Diseases and Disorders of the Male Reproductive system

Question 1

What is the function of the male reproductive system?

Answer 1

produces, trasfers and introduces sperm into female reproductive tract

Question 2

What are the parts of the male reproductive system?

Answer 2

penis - deposits sperm into female reproductive tract (body of penis is called the shaft, slightly bulging head is called the glans penis, loos skin covering penis forms the prepuce or foreskin)
scrotum - saclike structure that hangs behind the penis

Question 3

What doees the glands in the foreskin secrete?

Answer 3

waxy substance called smegma that collects btwn glans penis and the foreskin

Question 4

What happens during sexual arousal?

Answer 4

3 cylinders of erectile tissue fill the shaft of the penis

during sexual arousal these tissues fill with blood, causing penis to enlarge and become erect

Question 5

What testes do?

Answer 5

reside inside the scrotum and produce sperm

reside outside of body bc sperm production requires a temp lower than the rest of the body

Question 6

What are the seminiferous tubules?

Answer 6

sperm-producing factories within the testes

travel via male reproductive duct system (epididymis, ductus deferns, and urethra)

Question 7

What is semen?

Answer 7

viscous, white secretion with a slightly alkaline pH that contains sperm and accessory gland secretions

typical ejaculate contains abt 1 tsp of semen and contains btwn 40 and 100 million sperm

sperm live for 24-72 hrs in female reproductive tract

Question 8

What do the accessory glands include?

Answer 8

(they produce the most semen)

seminal vesicles - paired sacs located at the base of the bladder and produce roughly 65% of the fliud part of semen (thick, yellowish fluid that nourishes and activates the sperm)

prostate gland - sits just below the bladder and encircle the urethra and produces roughly 30% of the fluid portion of smeen, secretes a thin, milky fluid that enchances sperm motility and neutralizes the acidity of the male urethra and of the woman’s vagina

bulbourethral gland - tiny glands located below the prostate gland and produce roughly 5% of the fluid portio of semen, secrete a clear fluid into urethra during sexual arousal that serves as a lubricant for sex and neutralizes the acidity of residual urien in the urethra

Question 9

When does testosterone secretion begin?

Answer 9

begins approx 2 months after conception

during last 2 motnhs of gestation testosterone normally cause the testes to descend into the scrotum

Question 10

when does puberty starts for guys

Answer 10

testerone is barely detected in bodys by the age of 4-6, puberty

puberty is at 13, started by secretion of GnRH by hypothalamus which triggers secretion of FSH and LH by the anterior pituary gland

LH prooompts the testes to secrete testerone (1st sign of puberty in males is enlargement of testes) and FSH stimulates sperm production

Question 11

what does increased testosterone do?

Answer 11

e promotes the development of
secondary sex characteristics including pubic, axillary, and facial hair; darker and thicker
skin; increased activity of oil and sweat glands; deepening of the voice; enlargement of skeletal muscles; and an increase in bone growth and
density.

Question 12

What does physical exam of the male reproductive system?

Answer 12

visual exam of the external genitalia

palpate tumor to determine the presence of tumor

digital rectal exam (DRE) allows physican to palpate the prostate gland

Question 13

What are other tests that can be tested for the prostate?

Answer 13

Prostate-specific antigen (PSA) - cells of the prostate gland can be measured to determine the risk for prostate cancer and benign prostatic hyperplasia

urodynamic testing - assesses how well bladder and urethra r stroring and releasing urine

cytoscopy - used to view the urethra and bladder

biopsy, x-rays, MRI, CT scan and PET scan, urinalsysis and hormone testing

Question 14

What is prostatitis?

Answer 14

inflammation or infection of the prostate gland

10-12% of men experience prostatisis-like symptoms

affects mostly young and middle age

caused by gonococci from pt with gonorrhea, Staphylococcus, Streptococcus or Pseudomonas

Question 14

4 categories of prostatisis?

Answer 14

1. acute bacterial prostatitis
2. chronic bacterial prostatitis,
3. chronic prostatitis (chronic pelvic pain syndrome)
4. is asymptomatic inflammatory prostatitis

Question 15

what are risk factors for prostatitis?

