Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

CM 4 > Male GU > Flashcards

Male GU Flashcards

1
Q

urethral discharge dysuria, abd pain/abnml vaginal bleeding

A

Uretheritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

NAAT or urinalysis/dipstick with positive leukocyte esterase or large amount of wbc

A

urethritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Chlamydia treatment

A

Azithromycin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Gonorrhea treatment?

A

Cetriaxone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

All males with cystitis

A

complicated cystitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

MC pathogen of cystitis

A

E. coli.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Dysuria, bruning, frequency & urgency, hematuria, suprapubic pain, and tenderness.

A

Cystitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Urinalysis/dipstick with pyuria (<10 WBC/hpf), hematuria, leukocyte esterase, nitrites, cloudy urine.

A

cystitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Definitive diagnosis for cystitis

A

Urine culture w/ 100,000 CFUs and exact pathogen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What diagnosis for cystitis do you do for complicated cases

A

urine culture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

First line cystitis treatment

A

Nitrofurantoin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Complicated cystitis treatment

A

Fluoroquinolones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Terrible dysuria treatment

A

phenazopyridine- don’t use for more than 48 hrs and orange pee

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Pregnant cystitis

A

Nitrofurantoin, fosfomycin, augmentin or amoxicillin.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

involuntary urine leakage when the bladder is full

A

overflow incontinence `

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

when bladder detrusor muscle is underachieve or with bladder outlet obstruction (enlarged prostate)

A

overflow incontinence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

MCC of overflow incontinence

A

neurologic disorder or autonomic system dysfunction like MS, spinal injuries, sclerosis/stenosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

loss of urine with no warning and leakage or dribbling in setting of incomplete bladder emptying, weak or intermittent urinary stream, hesitancy, frequency, and nocturia.

A

overflow incontinence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Diagnose overflow incontinence

A

Post void residual > 200 ml

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

First line overflow incontinence

A

intermittent or indwelling catheter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

med to increase detrusor activity

A

Cholinergics (Bethanechol)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

overflow incontinence treatment if enlarged prostate

A

alpha blockers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

involuted leakage of urine with increased abdominal pressure that is greater than urethral pressure

A

stress incontinence aka laugh n pee

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

stress incontinence risk factors

A

young women who have had vaginal deliveries, surgery, estrogen loss, and prostatectomy.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

urine leakage with no urge to urinate prior to leakage

A

stress incontinence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

stress incontinence treatment

A

kegels, lifestyle modification- protective garments, weight losses smoking cessation, drinking less water

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

2nd line stress incontinence treatment

A

Pessaries, surgery (midurethral sling), alpha agonists

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

involuntary leakage preceded by or accompanied by sudden urge to urinate- strong urge to void with inability to make it to bathroom to urinate

A

urge incontinence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

urge incontinence mc in

A

older women

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

cause of urge incontinence

A

detrusor muscle overactivity (involuntary contractions). Occur with increased age and bladder infections.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

increased urgency and frequency, small volume voids, and nocturia.

A

urge incontinence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Treatment for urge incontinence

A

bladder training and Kegels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

First line med treatment for urge incontinence

A

Antimuscarinics (oxybutynin)- antispasmics that increase bladder capacity and they are anticholinergic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

cause bladder relaxation

A

Mirabegron

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

anticholinergic effect and alpha adrenergic agonist

A

TCAs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Surgery for urge incontinence

A

bottom to relax bladder muscle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

bedwetting while sleeping in children 5 y/o or older

A

enuresis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

enuresis primary

A

Absence of any period of time with nighttime dryness. May have a family history. Most common type

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

enuresis secondary

A

Enuresis after a dry period of at least 6 months. Usually due to a stressful event (parental divorce, birth of sibling, etc.)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

First line enuresis

A

motivational therapy, education. Bladder training.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Most effective long term treatment for enuresis

A

enuresis alarm: sensor on bed pad and goes off when wet continued until min of 2 wks of consecutive dry nights

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Desmopression in enuresis

A

nocturnal polyuria with normal bladder function capacity.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Refractory enuresis

A

TCAs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

MC GU cancer

A

Bladder cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

MC of bladder cancer

A

Urothelial (Transitional cell) carcinoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

MC risk factor for bladder cancer

A

smoking, male, over 40 y/o, occupational exposure to dyes, leather, rubber.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

painless int hematuria (often gross), dysuria, urgency and frequency

A

Bladder cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Diagnosis for bladder cancer

A

urinalysis, CT urology, cystoscopy w/ biopsy –> gold standard

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

Treatment for bladder cancer

A

Localized or superficial = tumor resection with f/u every 3 months
Invasive = cystectomy, chemotherapy, radiation
Recurrent = injection of BCG vaccine b/c immune reaction will stimulate cross reaction with tumor antigens

