MALE + FEMALE LABS Flashcards
(37 cards)
what test is used to dx prostate cancer
PSA- prostate specific antigen
- predicts course and stage of ds
- helps to dx but NOT used for routine screening
PSA
- used when
- elevated when
correlates with size of prostate
- good for dx and suspicion, not routine screen
- test if still elevated after 2-3 months
- elevated in prostate carcinoma and BPH
- inc after exams or biopsy
testicular cancer
- types and subtypes
- labs
germ cell tumors (MC)
- seminomas
- non seminomatous germ cell
sex cord/stromal tumors
- leydig
- sertoli
LABS
- hCG, AFP, LD (LD-1)
R stays more localized, but L can go further due to venous/lymphatics
bladder cancer
- Sx
- MCC
- Dx/labs
SS
- painless hematuria
- asx, further growth into mucosal layer and blood supply
MCC
- smoking
Dx
- urine cytology for cancer cells
gonadal dysfunction
- define
- what levels are influenced
partial androgen deficiency
- occurs when testosterone levels dec with age (adv age andropause)
- dec testosterone, normal gonadotropin levels (GnRH)
gonadal dysfunction
- SS
- tested when
SS
- mood changes
- sexual dysfunc
- dec RBC production
- dec muscle, hair growth
dx/labs
- tested when SS are present, not routine screening
gonadal dysfunc- partial androgen deficiency
- tx effects
- side effects
tx
- replacement will inc muscle mass, bone mass, protect against falls and reduce bone fractures
side effects
- patho of BPH (inc sx) and prostate ca, dec sperm count, dyslipidemia, inc CAD
DO NOT GIVE TO CAD!!!
gonadal dysfunc
- low v. high LH
low LH–> pituitary or hypothalamic problem
high LH–> secondary cause of low androgen level (meds, hypothyroid, anabolic steroids)
infertility
- define and causes
failure to conceive after 1 yr
causes
- production or blockage issue
infertility testing
semen analysis
- 2-5 days of abstinence
- testing viscosity, completeness of liquefaction, appearance, pH
- motility pattern (beating flagella and progressive motility)
- viability
- sperm agglut/antibodies
MCC of cervical cancer
HPV
- certain strains have higher risk
cervical cancer screening- pap smear
- ages 21-29
- 30-65
- <21 or >65 w/prior screening, and women who have had a hysterectomy
21-29
- GRADE A: screen every 3 yrs w cytology
30-65
- GRADE A: screen every 3 yrs w cytology, every 5 yrs w hrHPV testing alone, OR every 5 yrs with cotesting
<21 or >65 w/prior screening, and women who have had a hysterectomy
- GRADE D: do not screen
pregnancy testing and timing
urine hCG
- 14 days post conception
beta hCG
- 8-11 days post conception
- double every 1.5-2 days for the first 8 weeks
maternal serum screening
test for fetal abnormalities
- neural tube defects
- trisomy 21/down’s
- trisomy 18
maternal serum screening
- 1st and 2nd trimester work up
- 2nd trimester trisomy 18 v. 21 levels
1st (approx 12 wks)
- AFP, hCG, PAPP (pregnancy assoc plasma protein), nucal ultrasound
2nd
- AFP, hCG, estriol, inhibin A
- trisomy 18–> all will appear low
- trisomy 21–> AFP and estriol low, hCG and inihibin A elevated
common fetal abnormalities
- small mouth, jaw
- short neck
- shield chest or short prominent sternum
- wide set nipples
- occiput is prominent
- dysplastic or malformed ears
- clenched hands w overlapping fingers
- flexed big toe, prominent heels
maternal serum screening
fetal DNA screening
- testing for what
- recommended for
testing
- maternal serum
- does not tell of neural tube defects (must use US)
- gender
- chromosomal abnorm
recommended for
- mother >35 yo (geriatric)
- US suggested
- previous pregnancies
- lab abnormalities
ectopic pregnancy
- complications that inc risk
pregnancy outside of uterus
- can cause maternal death
- inc risk with tubal damage (infx), smoking, infertility, previous ectopic preg
ALWAYS work up if susepcting ectopic pregnancy
ectopic pregnancy
- Sx
- work up
- tx
Sx
- low abd pain, vaginal bleeding, adnexal mass
Work up
- transvaginal US, hCG levels (beta doubling time might rise)
tx
- methotrexate or surgical intervention
spontaneous abortion
- contributing factors
miscarriage
- 10-20% of pregnancies at <20 wks
contributing factors
- maternal age, previous, smoking, ETOH, drugs
spontaneous abortion
- potential causes
- secondary to chromosomal abnormalities
- recurrent if 3 or more consecutive
trophoblastic (GTD- gestational trophoblastic ds)
- define
- dx
- tx
ds process of placenta, CAN develop into malignancy
dx
- no fetal heart beat, elevatd hCG, shortened/rapid hCG doubling
tx
- dilation and excision (D&E), follow post surgical hCG to ensure reduction
trophoblasts develop into placental layer
trophoblastic ds hCG post D&E
hCG SHOULD fall to zero
- if it doesnt drop, can indicate there is still presence of trophoblastic tissue or cancer
preeclampsia/eclampsia
- difference in presentation
- additional findings
pre: HTN and proteinuria
eclampsia: HTN, proteinuria, AND SEIZURES
SS
- coagulopathies
- elevated liver enz
- renal failure
- cerebral ischemia
CONTROL SX till delivery