Answer 15

a past episode of prostatitis
an infection in the bladder or urethra
pelvic trauma
dehydration
using a urinary catheter
unprotected sexual intercourse
having HIV/AIDS.

Question 16

s/s of chronic bacterial prostatitis, chronic prostatitis, and asymptomatic inflammatory prostatis ?

Answer 16

• Chronic bacterial prostatitis:
- slow onset of signs and symptoms resembling acute
bacterial prostatitis that wax and wane
• Chronic prostatitis:
- resembles chronic bacterial prostatitis, without fever
• Asymptomatic inflammatory prostatitis:
- usually found during exam for
another condition and may not require treatment

Question 17

s/s of acute bacterial prostatis prostatitis?

Answer 17

based on category

Acute bacterial prostatitis:
- sudden onset of fever and chills
- flulike symptoms
- pain in the prostate gland, lower back, or groin
- urinary problems (including increased urinary urgency and frequency, difficulty or pain when urinating, inability to completely empty the bladder, and blood-tinged urine
- painful ejaculation

Question 18

How to diagnose and treat prostatitis?

Answer 18

diagnose - medical history, physical exam, DRE, culture, urinalysis, blood culture, WBC, ultrasonography, cytsoscopy and urodynamic testing

treat - OTC pain relievers, several wks of treatment with antibiotics (for bacterial prostatis), smooth muscle relaxants for urination problems for chronic prostatis

Question 19

how to prevent prostatis?

Answer 19

practing good hygiene
maintianing adequate hydration
early diagnosis and treatment for infections

Question 20

What is epididymitis?

Answer 20

inflammation of the epididymis

600,000 cases of epididymitis in men btwn age 18-35

etiology : STIs (gonorrhoeae, trachomatis), other infections )E. coli, pseudomonas), heart medication amiodarone, TB, urine in the epididymis ( UTIs), tuberuclosis, mumps, prostatectomy, trauma, prolonged use of indwelling catheter

Question 21

risk factors for epididymitis?

Answer 21

multiple sex partners
personal history of an STI
past prostate or urinary tract infections
uncircumcised penis
anatomical abnormality of the urinary tract
prostate enlargement
medical procedures that affect the urinary tract (surgery, catheter, and cystoscopy)

Question 22

s/s of epididymitis

Answer 22

tender, swollen, red or warm scrotum
testicle pain and tenderness (usually on one side)
painful urination or an urgent or frequent need to urinate
painful intercourse or ejaculation
chills or fever
lump on testicles
enlarged lymph nodes in groin
pain or discomfort in lower abd or pelvic area
discharge from penis
blood in semen

Question 23

How to diagnose and treat epididymitis?

Answer 23

diagnose - physical exam, urinalysis, urine culture, urethral swabs for chlamydia and gonorrhea, elevated WBC count, DRE, STI testing, ultrasound, and PET scan of testicles

treatment - antibiotics, OTC pain relievers, bed rest, elevation and application of ice packs to scrotum to relive s/s and swelling

Question 24

how to prevent epididymitis?

Answer 24

- abstinence - monogamy - use of latex condoms - early diagnosis and treatment for infections

Question 25

What is orchitis?

Answer 25

inflammation of the testes occurs 20-35% of men with mumps (10% of these cases have condition in both testicles) (may follow epididmyitis)

Question 26

risk factors for orchitis?

Answer 26

not being immunized against mumps, recurring urinary tract infections, surgery that involves genital or UT, being born with an abn in urinary tract, multiple sex partners, sex with a partner who has an STI, unprotected sex, personal history of STIs

Question 27

s/s of orchitis?

Answer 27

testicular swelling on one or both sides, pain ranging from mild to severe, tenderness in 1 or both testicles, nausea, vomiting, fever, chills, general malaise, and penile discharge

Question 28

how to diagnose and treat orchitis?

Answer 28

diagnose - physical exam, STI testing, urinalysis, ultrasound and PET scan (doppler ultrasonography) treatment - symptomatic, OTC pain relivers, bed rest, elevation and application of cold packs to scrotum (if bacterial than antibiotics)

Question 29

How to prevent orchitis?

