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Pathophysiology > Class 5 chapter 39 > Flashcards

Class 5 chapter 39 Flashcards

1
Q

Erectile Dysfunction

A

Inability to achieve and maintain erection sufficient to permit satisfactory sexual intercourse

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2
Q

Erectile Dysfunction causes

A

Psychogenic
Organic – most common
Both

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3
Q

Psychogenic erectile dysfunction

A

Performance anxiety
Emotional issues with partner
Depression

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4
Q

Organic erectile dysfunction

A
  1. Neurogenic (Stroke, spinal cord injury, surgery)
  2. Vascular (Hypertension, smoking, DM)
  3. Hormonal (Decreased androgen levels)
    4 Drug-induced (Antihypertensives, nicotine, alcohol, antidepressants, antipsychotics, B-blockers)
    Aging
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5
Q

Erectile dysfunction treatment

A

Psychosexual Counselling
Medication (Androgen replacement, Oral Phosphodiesterase type 5 inhibitors, Intracavernous - injections in penis itself to increase blood flow and maintain erection)
Prosthesis
Vascular surgery

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6
Q

Penile Inflammation/Infection

A

Due to trauma, irritation, infection
Candida albicans, bacteria
Often related to STIs

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7
Q

Penile Inflammation/Infection manifestations

A

Erythema, edema of glans and prepuce
Malodorous discharge
Blanitis xerotica obliterans (uncircumsized, foreskin becomes sclerosed, precursor to cancer)

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8
Q

Priapism

A

Involuntary, prolonged, painful erection d/t impaired blood flow in corpus cavernosa resulting in failure of detumescence

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9
Q

Priapism risk factors

A

Any age

Sickle cell disease, neoplasms

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10
Q

Priapism types

A 
1. Primary 
Happens without cause
2. Secondary 
Hematological, neurological, renal
Medications
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11
Q

Testicular Torsion

A

Twisting of the spermatic cord suspending testes

Extravaginal or Intravaginal

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12
Q

Extravaginal Testicular Torsion

A

More common fetus/neonate

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13
Q

Intravaginal Testicular Torsion

A

Emergency as in tunica vaginalis
Common in teenager d/t testicular growth
Obstructs venous drainage first, then arterial (Edema, pain, nausea)
Often second testes affected or will be
Surgery - fixate testes or orchiedectomy (removal)

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14
Q

Cryptorchidism

A

Failure of one or both testicles to move down inguinal canal into scrotal sac by 7-9 months gestation
Spontaneously descends by 3 months but rarely after 4 months
Abnormal testicular pathology by 6-12 months

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15
Q

Cryptorchidism risk factors

A

Prematurity, small birth weight, genetic if term-baby

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16
Q

Cryptorchidism complications

A

Infertility, testicular torsion, malignancy (high rate), psychological

17
Q

Cryptorchidism treatment

A

Surgery and follow-up screening

18
Q

Prostatitis causes

A

Spontaneous
Instrumentation
Secondary (HIV, DM, urethral strictures)

19
Q

Prostatitis types

A
  1. Acute bacterial (UTI related)
  2. Chronic bacterial
  3. Chronic prostatitis/pelvic pain syndrome
    Most common/least understood
    Inflammatory but not bacterial or non-inflammatory
  4. Asymptomatic inflammatory prostatitis
20
Q

Acute Prostatitis

A

E. coli most common pathogen

21
Q

Acute Prostatitis manifestations

A 
Fever, malaise
Dysuria, frequency
Pelvic aching pain (rectum, perineum)
Malodorous cloudy urine 
Rectal exam – swollen, tender, warm, thick discharge
22
Q

Benign Prostatic Hyperplasia (BPH)

A

Non-malignant enlargement of prostate d/t imbalance between cell proliferation and apoptosis
Common >60 years old
RELATED TO
- Proliferation of prostate cells
- Alpha 2 adrenergic receptors overact
- Detrusor instability & impaired bladder contractility (recent thoughts)

23
Q

BHP Manifestations

A

Prostate enlargement compresses urethra causing (Weak stream, urgency, dysuria, nocturia, overflow incontinence)
Bladder distension causes destructive changes in bladder wall (Hydroureter - more urine in ureter, hydronephrosis -more urine in kidneys, herniations
Infection)

24
Q

BPH Treatment

A
  1. Pharmacologic
    Alpha adrenergic blockers
    Alpha reductase inhibitors block androgens
  2. Herbal therapies
  3. Surgery
    Removal of enlargement (Transurethral prostatic resection (TUPR), Suprapubic, perineal)
    Laser vaporization, microwave, needle ablation
25
Q

Prostatic Cancer

A

2nd most frequently diagnosed cancer in men
Incident increases >50 years of age
Etiology (unclear)
- Familial connection
- Increased dietary fats may alter hormonal balance

26
Q

Prostatic Cancer manifestations

A

Asymptomatic initially
Metastasis to lung reflects lymphatic spread
Migration to bladder not until later
Bone pain (vertebral, rib, pelvis) often first sign d/t metastasis

27
Q

Prostatic Cancer screening diagnosis

A

Digital exam via rectum
Transrectal ultrasound
Prostatic Specific Antigen

28
Q

Prostatic Cancer treatment

A

Surgery
Radical Prostatectomy
Radiation
Hormonal therapy to reduce testosterone levels (Testosterone increases growth of tumour in prostate so tries to reduce)

Pathophysiology (13 decks)

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