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GU Survey 9Q > GU Final > Flashcards

GU Final Flashcards

1
Q

How much calcium consumption per day is linked to prostate cancer?

A

Over 1000mg/day

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2
Q

What is increased PSA indicative of?

A

Prostatitis
BPH
Adenocarcinoma of Prostate

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3
Q

Does Saw Palmetto increase PSA?

A

No

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4
Q

What age group is recommended to have a PSA and DRE routinely?

A

50 and above

Earlier with symptoms or risk factors

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5
Q

What ethnicity group is recommended to have a PSA and DRE routinely?

A

Hispanic

African American

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6
Q

What risk group is recommended to have a PSA and DRE routinely?

A

Smokers
Obese
Ejaculation 4x qw

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7
Q

What are the risk factors for prostate disease?

A 
Age > 50
Race
Fam Hx
Diet (high fats, sedentary lifestyle, obese)
Vasectomy
smoking
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8
Q

What are the symptoms of BPH?

A

-85-90% w/o Sx
-Difficulty initiating urine stream
-Interruption of stream
-Urinary frequency
-Urinary urgency
-Nocturia
Rectal exam -Non tender, soft, boggy

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9
Q

What are the symptoms of prostate cancer?

A
  • Often silent
  • 15-20% found in transurethral resection that is done for BPH
  • Blood in urine or semen
  • Pain/stiffness in back/hips/upper thigh/pelvis
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10
Q

What are the risk factors for prostate cancer?

A
  • Age > 50
  • Race
  • Fam Hx
  • Diet (high fats, sedentary lifestyle, obese)
  • Vasectomy
  • smoking
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11
Q

How do you manage prostate cancer?

A 
A) Tx determined by stage
- Hormone therapy
1) Antiandrogens
-Suppress estradiol and testosterone production
2) Viadur
-Medicated implant
B) If bone mets
- Fosamax
C) Radiation Therapy
D) Surgery
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12
Q

What values are considered low risk for prostate cancer?

A

PSA < 10
Gleason < 6
Stage T1c, T2a

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13
Q

What values are considered intermediate risk for prostate cancer?

A

PSA 10-20
Gleason 7
Stage 2b

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14
Q

What values are considered High risk for prostate cancer?

A

PSA > 20
Gleason 8-10
Stage T2c

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15
Q

What is the etiology of prostadynia?

A
  • Unknown
  • May be due to muscle spasm
  • Like nerve entrapment
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16
Q

What is the treatment for prostadynia?

A

Finestride

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17
Q

Are all scrotal masses cancerous or precancerous?

A

Usually benign

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18
Q

Are testicular or scrotal masses more malignant?

A

testicular

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19
Q

How do you evaluate scrotal/testicular masses?

A

Palpation

Transillumination

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20
Q

What are the different scrotal masses?

A
  • Hydrocele
  • Varicocele
  • Inguinal Hernia
  • Epididymitis
  • Orchitis
  • Testicular Cancer
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21
Q

Which of the testicular/scrotal masses transilluminate?

A

Hydrocelle

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22
Q

What is the function of the testes?

A
  • Produce sperm

- Secrete hormones such as testosterone

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23
Q

What are the common symptoms of testicular cancer?

A
  • Unilateral enlargement or change in way it feels
  • Painless lump or swelling or collections of fluid
  • Dull ache in back, groin or lower abdomen
  • Gynecomastia &/or mastalgia
  • Testicular discomfort/pain or feeling of heaviness
  • Occasionally, initial Sx related to METS to lungs, abdomen, pelvis or brain
  • Sometimes no Sx at all
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24
Q

What are the risk factors of testicular cancer?

A
  • Cryptorchidism
  • Genetic (ie: Kleinefelters)
  • Caucasian – 5 times incidence
  • Family Hx
  • HIV
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25
Q

How related to penile cancer is circumcision?

A

Circumcision decreases chance for penile cancer but since penile cancer has low incidence it is not a routine procedure and up to the parents

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26
Q

How related to penile cancer is HPV?

A

Low risk factor, only certain strains of HPV

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27
Q

How related to penile cancer is testicular cancer?

A

Cannot find information, but do not believe they are related

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28
Q

How related to penile cancer is prostate cancer?

A

Cannot find information, but do not believe they are related

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29
Q

What age group is most affected by penile cancer?

A

> 50 y/o

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30
Q

What are the AAP recommendations about male circumcision?

A

Medical benefits not sufficient to recommend routine circumcision

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31
Q

What is leukoplakia?