Answer 29

vaccination against mumps, abstinence, monogamy, use of latex condom and early diagnosis and treatment for STIs

Question 30

What is cryptorchidism?

Answer 30

no disease but is a failure of testes to descend from abd cavity (where they develop) into scrotum 3% of full-term male newborns have undescended testicles at birth 30% of premature male newborns have at least 1 undescended testicle (testicles descend during abt 8th month of gestation) etiology is unknown but hormones r suspected

Question 31

In over ___% of people being seen for cryptorchidism, the testes descend by the third month, and by age 1, ___% of all undescended testes have descended into the scrotum

Answer 31

50 80

Question 32

major s/s, risk factors, and etiolgy of cryptorchidism

Answer 32

s/s - not being able to feel 1 or both testicles in scrotum risk factors - low birth wt and premature birth etiology - abn testicular development (testicles have short spermatic artery, poor blood supply or both)

Question 33

how to diagnose and treat cryptorchidism?

Answer 33

visual exam, palpating the scrotum and abd to locate the testicles, ultrasound, MRI, laparoscopy and hormone and genetic testing treat - often descend spontaneously during 1st yr of life, if not by 4 then surgical manipulation (orchiopexy) or hormonal drug therapy (beta-human choriionic gonadotropic (b-hCG) or testosterone)

Question 34

What is testicular cancer?

Answer 34

cancer in or both testicles most common in men 20-35 (33 is avg) risk factors: crytporchidism, abn testes development, family or personal history of testicular cancer

Question 35

testicular cancer stats?

Answer 35

2013: 7,920 cases of testicular cancer will be diagnosed and 370 men will die from testicular cancer in the United States

Question 36

s/s and etiology of testicular cancer?

Answer 36

lump on a testicle that is painless testicular enlargement or swelling sensation of heaviness or achinig in lower and or scrotum few have acute pain or gynecomastia symptoms of advanced disease include enlarged lymph nodes in neck, dyspnea or cough, anorexia, bone pain, lower extremity swelling etiology - cryptorchidism, historyt of testicular cancer, previous GCT(s), infertiltiy, HIV infection, Down and Klinefelter syndrome

Question 37

how to diagnose and treat testicular cancer?

Answer 37

diagnose - medical history, physical exam, ultrasound, CT, chest radiography, radical orchiectomy, serum tumor marker tests (alpha-fetoprotein, lactate dehydrogenase, beta-human chorionic gonadotropin), radical inguinal orchiectomy (surgery to remove a testicle) and biopsy, imaging tests treat - surgery, radiation therapy, chemo (NSGCTs r chemosensitive and Seminomas r radiosensitive) and stem cell transplant

Question 38

survival rate?

Answer 38

5 yr relative survival is 95% if cancer has not metastasized outside the testicle than 5 yr survival rate is 99%

Question 39

what happens to males as they grow older?

Answer 39

pubic hair thins and grays external reproductive genitalia acquire a wrinkled and sagging appearance due to decrease in elasticity testerone levels decline = estes decrease in size sperm count decreased increased stimulation needed for erection

Question 40

What is a common problem in older males?

Answer 40

enlargement of the prostate glands (benign prostatic hyperplasia (BPH)) affects 60% of men in 60s and 80-90% of men in 70s and 80s risk factors r age, family history of enlarged prostate

Question 41

s/s BPH?

Answer 41

less than 1/2 of all men with BPH r symptomatic dribbling at the end of urinating inability to urinate incomplete emptying of the bladder incontinence needing to urinate two or more times per night pain with urination bloody urine slowed or delayed start of the urinary stream straining to urinate strong and sudden urge to urinate weak urine stream

Question 42

WHat is a metabolite of testosterone?

Answer 42

Dihydrotesterone BPH is directy dependent on DHT

Question 43

How to diagnose and treat BPH

Answer 43

diagnose - medical history, DRE, urine analysis, culture, PSA blood test, ultrasound, urodynamic testing & cystoscopy treatment - watchful waiting, meds such as alpha blocker to relax smooth muscle in prostate and increase urinary flow, hormone therapy to block conversion of testosterone to DHT and surgery

Question 44

What is prostate cancer?

