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USMLE

Goljan Renal Path 3

QuestionAnswer
patient with increased urinary frequency, has positive leukocyte esterase, dysuria, neutrophils in urine, negative bacterial culture, negative nitrites. what is diagnosis? Chlamydia
causes of sterile pyuria? chlamydia, TB
most common cause of transitional cell carcinoma of bladder? smoking
cyclophosphamide is used to treat what? Wegener's & Minimal Change Dz (also RA)
cyclophosphamide toxicity is prevented by what? Mesna
hypospadias is caused by what? failure of closure of urethral folds
most common cancer of penis is what? What is most common cause? squamous cell carcinoma due to lack of hygiene in uncircumcised penis. (shmegma)
what are two phases of testicular descent? tans-abdominal migration caused by mullerian inhibitory factor, and shortening of gubernaculum due to testosterone and dihydrotestosterone
undescended testicles before 2 years increased risk for what? seminomas in both testicles (even if appears normal)
streak ovaries put woman at risk for what? dysgerminomas
epididymitis at age <35 due to what? neisseria gonorrhea, chlamydia
epididymitis at ages >35 due to what? pseudomonas, E. coli
vericocoeles on what side and why? left, due to the spermatic vein on left is connected to left renal vein.
most common cause of male infertility vericocoele
what would happen if you block left renal vein? increases pressure on spermatic vein and causes vericocoele.
torsion of spermatic cord causes what? shortens the cord, so the testicle ascends into inguinal canal; pain; loss of cremasteric reflex
what is cremasteric reflex? scratching of scrotum causes the cremaster muscle to contract
hydrocoele is what? persistence of tunica vaginalis
painless enlargement of testicle has what on it's differential? cancer, cancer, cancer, cancer
most common cause of testicular cancer seminoma --> highly responsive to radiation
where do seminomas metastasize? para-aortic LNs
most common testicular tumor in kid? what's the tumor marker? yolk sac tumor (Alpha fetoprotein)
25 y/o male presents with unilateral gynecomastia and dyspnea. X-ray of lung shows numerous nodular masses. Where is the primary tumor and what kind? choriocarcinoma of testicle
why do choriocarcinomas develop gynecomastia? B-HCG is a leutinizing hormone analog --> acts like leutenizing hormone, so stimulates progesterone and causes duct growth in breast tissue
most common cause of testicular cancer in older men? malignant lymphoma metastaces
where in prostate gland does hyperplasia occur? periurethral area
where in prostate gland is cancer located? periphery (that's why you can feel it with your finger on rectal)
75 y/o man has urinary retention and massive bladder with dribbling urine. what is cause? BPH.
what hormone is totally responsible for prostate? dihydrotestosterone
BPH and prostate cancer is under the control of what hormone? dihydrotestosterone
how do you treat prostate cancer and BPH 5-alpha-reductase inhibitor
most common cancer in men? prostate cancer
Created by: Asclepius