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Genitourinary > GU 2 - Male Conditions > Flashcards

GU 2 - Male Conditions Flashcards

1
Q

MC benign enlargement/tumor of prostate

A

BPH

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2
Q

BPH requires what two things for PE?

A
  1. DRE

2. PSA w/o prostate massaging before testing

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3
Q

Must also perform a _____ to r/o prostatitis in BPH

A

C&S

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4
Q

____ Drug class (ex. ____) to relax smooth muscle of bladder and prostate but DOES NOT reduce the size of the prostate in BPH

A 
Alpha blockers drug class
ex. is Tamsulosin
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5
Q

____ Drug class (ex. ____) to block conversion of testosterone to DHT to reduce the size of the prostate in BPH

A

5-alpha reductase inhibitors

ex. is finasteride

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6
Q

OTC dietary supplement for BPH that is sometimes used with variable efficacy

A

saw plametto

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7
Q

is chronic or acute prostatitis more common?

A

chronic

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8
Q

prostatitis organisms > 35 y/o

A

E.coli, Kleb, Proteus, other GNR

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9
Q

prostatitis organisms < 35 y/o

A

gonorrhea and chlamydia

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10
Q

none organism cause of prostatitis

A

reflux of infected urine back into urethra and into ascending parts usually secondary to cath usage

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11
Q

acute or chronic prostatitis is ASx?

A

chronic

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12
Q

DRE of prostatitis

A

acute: boggy, tender prostate
chronic: enlarged, nontender

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13
Q

ABX duration of prostatitis

A

28 - 30 days

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14
Q

MC prostate cancer type

A

adenocarcinoma

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15
Q

urinary retention, back pain, hematuria, bone pain in a male

A

prostate cancer

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16
Q

Most prostate cancer is ___ in the beginning. (clinical manifestations)

A

ASx

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17
Q

Once the Sx appear for prostate cancer, you start to see _____ sx and it’s quite common for the cancer to have ____.

A

Bone pain sx

common for the cancer to have spread/metastasized to lymph nodes/bones (spine/pelvis)

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18
Q

DRE shows hard, nodular, asymmetrical, irregular prostate

A

prostate cancer

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19
Q

PSA does not = ____

A

prostate cancer

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20
Q

best diagnostic study for prostate cancer

A

transrectal U/S with a biopsy if indicated in different areas of prostate

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21
Q

prostate cancer is a ______ type of cancer

A

slow metastasizing cancer

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22
Q

Patient is > 65 and has prostate cancer. What’s the best way to manage?

A

Watchful waiting

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23
Q

heavy scrotum, herniation into scrotum, filariasis

A

hydrocele

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24
Q

Hydroceles are usually ____

A

congenital

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25
Q

Collection of fluid in serous scrotal space between the layers of tunica vaginalis

A

hydrocele

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26
Q

communicating hydrocele

A

fluid from peritoneum enters the hydrocele and flows back and forth freely

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27
Q

non-communicating hydrocele

A

herniation of thickened cord above testicle on affected side (no free fluid movement)

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28
Q

Hydrocele’s do or do not transilluminate?

A

DO transilluminate

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29
Q

tropical infection with filariasis

A

can cause a hydrocele

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30
Q

transillumination, bag of worms, varicosities

A

varicocele

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31
Q

Varicose veins that drain into internal spermatic veins

A

varicocele

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32
Q

Bag of worms posterior and superior to testes

A

varicocele

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33
Q

round soft painless mass above and behind testicle

A

spermatocele

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34
Q

spermatocele

A

Epidydimal cysts containing sperm (scrotal mass)

35
Q

1) Painless, cystic testicular mass on PE

Round, soft mass at epidydimal head, superior and posterior, separate from testicle

A

spermatocele

36
Q

positive Phern’s sign, Cremasteric reflex

A

epididymitis

37
Q

STI form of epididymitis

A

due to gonorrhea or chlamydia

38
Q

NON STI forms of epididymitis

A

E.coli, Pseudomonas, Kleb

39
Q

lifting testicle decreases pain

this PE test is also + in what condition?

A

Phern’s sign

epididymitis

40
Q

brushing thigh and scrotum lifts

this PE test is also + in what condition?