Answer 44

malignant tumor that forms in tissue of the prostate gland etiology is idiopathic (testosterone stimulates growth of prostate tumor cells)

Question 45

prostate cancer stats?

Answer 45

in 2013 approximately 238,590 cases of prostate cancer will be diagnosed 29,720 men will die from prostate cancer in the United States. An estimated 1.1 million men were diagnosed with prostate cancer 307,000 died of prostate cancer worldwide in 2012

Question 46

What is the 2nd leading cause of cancer death in men?

Answer 46

prostate cancer (behind lung cancer)

Question 47

risk factors for prostate cancer?

Answer 47

age (over 65), family history of prostate cancer, race (more common in AA), certain prostatic changes (prostatic intraepithelial neoplasia), mutations in BRCA1 or BRCA2 and diet high in animal fat

Question 48

s/s of prostate cancer?

Answer 48

may be asymptomatic not being able to pass urine having a hard time starting or stopping the urine flow needing to urinate often especially at night weak flow of urine urine flow that starts and stops pain or burning during urination difficulty having an erection blood in the urine or semen frequent pain in the lower back, hips, or upper thighs

Question 49

how to diagnose and treat prostatic cancer?

Answer 49

diagnose - DRE, PSA, ultrasound and biopsy treatment - prostate cancer grows v. slowly so some men don't need treatment (active surveillance), other options r surgery (radical prostatectomy, orchiectomy), radiation therapy brachytherapy (direct implantation f radiation source into prostate) and chemo, Androgen deprivation therapy (ADT), surgical or medical orchiectomy, need to decrease testerone (orchiectomy), meds to decrease testerone, block uptake of testerone by tumor cells or stop testosterone production by adrenal glands

Question 50

What is the 5 yr survival rate for prostate cancer?

Answer 50

100% for local and regional prostate cancer 31% for distant prostate cancer

Question 51

What is erectile dysfunction (ED)?

Answer 51

impotence, aka inability of male to achieve and maintain an erection sufficient for sex primary ED - man has never been able to complete sex successfully secondary - man has been able to have intercourse at least once

Question 52

stats of ED?

Answer 52

More than 18 million men in the United States age 20 and over suffer from ED. As men age, their risk for ED increases dramatically: 70% of men age 70 or over report erectile problems, compared with 5% of men age 20–40.

Question 53

etiology of ED?

Answer 53

sexual arousal increases bloodflow to penis and compresses veins carrying blood away from penis, causing reection caused by medical conditions that restrict blood flow to penis such as diabetes, kidney disease, neurological disease, vascular disease, smoking, hypercholsterolemia, and prostate cancer treatment, neurologic elements may interput impulse transmission btwn CNS and penis

Question 54

how to diagnose and treat ED?

Answer 54

diagnose - medical history, physical exam, blood tests (CBC, liver and kidney function test, lipid panel, thyroid function test, blood hormone studies), urinalysis, ultrasound, overnight erection test, psychological exam treat - meds to increase blood flow to erectile tissue by relaxing smooth muscle of the penis, other treatments r testeosterone therapy, surgery, penis pump or implant, external vacuum devices, penile injection therpay, therapy, and treatment for underlying condition

Question 55

What are STIs?

Answer 55

sexual transmitted infections (STIs) r infections spread by sexual contact (includes unprotected oral, anal or vaginal intercourse) caused by bacteria, viruses and protozoans

Question 56

STIs stats?

Answer 56

The CDC estimates 20 million new STIs occur each year in the United States, almost half of them among people ages 15–24. STIs cost the United States health care system an estimated $16 billion annually.

Question 57

what can undetected STIs do?

Answer 57

have serious consequences like infertility, PID, cervical cancer, and adverse pregnancy outcome

Question 58

risk factors of STIs?

Answer 58

unprotected sex, muliple sex partners, a history of STIs, being under 25, sexual contact under influence of drugs or alc

Question 59

how to prevent + diagnose STIs?

Answer 59

prevent : abstinence, monogmay, condom use diagnose : staining, culture, DNA test, and antigen or antibody testing

Question 60

Gonorrhea?

