Urinary, Hormonal, and Tumor Marker Overview for Medical Students

Hematuria

Presence of blood or red blood cells (RBCs) in the urine.

Glucosuria (Glycosuria)

Presence of glucose in the urine, typically occurring when blood glucose levels exceed the renal threshold (≈ 180 mg/dL).

Pyuria

Presence of pus or white blood cells (WBCs) in the urine, indicating inflammation or infection in the urinary tract.

Salpingitis

Inflammation or infection of the Fallopian tubes.

Balanitis

Inflammation of the glans penis or the head of the penis.

Cystitis

Inflammation or infection of the urinary bladder.

Gynecomastia

Non-cancerous enlargement of male breast tissue caused by an imbalance between estrogen and androgen action.

Acute Mastitis

Sudden, painful inflammation of the breast tissue, most commonly occurring during lactation due to bacterial invasion (frequently Staphylococcus aureus) through a cracked nipple.

Prolactin

Stimulates milk production (lactation) in the mammary glands following childbirth.

Oxytocin

Stimulates uterine contractions during labor and triggers the 'milk ejection' (let-down) reflex during breastfeeding.

Estrogen

Promotes the development and maintenance of female secondary sexual characteristics, regulates the menstrual cycle, and promotes endometrial proliferation.

Progesterone

Prepares the endometrium for egg implantation, maintains early pregnancy, and inhibits uterine contractions during gestation.

Testosterone

Primary male sex hormone responsible for male secondary sexual characteristics, spermatogenesis, libido, and muscle mass maintenance.

Luteinizing Hormone (LH)

Triggers ovulation and corpus luteum formation in females; stimulates Leydig cells in males to produce testosterone.

Renin

An enzyme secreted by juxtaglomerular kidney cells that converts angiotensinogen to angiotensin I, initiating the RAAS pathway to regulate blood pressure and fluid balance.

Antidiuretic Hormone (ADH / Vasopressin)

Increases water reabsorption in the kidney's collecting ducts, concentrating urine and expanding plasma volume.

Follicle-Stimulating Hormone (FSH)

Stimulates ovarian follicle maturation in females and initiates spermatogenesis in Sertoli cells in males.

Gonadotropin-Releasing Hormone (GnRH)

Secreted by the hypothalamus to stimulate the anterior pituitary to release LH and FSH.

Alpha-Fetoprotein (AFP)

Used to aid in the diagnosis and monitoring of Hepatocellular Carcinoma (HCC) and Non-Seminomatous Germ Cell Tumors.

Human Chorionic Gonadotropin (hCG)

Used to aid in the diagnosis and monitoring of Gestational Trophoblastic Disease and Testicular Germ Cell Tumors.

Basal Cell Carcinoma (BCC)

Most common epithelial malignant tumor of the face.

Endometrial Carcinoma

Malignant neoplasm of female genital organs, most common overall in developed nations.

Wilms Tumor (Nephroblastoma)

Solid renal tumor in children.

Papillary Thyroid Carcinoma

Malignant thyroid tumor.

Urothelial Carcinoma

Malignant tumor of the urinary tract.

Germ Cell Tumors

Testicular tumors, specifically Seminoma as the most common single histologic subtype.

Fibroadenoma

Benign tumor of the breast.

Teratoma

A germ cell tumor composed of tissues derived from multiple germ layers (ectoderm, mesoderm, endoderm).

Hydatidiform Mole

An abnormal placental development characterized by swollen, edematous chorionic villi.

Primary Syphilis

Painless Chancre: A single, hard, indurated, non-tender ulcer at the site of inoculation.

Secondary Syphilis

Diffuse Rash: Non-pruritic maculopapular rash involving the palms of the hands and soles of the feet.

Genital Herpes (HSV-2 / HSV-1)

Painful Vesicles: Clusters of small, fluid-filled blisters on an erythematous base.

Cervical Cancer

Early Stages: Frequently asymptomatic.

Symptomatic Stages

Irregular vaginal bleeding, post-coital spotting, foul-smelling vaginal discharge, and pelvic pain.

Advanced cases of Gonorrhea

Cause lower extremity edema or hydronephrosis due to ureteral obstruction.

Purulent Discharge

Thick, yellow-green urethral discharge.

Dysuria

Severe burning pain during urination.

Epididymitis

Testicular pain if infection ascends.

Spontaneous Abortions

Chromosomal abnormalities (fetal aneuploidy, e.g., trisomies).

Thyroid Enlargement (Goiter)

Worldwide: Iodine deficiency. Developed nations: Autoimmune thyroid disease (e.g., Hashimoto's thyroiditis, Graves' disease).

Bilateral Nodularity of Breast in Premenopausal Women

Fibrocystic breast changes (hormonally responsive benign tissue changes).

Acute 'Honeymoon' Cystitis

Staphylococcus saprophyticus (frequently associated with recent sexual activity in young females; E. coli remains the most common overall cause of cystitis).

Prostatic Enlargement in Older Men

Benign Prostatic Hyperplasia (BPH) driven by dihydrotestosterone (DHT) and aging.

Vaginitis (Protozoan)

Trichomonas vaginalis.

Impetigo

Staphylococcus aureus (most common) or Streptococcus pyogenes.

Acromegaly

Growth hormone (GH)-secreting pituitary adenoma.

Urinary Stones (Nephrolithiasis)

Calcium oxalate stones (predisposed by dehydration, hypercalciuria, hyperoxaluria).

Graves' Disease

Autoimmune; TSH receptor-stimulating antibodies (TSI).

Cryptorchidism

Failure of testicular descent into the scrotum during development.

Sheehan's Syndrome

Ischemic necrosis of the anterior pituitary due to severe postpartum hemorrhage.

Cushing's Syndrome

Hypercortisolism (exogenous steroids, ACTH-secreting pituitary tumor [Cushing's disease], or adrenal tumors).

Neuroblastoma

Malignant tumor originating from neural crest cells (adrenal medulla or sympathetic chain).

Endometriosis

Presence of endometrial glands and stroma outside the uterine cavity.

Acute Glomerulonephritis

Immune complex deposition (e.g., Post-Streptococcal GN via Group A Streptococcus).

Screening Mammography

Sensitivity ranges from 75% to 90%, but decreases in women with dense breast tissue.

Core Needle Biopsy

The diagnostic gold standard, offering >98% accuracy for definitive histologic diagnosis, hormone receptor status (ER/PR), and HER2 expression.

Addison's Disease (Primary Adrenal Insufficiency)

Glucocorticoid Replacement: Daily oral hydrocortisone or prednisone.

Hypertension of Chronic Kidney Disease (CKD)

First-Line Pharmacotherapy: ACE Inhibitors (e.g., lisinopril) or Angiotensin Receptor Blockers (ARBs) (e.g., losartan).

Anterior Pituitary Hormones

Growth Hormone (GH), Thyroid-Stimulating Hormone (TSH), Adrenocorticotropic Hormone (ACTH), Follicle-Stimulating Hormone (FSH), Luteinizing Hormone (LH), Prolactin (PRL).

Posterior Pituitary Hormones

Antidiuretic Hormone (ADH / Vasopressin), Oxytocin.