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

increased estrogen or decreased androgens

A

gynecomastia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

gynecomastia risk factors

A

high maternal estrogen, puberty, older males

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

palpable mass of tissue at least 0.5 cm in diameter and centrally located under nipple, symmetrical, tender to plapation

A

gynocomastia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

management for gynocomastia

A

Supportive = stop offending medications
Tamoxifen = selective estrogen receptor modifier that is an estrogen antagonist in the breast
Surgery if refractory to medical therapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

narrowing of lumen due to infection, injury, or surgical manipulation produces a scar that reduces the caliber of urethra

A

urethral strictures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

chronic obstructive voiding sxs (weak urinary cream & incomplete bladder emptying)

A

urethral strictures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

urethral strictures diagnosis

A

Cystourethroscopy (or variation of)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

urethral strictures treatment

A

Dilation or surgical reconstruction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

MC urethral injury

A

men

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

MCC of urethral injury

A

blunt force trauma, pelvic fractures, MVA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

gross hematuria, difficulty urinating, urinary retention, lower abd pain, blood at urethral meatus, swelling or ecchymosis of scrotum, penis or perineum or high riding prostate.

TRIAD: Blood at meatus, inability to void, distended bladder

A

urethral injuryq=

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

urethral injury diagnosis

A

Retrograde urethrogram

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

urethral injury treatment

A

surgery, catheter placement & healing for mild

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

hypospadias

A

ventral placement of urethral opening

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

MCC of hypospadias

A

failure of the urogenital folds to fuse during development

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

increased UTIs, erectile dysfunction, abnml foreskin with incomplete closure around glans, abnml penile curvature

A

hypospadias

66
Q

hypospadias management

A 
Do NOT circumcise while infant - foreskin may be used to repair later
Surgical correction (arthroplasty) which may include penile straightening. Usually performed between 6 months and 1 year
67
Q

epispadias

A

dorsal placement of urethral opening

68
Q

epispadias MCC

A

failure of midline penile fusion

69
Q

upward curvature of penis, absent dorsal foreskin, clitoris w/ two tips, small/laterally displaced labia majora.

A

epispadias

70
Q

epispadias diagnosis

A

prenatal US

71
Q

retracted foreskin that can’t be returned to normal position

A

Paraphimosis

72
Q

Paraphimosis causes

A

forceful retraction of foreskin and can occur after blantitis or penil inflammation

73
Q

severe pain and swelling for penis

A

Paraphimosis

74
Q

Paraphimosis management

A

Manual reduction after reducing edema with cool compresses or pressure dressing
Definitive = incisions (dorsal slit) or circumcision

75
Q

inability to retract foreskin over glans caused by scarring of foreskin after trauma

A

phimosis

76
Q

phimosis management

A 
Proper hygiene (wash that sucker out!), stretching exercises
4-8 weeks topical corticosteroids can increase retractility
Circumcisions for definitive management
77
Q

prolonged painful erection without sexual inflammation

A

priapism

78
Q

priapism causes

A

ischemia (decreased venous outflow)

79
Q

Etiologies of priapism

A

MC- idiopathic, 2nd is sickle cells

80
Q

priapism diagnosis

A

Cavernosal blood gas:
ISCHEMIC (low-flow) = hypoglycemia, hypoxemia, hypercarbia & acidemia
NON-ISCHEMIC = normal
Doppler sono = will show blood flow

81
Q

priapism management of ischemia

A

Phenylephrine (found in Sudafed & Preparation H) via intracavernosal injection (OUCH!). This will cause contraction of the cavernous smooth muscle, which will allow more venous outflow.

Needle aspiration of corpus cavernosum & irrigation to remove blood, especially if erection > 4 hours, with or without phenylephrine, and ice
Surgery if not responsive to above

82
Q

age of diagnosis for penile ca

A

60

83
Q

MC type of penile ca

A

squamous cell, HPV 16, 6, 18

84
Q

risks of penile ca

A

smoking, lack of circumcision, HIV

85
Q

leukoplakia on shaft of penis associated with HPV 16 some will progress to squamous cell carcinoma

A

Bowen’s Disease

86
Q

mass or palpable lesion on penis, mc on clans, coronal sulcus, or prepuce

A

penile cancer

87
Q

cryptorchidism

A

testicle not descended into scrotum by 4 months

88
Q

MC cryptorchidism

A

right side

89
Q

risk factors for cryptorchidism

A

prematurity, low birth weight, maternal obesity or DM

90
Q

empty, small scrotum, inguinal fullness

A

cryptorchidism

91
Q

Cryptorchidism diagnosis

A

Scrotal sono or MRI

92
Q

Cryptorchidism treatment

A

Orchiopexy (bringing down the testes and attaching to scrotum) as early as 4-6 months, ideally before 1 year, must be done before 2 years