Answer 60

transmitted through sexual contact and during childbirth etiology - gram-negative coccus bacterium Neiserria gonorrheae

Question 61

gonorrhea stats?

Answer 61

Less than half of these infections are reported to the CDC (334,826 in 2012). WHO estimates 62 million people are infected with gonorrhea annually worldwide

Question 62

s/s for gonorrhea?

Answer 62

50% of men and women r asypmtomatic men - burning sensation when urinating, a white, yellow or green discharge from the penis, or painful or swollen testicles women - painful or burning sensation when urinating, increased vaginal discharge or vaginal bleeding btwn periods

Question 63

What can gonorrhea do to a person?

Answer 63

women - common cause of PID men - epididymitis (can lead to infertility) newborn - blindness, joint infection, or a life-threatening blood infection (to prevent erythromycin is routinely placed in the eyes of newborn babies)

Question 64

how to diagnose and treat gonorrhea?

Answer 64

DNA testing (nucleic acid amplification, nucleic acid hybridization), culture from infected site, enzyme-linked immunosorbent assay, or Gram stain treat - injection of antibiotic + oral antibiotic

Question 65

what is syphilis?

Answer 65

transmitted through sexual contact, direct contact with a syphilis chancre and during childbirth primary stage is appearance of 1 or more chancres where Treponema pallidum enter body (chancres r small, painless, firm, round lesions lasting 3-6 wks and heal w/o treatment) secondary stage is when priamry lesions heal and spirochete Treponema pallidum disseminiates through the body, nonitchy, widespread rash that may appears rough, red, or reddish-brown spots late syphilis appears 10-15 yrs after infection (brain, nerves, eyes, heart, bv, liver, bones, and joints r damaged)

Question 66

syphilis stats?

Answer 66

In 2012, 15,667 cases of primary and secondary syphilis were reported to the CDC In the United States, men having sex with men accounts for 75% of syphilis cases. The WHO estimates that more than 12 million people are infected with syphilis annually worldwide

Question 67

s/s of secondary syphilis

Answer 67

fever, fatigue, headache, sore throat, patchy hair loss, wt loss, muscle aches, fatigue, swollen lymph nodes

Question 68

s/s of late stage of syphilis?

Answer 68

gummas (lesions) have invaded body organs and systems, causing widespread damage to point of being debilitating and life threatening difficulty corrdinating muscle movements paralysis numbness gradual blindness dementia

Question 69

congenital syphilis?

Answer 69

transmitted to the fetus via the placenta 50% of these pregnancies result in stillbirth or neonatal death kills more than 1M each yr worldwide

Question 70

s/s of congenital syphilis?

Answer 70

rash, fever, irritabilty, failure to thrive, saddle nose

Question 71

syphilis etiology?

Answer 71

gram-negative spirochete bacterium Treponema pallidum

Question 72

how to diagnose and treat syphilis?

Answer 72

diagnose - darkfield microscopic visualization of the bacterium from chancre scrapings and antibody testing (veneral disease research lab test, rapid plasm regain test, enzyme immunoassay test, fluorescent treponemal antibody absorption test, and Treponema pallidum particle agglutination assay) treat - antibiotics (kills bacterium and prevents further damage but cant repair damage already done)

Question 73

stats of chlamydia?

Answer 73

In 2012, 1,422,976 cases of chlamydia werereported to the CDC, but most people with chlamydia are not aware of their infections. WHO estimates that more than 92 million chlamydial infections occur annually worldwide

Question 74

What is clamydia?

Answer 74

transmitted by sexual contact and vaginal disease known as "silent" disease bc most ppl with it are asymptomatic causes urehtritis in men and urethritis and cervicitis in women

Question 75

s/s of chlamydia?

