Exam 3 Male GU

Question 1

A specific antigen produced by the cells of the prostate capsule and periurethral glands. Increased in both Prostate Cancer and BPH

Answer 1

Prostate specific antigen

<4.0ng/mL is normal

Question 2

If PSA is increased in both BPH and Prostate Cancer, how do you tell which it is?

Answer 2

Serum Acid Phosphatase is elevated when a malignancy has metastisized. Check serum acid phosphatase along with PSA and a digital rectal exam when screening for prostate cancer

Question 3

Finasteride (Proscar)

Answer 3

shrink prostate gland and improve urinary flow
may be combined with doxazosin (Cardura)
5-alpha reductase inhibitors: blocks body’s production of male hormone that causes the prostate the enlarge (DTH)
also treats male pattern baldness

Question 4

Terazosin hydrocloride (Hytrin)
Doxazosin (Cardura)

Answer 4

alpha 1 adrenergic blocker (Blocks NE) to relax veins and arteries, muscles of prostate and bladder neck, making it easier to urinate. also treats htn and may cause dizziness or fainting (may take at bedtime to reduce adverse symptoms)

Question 5

What is significant pt teaching about Avodart?

Answer 5

Do not donate blood until 6 months after final dose

transfusion may go to a pregnant female and cause miscarriage or birth defects; also hepatotoxic

Question 6

Which meds may cause urinary retention?

Answer 6

anticholinergics, antihistamines, decongestants

Question 7

What dietary considerations go with BPH?

Answer 7

increase lycopene (tomatoes and beets, apples and cranberries) 
increase fiber

Question 8

which herb is thought to be helpful in BPH?

Answer 8

saw palmetto

Question 9

What is a nursing consideration for patients receiving epidural or spinal anesthesia?

Answer 9

may cause respiratory paralysis, artifcial ventilation may be required until the effects of the anesthesia wear off

Question 10

what is a disadvantage to a TURP?

Answer 10

only small pieces of the prostrate gland are removed-remaining prostate tissue may continue to grow and cause uriniary obstruction, requiring more TURPS

Question 11

Why is surgery time limited in a TURP?

Answer 11

the nonconducting agent, glycine, can cause damage to surrounding tissue after prolonged exposure. The grounding ESU pad and nonconducting fluid are needed to prevent the electrical current from disturbing surrounding tissues–>TUR syndrome

Question 12

Is TUR syndrome an issue if performing a bipolar TURP?

Answer 12

no, saline can be used for irrigation, no grounding pad or glycine required!

Question 13

Laser prostate surgery benefits?

Answer 13

"Greenlight" or KTP procedure
decreased bloodloss
elimination of TUR syndrome
ability to treat larger glands
ability to treat pts who are actively on anticoag therapy for unrelated diagnoses

Question 14

When do you increase the irrigation fluid rate when using continuous bladder irrigation?

Answer 14

the irrigation rate should be increased when the drainage becomes bright red.

Question 15

What do you treat bladder spasms with (esp. post op of a prostatectomy)?

Answer 15

B&O Belladonna and opium

Question 16

A procedure to check if there are rapidly dividing cells, such as cancer cells, in the bone. A very small amount of radioactive material is injected into a vein and travels through the bloodstream. The radioactive material collects in the bones and is detected by a scanner

Answer 16

radionuclide bone scan

Question 17

a surgical procedure to remove one or both testicles to decrease male hormone production

Answer 17

Orchiectomy

Question 18

Which chronic disease has a high occurrence of ED associated with it?

Answer 18

Diabetes Mellitus-40% of male diabetics have ED

Question 19

what is priaprism?

Answer 19

prolonged erection

Question 20

a slow form of testicular cancer usually found in men in their 30s and 40s. The cancer is usually just in the testes, but it can spread to the lymph nodes. This type is very sensitive to radiation therapy

Answer 20

Seminoma

Question 21

the more common type of testicular cancer tends to grow more quickly and is often made up of more than one type of cell: choriocarcinoma, embryonal carcinoma, teratoma, yolk sac tumor

Answer 21

Nonseminoma

Question 22

Are the testicular tumors called stromal tumors (Leydig or Sertoli) cancerous?

Answer 22

No, and they usually occur in childhood

Question 23

What does presence of beta HCG indicate?

Answer 23

always a malignancy

Question 24

a blood chemistry study, usually part of a liver panel, useful in assessing liver and pulmonary disease. This is produced by ALL TUMORS, and normal range is 48-115

Answer 24

LDH

Question 25

“tells you where on the map!”

this diagnostic lab is not diagnostic on its own, but can differentiate the source for tumor among liver, bone, and germ cell origin. It helps confirm malignancy in a small number of paitents

Answer 25

PLAP

placental Alkaline Phosphatase

Question 26

the medical condition of a male not having any measurable level of sperm in his semen. Many forms are amenable with treatment

Answer 26

azoospermia

Question 27

semem with a low concentration of sperm, a common finding in male infertility

Answer 27

oligospermia

Question 28

constricted prepuce that cannot be retracted over the glans-this is an emergency requiring circumcision

Answer 28

Phimosis and Paraphimosis
tell pt to take a warm bath to allow dressing to loosen
barbiturate sleeping medication

Question 29

what can cause priapism?

Answer 29

thrombosis of veins of corpora cavernosa
leukemia
sickle cell disease
DM
malignancies
abnormal reflex
some drugs

Question 30

How do you treat priapism?

Answer 30

urologic emergency
meperidine
warm enemas
urinary or suprapubic catheterization
large-bore needle or surgical intervention

Question 31

epididymitis

Answer 31

The epididymis is a long, tightly coiled tube located behind each testicle that connects the testicle to the ductus deferens and stores sperm.

Acute epididymitis is inflammation of the epididymis, causing pain and swelling of the scrotum. Most cases are caused by sexually transmitted bacterial infections occurring in men age 19 to 35 years old.

Chronic epididymitis refers to inflammation characterized by persistent testicular pain in the absence of scrotal swelling. This condition is usually more difficult to treat and may result in long-term pain.