A

Hyperkeratotic, scaly, white patches of penile epithelium, biopsy necessary

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32
Q

What is condyloma?

A

A painless, enlarging, warty-like growth in HPV

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33
Q

What are squamous cell cancers of the penis?

A

Skin cancer

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34
Q

What is Bowen’s Dz?

A

An intraepidermal (pre)cancerous indurated erythematous plaque; ulcerated center; development of pinkish or brownish papules covered with a thickened horny layer; biopsy is necessary

35
Q

What is priapism?

A

Neurotic sustained painful erection with acute onset

36
Q

What is Peyronie’s?

A

Plaque’s /strands of dense fibrous tissue surrounding the corpus cavernosum -> deformity & painful erection; impotence

37
Q

What is Posthitis?

A

Inflammation of the prepuce

38
Q

What is Phimosis?

A

Condition where the male foreskin cannot be fully retracted from the head of the penis

39
Q

What are the causes of male sexual dysfunction?

A
  • Drugs
  • Blood flow abnormalities
  • Nerve abnormalities
  • Hormonal abnormalities
  • Psychological
  • Depression
  • Stress
  • Performance anxiety
  • Misinformation about sexuality
40
Q

What is andropause?

A

Low androgen levels

  • Testosterone
  • Dehydroepiandrosterone
  • androstenedione
41
Q

What is low in androgen deficiency?

A
  • Testosterone
  • Dihydrotestosterone
  • Low DHEA
42
Q

What is androgen deficiency not associated with?

A

Low FSH

43
Q

What has an antiaromatase effect and decreases symptoms of andropause?

A

Zinc

44
Q

What are the risk factors of UTI?

A
  • Sexual Activity
  • Hygiene
  • Hormones
  • BMI
  • Low fluid intake
  • Delayed voiding
  • GU anomalies, stones, BPH
  • Catheterization
45
Q

How do you prevent UTI’s in Women?

A
  • Cranberry
  • Hydration
  • D-mannose
  • Lactobacillus
  • Topical E3
46
Q

How do you prevent UTI’s in Men with BPH?

A
  • Urinate frequently
  • Saw palmetto
  • Cranberry
  • Hydration
  • Lactobacillus
47
Q

What is the treatment for UTI?

A

Antibiotics:

  • Macrobid,
  • Septra ds
  • ciprofloxacin
48
Q

What is the treatment for cystitis?

A
  • Bladder distention
  • Pentosan polysulfate sodium
  • Aspirin/ibuprofen
  • Tricyclic antidepresants
  • Antihistamines
  • Narcotic analgesic
  • Calcium channel blockers
  • Immune suppression
  • Heparin
  • Hyaluronic acid
49
Q

What UA results are expected with a UTI?

A 
A) Dipstick
-RBC
-Proteinuria
-Leukocyte Esterase
-Nitrites
B) Microscopic
->10 wbc/hpf
-Too numerous to count bacteria
50
Q

What causes interstitial cystitis?

A 
A)No known cause
B)Theories
-Infectious
-Autoimmune
-Mechanical injury
-Mast cell activation
-Alteration in bladder lining
51
Q

Is surgery recommended for interstitial cystitis?

A

No

52
Q

Do diet changes help some patients with interstitial cystitis?

A

A) Yes, but there is no scientific evidence linking diet to IC
B) Sx increased possibly by
-Artificial sweeteners
-Alcohol, Tomatoes, Spices, chocolates, caffeinated, citrus beverages, acidic foods

53
Q

What are the risk factors for urinary tract cancer?

A

-***Smoking
-Age
-Chronic bladder inflammation
(Recurrent, UTI, urinary stones)
-Consumption of aristolochia fangchi
(Botanical for weight loss)
-High saturated fat diet
-External beam radiation
-Fam Hx of bladder cancer
-Gender (male)
-Infection with Schistosoma Haematobium
-Race (caucasian)
-Tx with certain drugs (cyclophosfamide – to tx cancer)

54
Q

What are the symptoms of UT cancer?

A
  • Hematuria
  • Frequent urination
  • dysuria
55
Q

What are the symptoms of pelvic prolapse?

A
  • Menstrual cramps
  • Pulling in pelvis
  • Constipation
  • Urinary incontinence
  • Low back pain
  • Decrease in symptoms when lying
56
Q

What hormone deficiency predisposes a person to pelvic prolapse?

A

Estrogen

57
Q

What are the causes of incontinence?