93
Q

Cryptorchidism complication

A

testicular cancer

94
Q

serous fluid collection within layers of tunica vaginalis of scrotum

A

hydrocele

95
Q

MCC of what is hydrocele

A

painless scrotal swelling

96
Q

MCC Of hydrocele

A

idiopathic,

97
Q

fluid from abdomen enters scrotum via patent processes vaginalis that failed to close

A

communication hydrocele

98
Q

fluids from mesothelial lining of tunica vaginalis

A

noncommunicating hydrocele

99
Q

painless scrotal swelling often increases during the day

A

hydrocele

100
Q

hydrocele PE

A

translucency (transilluminates), fluids located anterior and lateral to the testes, swelling worse w/ valsalva if it is the communicating type

101
Q

Diagnosis of hydrocele

A

testicular sono

102
Q

hydrocele management

A

Usually no treatment is needed because often resolves spontaneously
Surgical excision may be needed if persists after 1 year old (often occur at birth but resolve within 12 months) or in adults with communicating types to reduce the risk of a hernia.

103
Q

cystic testicular mass of varicose veins

A

varicocele

104
Q

asymptomatic varicoceles usually painless by may cause dull ache or heavy sensation

A

varicocele

105
Q

On left, scrotal mass with bag of worms of spaghetti in bag superior to testicle, dilation worsens when pt is upright or with valsalva, less apparent when the pt is supine or with testicular elevation

A

varicocele

106
Q

varicocele management

A

Surgery in some cases for pain, infertility or impaired testicular growth

107
Q

r sided varicocele due to

A

abd malignancy

108
Q

left side varicocele

A

renal cell carcinoma

109
Q

gradual onset of localized testicular pain and swelling usually unilateral may be associated with fevers, chills, dysuria, urgency & frequency, no n/v.

A

epididymitis

110
Q

MCC in male 14-35 of epididymitis

A

chlamydia or gonorheaa

111
Q

MCC in males of epididymitis

A

e. coli

112
Q

Positive Prehn sign and + cremasteric reflex

A

epididymitis

113
Q

diagnosis of epididymitis

A

Scrotal sono = best initial test; will show enlarged epididymis, increased testicular blood flow (can also rule out torsion)
Urinalysis = check for infection
CT/GC testing

114
Q

epididymitis

A

Scrotal elevation, NSAIDS, cool compresses
If under 35 y/o, treat with….ceftriaxone and azithromycin
If over 35 y/o, treat empirically with Fluoroquinolones

115
Q

painless, cystic testicular mass

A

spermatocele (more than 2 cm) /epididymal cyst (less than 2 cm)

116
Q

soft round mass at head of epididymis, seperate from testicles freely movable transilluminates

A

spermatocele/epididymal cyst

117
Q

scrotal pain, swelling and tenderness

A

orchitis

118
Q

scrotal erythema and tenderness

A

orchitis

119
Q

orchitis treatment

A

Symptomatic - NSAIDS, bed rest, scrotal support/elevation, cool pack

120
Q

orchitis MCC

A

mumps

121
Q

abrupt onset of scrotal, inguinal, lower abd pain, n/v

A

testicular torsion

122
Q

swollen, tender, retracted (high) testicle, may lie horizontally, negative preen sign, negative cremasteric reflex

A

testicular torsion

123
Q

testicular torsion diagnosis

A

Clinical diagnosis -> immediate surgery!
Testicular doppler sono - most commonly used
Emergency surgical exploration (definitive) - preferred over sono if highly suspected!

124
Q

testicular torsion management

A

Urgent detorsion & orchiopexy within 6 hours of pain onset.
Irreversible damage likely if > 12 hours.
Manual detorsion should be done if surgical intervention not available
Orchiectomy if not salvageable

125
Q

MC age for testicular cancer

A

15-25 y/o (avg32)

126
Q

Risk factor for testicular cancer

A

undescended testicle, white, Klinefelter syndrome, hypospadias

127
Q

Seminomas

A

Simple (no alpha-fetaprotein)
Sensitive to radiation
Slower growing
Stepwise spread

128
Q

Nonseminomas

A

Associated with increased serum alpha-fetoprotein & beta-hCG and resistant to radiation.
Yolk sac (MC in boys 10 y/o and younger)
Choriocarcinoma (worst prognosis)

129
Q

Gonadoblastoma

A

testicular lymphom

130
Q

painless testicular mass may have dull pain or testicular tenderness

A

testicular cancer

131
Q

firm hard fixed mass that does no transilluminate

A

testicular cancer

132
Q

testicular ca diagnosis

A

Sonogram - initial test of choice
Tumor markers (what are tumor markers?)
If nonseminoma, increased serum alpha-fetoprotein & beta-hCG a