A

Cremasteric reflex

epdidymitis

41
Q

MUMPS, monocytes, MONO test

A

orchitis

42
Q

Inflammation of testicle commonly from systemic infections like MUMPS

A

orchitis

43
Q

Bell-Clapper defect, Loss of cremasteric reflex & phren’s sign

A

testicular torsion

44
Q

Teenage males following scrotal trauma or physical activity

Can just wake up with it in the AM

A

testicular torsion

45
Q

Testicular U/S with doppler with no arterial flow

A

testicular torsion

46
Q

Rapidly spreading necrotizing infection of scrotum

A

Fournier’s gangrene

47
Q

RF for Fournier’s gangrene (4)

A

DB
obesity
Pelvic trauma
immunocompromised

48
Q

20-35 y/o, AFP, beta HCG tumor markers, CT of head/chest/abdomen/pelvis, painless/firm/hard/fixed scrotal mass

A

testicular cancer

49
Q

Testicular cancer is common in _____ y/o males

A

Common in 20 - 35 y/o males

50
Q

Testicular cancer RF are ____ & ______

A

cryptoorchidism

kleinfelter’s

51
Q

MC testicular cancer type

A

germ cell tumors

52
Q

Two main types of testicular cancer

A

germ cell and non-germ cell tumors

53
Q

germ cell tumors of testicular cancers - comprised of what two categories?

A

seminomas

nonseminomatous

54
Q

Which is MC? Seminomas or nonseminomatous?

A

seminomas

55
Q

What are the four types of nonseminomatous?

A
  1. emryonal carcinoma
  2. choriocarcinoma
  3. teratoma
  4. yolk sac carcinoma
56
Q

Which of the nonseminomatous testicular cancers is MC in young boys?

A

yolk sac carcinoma

57
Q

Which of the nonseminomatous testicular cancers is most aggressive?

A

choriocarinoma

58
Q

Which of the nonseminomatous testicular cancers rarely metastasizes?

A

teratoma

59
Q

Which of the nonseminomatous testicular cancers has a high malignancy and has hemorrhage/necrosis?

A

embryonal carcinoma

60
Q

What are the two subtypes of non-germ cell tumors of testicular cancer?

A
  1. leydig cell tumors

2. sertoli cell tumors

61
Q

Why do a CT scan and/or CXR for testicular cancer?

A

CT scan (metastasize to head, chest, abdomen, pelvis)

CXR (metastasize to chest)

62
Q

Painless mass/lump or firmness of testicle

A

testicular cancer

63
Q

testicular cancer subtype that is hormonally active and common in precocious puberty

A

leydig cell tumors (non-germ cell type)

64
Q

testicular cancer tumor marker of beta HCG

A

seminoma

nonseminoma, subtypes choriocarcinoma and embryonal (embryonal also has AFP)

65
Q

testicular cancer tumor marker of alpha fetal protein

A

nonseminoma, subtypes yolk sac and embryonal (also has beta HCG)

66
Q

testicular cancer tumor marker for teratoma

A

NONE! Its made up of hair, teeth, and nails….

67
Q

low testosterone, androgen deficiency in aging male (ADAM) AKA

A

hypogonadism

68
Q

Clinical presentation for hypogonadism

A

Most are ASx and have no problems

69
Q

Contraindication to testosterone replacement therapy for hypogonadism

A

polycythemia as testosterone thickens the blood (no one with HCT > 55%)

70
Q

Hypogonadism that you decide to treat with testosterone and you see a Rapid rise in PSA in first 3-6 months = ________?

A

early prostate cancer that was preexisting

71
Q

Balanitis

A

Inflammation of superficial tissues of glans

72
Q

Balanoposthtis

A

inflammation of foreskin and glans

73
Q

1) Infections due to poor hygiene, erosion of tissues with erythema and yeast overgrowth

2) Pruritius, tenderness, pain, dysuria, localized edema
Can see ulceration and lymphadenopathy

A

Balanitis/Balanoposthtis

74
Q

MCC of erectile dysfunction

A

decreased arterial flow due to peripheral vascular disease

75
Q

Meds that can cause ED (3)

A

antihypertensives (beta blockers)
antidepressants (TCAs)
opioid analgesics

76
Q

_______ is key neurotransmitter for erectile production

A

Nitric oxide

77
Q

Erection lasting > 4 hours

A

priapism

78
Q

Diagnostics of priapism

A

penile ABG

CBC

79
Q

Dupuytren’s contracture

A

Peyronie’s disease

80
Q

Abnormal curvature and shortening of penis during erection due to scarring of tunica albuginea of the corpora cavernosa

A

Peyronie’s disease

81
Q

Penile cancer peaks in the ___ decade of life

A

seventh

82
Q

penile cancer is linked with HPV strain ___

A

18

83
Q

Penile cancer is very rare in those that are _____

A

circumcised

Genitourinary (5 decks)

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