A

Neurologic disorders from CNS, spinal cord & peripheral nerves

58
Q

Which age groups does pelvic prolapse affect?

A

Postmenopausal

59
Q

What conditions can a UA be used to screen?

A
  • Kidney dz
  • UTI
  • Bladder Dz
  • Diabetes
  • Liver Dz
  • Starvation/diet
  • Illness/infection
  • Hepatitis
60
Q

What does a UA detect?

A
  • Color
  • pH
  • Specific gravity
  • Leukocyte Esterase
  • Ketones
  • Nitrite
  • Protein
  • Blood
  • Glucose
  • Bilirubin
  • Urobilinogen
61
Q

How do u detect proteinuria?

A

UA

62
Q

What is the next step after a single positive test for proteinuria?

A
  • Wait two weeks and perform again, if confirmed then:

- CMP (Comprehensive metabolic panel), BUN, Creatinine, Albumin

63
Q

What are the DDx’s for proteinuria?

A

A) Renal
-UTI, nephrolithiasis, acute kidney failure, glomerulonephritis, nephrotic syndrome, renal METS
B)Functional
-Fever, exercise

64
Q

Is proteinuria present with UTI’s?

A

sometimes

65
Q

Hematuria is ________ unless proven otherwise.

A

cancer

66
Q

If hematuria is found, when should you retest?

A

-2 weeks?
-Further work up
Microscopic
Cystoscopy
IVP
CT/US

67
Q

Hematuria is a symptom of what conditions?

A
  • Stone
  • Infection
  • Trauma
  • Tumor
  • Medications
68
Q

Urinary casts are associated with?

A

Kidney infection of some sort – there are many types and many casts

69
Q

What are the stages of chronic renal disease?

A

1) Stage 1
- Kidney damage w/ normal GFR
2) Stage 2
- Kidney damage w/ mild
- decrease GFR (60-89)
3) Stage 3
- Moderate decrease GFR (30-59)
- Anemia & bone problems
4) Stage 4
- Severe decrease GFR (15-29)
- Dialysis or transplant
5) Stage 5
- Kidney Failure (GFR <15)
- Dialysis/transplant

70
Q

What are the symptoms of chronic renal disease?

A
  • Fatigue
  • Poor concentration
  • Poor appetite
  • Insomnia
  • Nocturnal muscle cramping
  • Peripheral & periocular edema
  • Dry, itchy, skin
  • Increased frequency, nocturia
71
Q

What are the UA findings in chronic renal disease?

A
  • Proteinuria
  • Hematuria
  • Creatinine clearance f’d up
  • GFR decreased
72
Q

How is GFR calculated?

A

Via creatinine clearance

73
Q

What systemic disease can cause kidney damage?

A
  • DM

- Hypertension

74
Q

What hormones are produced by the kidney?

A
  • Erythropoietin
  • Renin
  • Calcitriol
75
Q

What are the diet/lifestyle changes required for kidney disease?

A
  • Limit protein
  • Limit cholesterol
  • Decrease smoking
  • Decrease sodium
  • Decrease potassium
76
Q

What are the dietary recommendations for patients with kidney stones?

A
  • Low purine diet
  • Low oxalate diet
  • Increase fluids
77
Q

What is the treatment for kidney stones?

A
  • Ultrasound
  • Wait (which sucks)
  • Surgery
78
Q

What increases the risk of urinary stones?

A
  • Pregnancy
  • Urinary tract abnormalities
  • Southern US Diet
  • Foods
  • Weight
  • Stress
  • Bedridden
79
Q

What are the differences between male and female in reference to urinary stones?

A

1) Men DDx
- Testicular torsion, pyelonephritis, acute prostatitis, appendicitis, pancreatitis,
2) Female
- Ovarian cyst, ovarian torsion, ectopic pregnancy, pyelonephritis, appendicitis, pancreatitis

80
Q

Do all urinary calculi require emergency intervention?

A

No

81
Q

What are the symptoms of urinary calculi?

A
  • Sudden onset acute pain, flank pain radiating to groin, back flank pain
  • Location travels with stone
  • Local pain w/o rebound tenderness
  • Dysuria, urinary urgency & increased fq
  • CVA tenderness
  • Hematuria
  • Diarrhea, nausea/vomit, diaphoresis
82
Q

What imaging is used for urinary calculi?

A
  • KUB (supine abdomen)
  • Non contrast Spiral CT
  • IVP
83
Q

What is a KUB used for with calculi?

A

Determine size, shape and location

GU Survey 9Q (2 decks)

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