Answer 75

women: (high % of women have no symptoms) - abnormal vaginal discharge - a burning sensation when urinating - lower abd pain - low back pain - nausea - fever -pain during intercourse (dyspareunia) - bleeding btwn menstrual periods men: (75% of men have symtpoms 1 to 3 weeks after exposure) - penile discharge - burning sensation when urinating, burning and itching around the urethral orfice

Question 76

complication for chlymadia (split by ppl)

Answer 76

Women 1. untreated infection can spread into uterus or fallopian tubes and caused PID (10-15% of women w/ untreated chlamydia) 2. female sterility Pregnant Women 1. can lead to premature delivery 2. babies can have chlamydial infections in eyes and respiratory ract 3. cause early infant penumonia and conjuntivits in newborns Men 1. rare but sometimes infection spreads to epididymis, causing pain, fever, and infrequently serility (can sometimes cause arthritis that can be accompanied by skin lesions and inflammation fo eye and urethra known as Reiter's syndrome)

Question 77

etiology of chlamydia?

Answer 77

gram negative coccus bacterium Chlamydia trachomatis

Question 78

diagnose and treat chlamydia?

Answer 78

diagnose - culture, DNA probe testing (nucleic acid amplification test, nucleic acid hybridization test), and antigen testing (direct fluorescent antibody test) treat - antibiotics (injection then oral antibiotics)

Question 79

What is etiology of trichomoniasis?

Answer 79

protozoal infection of lower genitourinary tract (usually vaginal for females and urethral in males) etiolgoy is protozoan Trichomoas vaginalis

Question 80

trichomoniasis stats?

Answer 80

There are an estimated 7.4 million trichomoniasis cases annually in the United States, with over 180 million cases reported annually worldwide. Only about 30% of those infected develop signs and symptoms of trichomoniasis.

Question 81

s/s of trichomoniasis?

Answer 81

most are asymptotomatic men - itching or irritation inside penis - burning after urination or ejaculation - penile discharge Women - itching - burning -redness or soreness of genitals - discomfort with urination - thin discharge with an unusual smell that can be clear, white, yellowish or greenish - strawberry cervix

Question 82

Diagnose and treat of trichomoniasis?

Answer 82

diagnose - potassium hydroxide whiff test (KOH is added to vaginal discharge, strong fishy odor is postiive result), wet- mount microscopic visualization, Pap test, culture, DNA testing (nucleic acid hybridization, nucleic acid amplification) and trichomonas antigen test, cervix exame for strawberry cervix treat - antiparasitic meds (antiprotozoal drugs (never take alc w/ meds))

Question 83

Who does the CD recommend get chlamydia testing yrly

Answer 83

older women with risk factors for chlamydial infections (those who have a new sex partner or multiple sex partners), and all pregnant women

Question 84

What is Genital herpes?

Answer 84

STI caused by herpes simplex virus (HSV), most specifically (HSV-2) which can be spread through secretions from the moiuth or genitals incurable, recurrent infection of skin of genital area, ulcerations spread through direct skin-to-skin contact, causing painful genital sores similar to cold sores

Question 85

What is HSV-1?

Answer 85

usually afffects mouth and lips, causing cold sores or fever blisters spread from mouth to genital during oral sex

Question 86

genital herpes stats?

Answer 86

The CDC estimates in the United States 16.2%, or about one out of six, people age 14–49 have a HSV-2 infection WHO estimates worldwide 536 million people age 15–49 have a HSV-2 infection Genital HSV-2 infection is more common in women (approx one out of five women age 14–49) than in men (approximately one out of nine men age 14–49).

Question 87

HSV-2 s/s

Answer 87

most ppl r asymptomatic signs are one or more painful blisters on around the gentials (blisters rupture = ulcersa that take up to 4 wks to heal) goes latent and becomes active timre from time = outbreak of blisters (decrease in frequency over time) first episode is accompained by systemic influzena symtpoms: swollen glands, fever, headache, painful urination

Question 88

what happens to babies born to herpes infected mothers?

Answer 88

can be exposed to virus during birthing process may result in brain damage, blindness, or death for newborn if woman has active genital herpes at delviery C section

Question 89

How to diagnose and treat HSV-2?

Answer 89

diagnose - medical histroy, physical exam, culture, nucleic acid amplification and antibody testing testing - no treatment bu antiviral meds to shorten outbreaks and make them less severe (monitor women with herpes for cervical cancer w/ Pap smear every 6 months)

Question 90

What are genital warts?

