Genitourinary

Question 1

Prostate gland is

Answer 1

an accessory reproduction gland, secretes a milky fluid that makes 30% of semen and contains a clotting enzyme to thicken semen in the vagina.

Question 2

Benign prostatic hyperplasia is

Answer 2

an increase in smooth muscle tone and resistance from prostatic intersitial cells, enlargement of the prostate due to an increase of cell number therefore obstructing the urethra. Occurs >65 years and increased androgen levels

Question 3

Luminal cells produce

Answer 3

Prostate Specific Antigen (PSA) which helps to liquify semen after ejaculation

Question 4

Basal cells and luminal cells rely on

Answer 4

androgens including testosterone (produced by testes) and dihydrotestosterone (produced by the prostate by 5a reductase converting testosterone) for survival

Question 5

5a reductase activity

Answer 5

increases with age but testosterone decreases which can cause hyperplasia

Question 6

stagnation of urine due to BPH

Answer 6

promotes bacterial growth - can cause UTI

Question 7

Patho of BPH

Answer 7

Hyperplasia - enlarged prostrate (static)
Hyperplasia of the smooth muscle tone and resistance (dynamic)
aging and testosterone decreasing and 5a reductase increasing creating an imbalance of growth factor and signalling pathways and epithelia interactions = growth promotion and tissue remodelling.
Creates local inflammation - altered cytokine/ROS
Increased O2 demand causes hypoxia
Remodelled environment with prolonged inflammation
Compresses urether.

Question 8

CM of BPH

Answer 8

Weak and dribble of urine
Strain when urinating
Dysuria (pain when urinating)
Hesitancy urinating,
Sense of incomplete bladder emptying leading to nocturia

Question 9

Diagnosis

Answer 9

digital rectal examination,

levels of Prostate specific antigen (PSA) are increased with BPH not prostate cancer

Question 10

Treatment of BPH

Answer 10

Relieving obstruction and allowing normal urine flow

Question 11

Medications for BPH

Answer 11

5a reductase inhibitor - inhibiting the conversion of testosterone into dihydrotestosterone = dutasteride/finasteride
a1a - antagonists - bind to alpha 1 receptors of the smooth muscle (tamsulosin has greater selectivity for bladder and prostate a1 receptors) Prazosin and Phenoxybenzamine are also a1 antagonists
Combinations : Duodart, Tamsulosin

Question 12

TURP is

Answer 12

Trans Urethral Resection of the Prostate is a surgical procedure to remove part or all of the prostate

Question 13

Does BPH increase the risk of prostate cancer?

Answer 13

Nope

Question 14

During BPH the bladder…

Answer 14

Dilates and hypertrophy

Question 15

Gonorrhea is caused by a gram (-) bacteria

Answer 15

called n.gonorrhaoeae

Question 16

Symptoms of gonorrhoea include

Answer 16

urethritis,
cervitis,
vaginitis, 
purulent discharge - pus colour and smelling
burning when urinating

Question 17

Gonorrhoea initiates inflammation from circulating neutrophils

Answer 17

bacteria releases catalase to inhibit the neutrophils action and causes harmful proteases to be excreted when the neutrophil bursts

Question 18

Syphillis is caused by

Answer 18

Treponema pallidum, gram (-) bacteria can be transferred by bodily fluids, contaminated needles and touching of a leaky chancre

Question 19

Syphillis has three stages

Answer 19

Primary (Localised) forming painless skin chancres - localised to infected area
Secondary - bacteria spreads systemically and is found in the lymph nodes - most infectious stage - lesions present on hands and feet
Latent - asymptomatic - serology confirms
Tertiary - most severe/rare when the bacteria enters organs and creates localised damage such as the heart or spinal cord.

it is a type IV (4) Hypersensitivity

Question 20

Syphillis if reaches the heart can cause

Answer 20

aortitis

Question 21

If syphillis reaches the spinal cord/CNS it can cause

Answer 21

neurosyphilis - deterioration of the brain

Question 22

Common sign of secondary stage syphillis is

Answer 22

rash on hands and feet and swollen lymph nodes

Question 23

Genital herpes is caused by either

Answer 23

Type 1 (HSV-1) or type 2 (HSV-2) Herpes Simplex Virus (HSV)

Question 24

Transmitted via sexual intercourse from

Answer 24

lesion friction against mucosal surface

Question 25

Vertical transmission can be seen with which STIs?

Answer 25

Syphillis, Gonorrheoa and Herpes -

Vertical transmission - direct transmission from mum to baby from the birthing canal