Flashcards in Diagnostic Testing Deck (65)
Hormones in Gonadal Function
Symptoms of Testosterone Deficiency
Decreased muscle mass
Decreased body hair
What is the single most important diagnostic test for male hypogonadism?
Test to Measure Testosterone
Serum total testosterone
What is measured with serum total testosterone
Protein bound testosterone
Issues when Sex Hormone Binding Globulins (SHBG) is Increased & Less Free Testosterone
Issues when Sex Hormone Binding Globulins (SHBG) is Decreased & More Free Testosterone
When should one measure a testosterone level?
8 AM when testosterone levels are the highest
If testosterone is low twice, what should you measure next?
What is the disorder if testosterone is low and LH & FSH is high?
What is the disorder if testosterone is low and LH & FSH are not elevated?
Liver or kidney disease
Causes of Primary Hypogonadism
Causes of Secondary Hypogonadism
Benign tumors & cysts
Prostate specific antigen
Where is PSA secreted from?
Epithelial cells of the prostate
Liquefy semen in the seminal coagulum to allow sperm to swim freely
Causes of Elevated PSA
Prostatic inflammation or infection
Perineal trauma: bike riding, sexual activity, DRE (rare)
What is elevated PSA an indirect measurement of?
Prostate glandular size in men without cancer
Values increase with age
Causes of Decreased PSA
Medications that Reduce PSA
5-alpha-reductase inhibitors (50% reduction)
PSA & Prostate Cancer
Determine extent of cancer
Response to treatment
Screening method for detection??
What is most important for PSA values?
The trend of the individual
Parameters of PSA
PSA density (serum PSA/prostate volume)
PSA velocity (change in PSA over time)
Free/Total PSA (PSAII)
PSA Density (PSAD)
Levels higher in men with BPH
Higher PSAD indicates greater likelihood of cancer
How is PSAD measured?
Volume (size) of the prostate with a TRUS and divides the PSA number by the prostate volume
Define PSA Velocity (PSAV)
Rate of change in PSA over time
How is PSA velocity (PSAV) measured?
Transrectal prostate biopsy
Disorder with Free PSA Elevated Compared to Bound PSA
Disorder with High Level of Bound PSA
Likely prostate cancer