult males
• LEFT SIDE because increased resistance to flow due to left gonal vein drainage into left renal vein
• can cause infertility due to increased temperature
• bag of worms appearence
• diagnosed by doppler
• treatment: varicocelectomy, embolization by interventional radiologist

Question 7

tunica vaginalis lesions

Answer 7

lesions in the serous covering of the testis present as testicular masses that can be transilluminated

hydrocele: increased fluid secondary to incomplete obliteration of processus vaginallis
spermatocele: dilated epidymal cyst

Question 8

priapism

Answer 8

painful sustained erection not assoc. with sexual stimulation of desire

assoc. with trauma, sickle cell disease (sickled RBCs get trapped in vascular channels), medications (anticoagulants, PDE-5 inhibitors, antidepressants, alpha blockers, cocaine)

Question 9

squamous cell carcinoma of penis

Answer 9

more common in asia, africa and south america
assoc with HPV, lack of circumcision

insitu lesions before:
bowen disease: penile shaft, presents as leukoplakia
Erythroplasia of queyrat: cancer of glans, presents as erythroplakia
bowenoid papulosis: presents as reddish papules