133
Q

Seminoma, Stage I

management

A

Radical orchiectomy & possible radiation

134
Q

Seminoma, Stage 2

management

A

Debulking chemo followed by orchiectomy & radiation

135
Q

Nonseminoma, Stage I management

A

radial orchiectomy

136
Q

increased frequency, urgency, nocturia, hesitancy, weak or int stream, incomplete emptying & dribbling,

A

BPH

137
Q

diagnosis of bph

A

Digital Rectal Exam (DRE): uniformly enlarged, firm, nontender, rubbery prostate
Prostate Specific Antigen (PSA): correlated with risk of symptom progression. (Normal < 4 ng/mL)
U/A to look for hematuria (or other cause of symptoms)
Urine cytology if at risk of bladder cancer (Smoker)

138
Q

BPH management

A

sxs relief: 1st line- Alpha 1 blockers (Tamsulosin, Terazosin, Doxazosin)
2nd line- 5 alpha reductase inhibitors (finasteride & dutasteride)

139
Q

Alpha-1 blockers: Tamsulosin, Terazosin, Doxazosin

MOA and SE

A

Smooth muscle relaxation of prostate & bladder neck leading to decreased urethral resistance, obstruction relief and increased urinary outflow.
SE = dizziness & orthostatic hypotension

140
Q

5-alpha reductase inhibitors: Finasteride & Dutasteride

MOA and SE

A

inhibits conversion of testosterone to dihydrotestosterone which suppresses prostate growth which decreases size of prostate and decreases need for surgery
SE = sexual dysfunction, decreased libido, breast tenderness & enlargement

141
Q

BPH Surgery

A

If persistent, progressive or refectory despite medical therapy for 12-24 months
Transurethral resection of prostate (TURP) removes excess prostate tissue
Risks = sexual dysfunction, urinary incontinence

142
Q

Men < 35 MCC of acute prostatitis

A

Chlamydia and gonorrhea

143
Q

men > 35 MCC of acute prostatitis

A

e.coli

144
Q

children acute prostatitis

A

mumps

145
Q

fever, chills, perineal pain, lower back or abd pain, increased frequency, urgency, nocturia, hesitancy weak or int stream =, incomplete emptying and dribbling

A

acute prostatitis

146
Q

tender, got boggy prostate

A

acute prostatitis

147
Q

Diagnosis of acute prostatitis

A

Urinalysis & culture = WBC increased, bacteria

Avoid prostatic massage (may cause bacteremia)

148
Q

acute prostatitis management

A

Acute < 35 y/o = Treatment for CT & GC.
Acute > 35 y/o = Fluoroquinolones or Bactrim x 4-6 WEEKS (outpatient); IV fluoroquinolones with or without Aminoglycoside)

149
Q

chronic prostatitis MCC

A

e coli

150
Q

recurrent Otis or int dysfunction, malaise, arthralgia, increased frequency, urgency, nocturia, hesitancy, weak or intermittent stream, incomplete emptying & dribbling

A

chronic prostatitis

151
Q

non tender boggy prostate

A

chronic prostatitis

152
Q

diagnosis chronic prostatitis

A

Urinalysis & culture often normal, so prostatic massage often done (IF and only if you know it is chronic) to increase bacterial yield

153
Q

management of chronic prostatitis

A

Fluoroquinolones or Bactrim x 6-12 WEEKS
If refractory, TURP
Alpha-1 blockers can help with chronic pain

154
Q

2nd mc ca in men

A

prostate cancer

155
Q

MC type prostate cancer

A

adenocarcinoma

156
Q

prostate cancer

A

slow growing tumor of prostate

157
Q

risk factors of prostate cancer

A

Age (>40) & genetics
Black men have higher incidence
Diet (high in animal fat)

158
Q

Most pts are asymptomatic and are dx either abnormal DRE or via workup after abnormal PSA or after invasion of bladder, urethral obstruction or bone involvement
Back or bone pain with METS to bone, weight loss

A

prostate cancer

159
Q

diagnosis of prostate cancer

A 
DRE = hard, indurated, nodular, enlarged, ASYMMETICAL prostate
PSA = above 4 ng/mL (but elevated PSA can be seen with other disorders)

If either of these are “positive,” then a biopsy is typically done:
Transrectal ultrasound-guided needle biopsy = most accurate test
If the PSA is over 10, a bone scan is usually also done, because the most common site of METS is the bone
Gleason grading system is used to determine aggressiveness or malignant potential (higher grade = more benefit from surgical removal of prostate)

160
Q

management of local prostate cancer

A

Observation/surveillance if low risk, clinically localized or life expectancy < 10 years
VS
Definitive treatment with external beam radiation, brachytherapy or radical prostatectomy
Risks of prostatectomy = incontinence and erectile dysfunction

161
Q

management of advanced prostate cancer

A

External beam radiation
Hormonal therapy = androgen deprivation (meds) and/or orchiectomy
Chemotherapy if hormonal therapy is ineffective

CM 4 (9 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions