Repro 4 - Penis And Prostate Pathology

Question 1

What can cause sexual dysfunction?

Answer 1

Drugs: (Antihypertensives, Neuroleptics, SSRIs). Alcohol. Atherosclerosis. Depression. Diabetes. Hyperprolactinemia. Low testosterone. Performance anxiety.

Question 2

What are three mechanisms of Erectile dysfunction?

Answer 2

Failure to initiate (psychogenic, endocrinologic, neurogenic). Failure to fill (atherosclerosis). Failure to store adequate blood volume w/ lacunar network.

Question 3

How do phosphodiesterase inhibitors work?

Answer 3

Inhibit cGMP phosphodiesterase, causing an increase in cGMP, leading to smooth muscle relaxation in corpus cavernosum, causing more blood flow to the penis, making an erection.

Question 4

What are the three types of Bowen disease?

Answer 4

Bowen disease. Erythroplasia of Queyrat. Bowenoid papulosis.

Question 5

What is Bowen disease?

Answer 5

A gray, solitary, crusty plaque on the penile shaft or scrotum. Can occasionally progress to invasive squamous cell carcinoma (Less than 10%). Peak incidence in 5th decade of life.

Question 6

What is Erythroplasia of Queyrat?

Answer 6

Red, velvety plaque usually involving the glans.

Question 7

What is Bowenoid papulosis?

Answer 7

Multiple papular lesions which do not become invasive. Typically affects younger individuals.

Question 8

What is the cause of Condyloma acuminatum?

Answer 8

HPV 6 and 11.

Question 9

What is Peyronie disease And what is the cause?

Answer 9

Angulation of penis. Due to inflammation and fibrous tissue formation of tunica albuginea. Leads to painful erection and dyspareunia.

Question 10

What is balanitis?

Answer 10

Inflammation of the glans penis. 40% due to candida. More common in uncircumcised men and in diabetics.

Question 11

What is the treatment for prostatitis?

Answer 11

Fluoroquinolones, Levofloxacin, TMP-SMT. Treat for 4 weeks.

Question 12

What would be the cause of prostatitis in patients younger than 35?

Answer 12

Gonorrhea. Chlamydia.

Question 13

What would be the cause of prostatitis in patients older than 35?

Answer 13

E.coli. Klebsiella. Serratia. Enterobacter. Proteus.

Question 14

What are the treatments for Benign Prostatic Hyperplasia?

Answer 14

Nonselective alpha1-blockers (Doxazosin, Prazosin, Terazosin). Selective alpha1 A,D blocker: (Tamsulosin). 5-alpha-reductase inhibitors.

Question 15

Where do prostatic adenocarcinoma grow compared to BPH?

Answer 15

BPH grows in the medial and lateral lobe of prostate. Cancer grows in posterior lobe of prostate.

Question 16

Where does Prostatic adenocarcinoma likes to metastasize? What lab marker would be increased as a result?

Answer 16

Likes to metastasize to bone. Alkaline phosphatase will be increased.

Question 17

How does Flutamide differ from finasteride in relation to mech of action and clinical use?

Answer 17

Flutamide inhibits testosterone receptors and is used in prostate cancer. Finasteride is an 5alpha-reductase inhibitor, preventing the conversion of testosterone to DHT. Used in BPH and male-pattern baldness.

Question 18

RFF: Most common cancer in men.

Answer 18

Prostate cancer.