Answer 90

benign neoplastic growths on epidermis of genitals single or multiple growths or bumps that appear in genital areas & r sometimes shaped like cauliflowers can appear on vulva, in or around vagina, scrotum, anus, cervix, penis, groin or thigh

Question 91

Gential warts stats?

Answer 91

According to the CDC, approx 6.2 million new cases of sexually transmitted human papillomavirus (HPV) infections occur annually in the United States. At least 20 million people in the United Statesare already infected with HPV At least 50% of sexually active men and women acquire genital HPV infection at some point in their lives By age 50, at least 80% of women will have acquired genital HPV infection The WHO estimates the prevalence of genital HPV nfection in the world to be 440 million

Question 92

Approximately ___% of genital warts are caused by HPV 6 and HPV 11

Answer 92

90

Question 93

Diagnose and treat genital herpes?

Answer 93

diagnose - appear within wks after sexual contat with infected partner, might not develop for several months, diagnosed by physical exam, biopsy to rule out carcinoma treat - immune system usually clears it in 90% of cases within 2 yr, also can be removed by meds that erode wart tissue (keratolytic agent, antiviral cream) , electrocautery, cryosurgery and laser surgery (no cure)

Question 94

What is chancroid?

Answer 94

- aka soft chancre - bacterial infection of genitalia that causes a necrotizing ulceration and lymphadenopathy - caused by Haemophilus ducreyi

Question 95

s/s of chancroid?

Answer 95

- shallow and painless lesion appears pn skin or mucous membrane at site of entry, 7-10 days after sexual contact with infected person - tender, superative inguinal adenoapthy is noted on physical examination - ulcer usually deepens and becomes purulent and can be spread to other areas of body via autoinculation

Question 96

how to diagnose and treat chancroid?

Answer 96

diagnose - clinical appearance of lesions, Gram staining, rule out syphiliis or HSV treatment - antiobiotic therapy, drain lesions surgically, good personal hygeine is advised, keep infected areas clean anddry and to refrain from sexual contact

Question 97

With regular unprotected intercourses abt __% of couples conceive within 1 year. In about __% of cases, male causes infertility, in another __% of cases females caue infertility?

Answer 97

90 40 40

Question 98

causes of infertility in men?

Answer 98

- most common cause is idiopathic (40-50%) - testicular dysfunction, congenital disorders of the testes, certain developmental disorders, chromosomal abnormalities, varioceles (= 30-40%) - disorders of sperm transport and diseases of hypothalamus or pituary gland - environmental factors such as certain drugs, radiaion, smoking or pollutant

Question 99

cause of infertility in women?

Answer 99

- ovulatory dysfunction or failure to ovulate - endometriosis - scar tissue from infection, ectopic pregnancy or surgery - blocked fallopian tubes, caused by PID from STDs - congenital structural or chromosomal disorders - tumors - antisperm antibodies in female vaginal secretions - medications that compromise fertilty - psychological distress

Question 100

how to diagnose infertility?

Answer 100

men - history w/ special attention to childhood diseases, phyiscal exam for structural abn, personal or familial genetic or endocrine disorders, semen analysis, chromosome and testosterone testing, women - charting of menstrual cycle, hormone levels r studies through blood tests, fallopian tubes, uterine cavity r visualized through hysterosalpingography to determine tubal patency, laparoscopy

Question 101

how to treat infertility?

Answer 101

- unless condition is untreatable - course of action to achieve pregancy may include treatment of infection, surgery o remove blockage, the use opf fertility drugs (FSH, intrauterine insemination (IUI), vitro fertilization (IVF)

Question 102

What is torsion of the testicle

Answer 102

- one testicle is twisted out of its normal position - bv supplying testicles become kinked = prevention of blood flow - spontaneous or caused by trauma - s/s r sudden, severe pain in 1 testicle, can cause N&V, usually constant, scrotum becomes swollen, red and tender

Question 103

Diagnose and treat torsion of testicle

Answer 103

diagnose - pt history, physical exam (testicle usually has abn horinzotanl lie in scrotum), Doppler ultrasonography (shows little or no blood flow) treat - surgical intervention, bilateral orchiopexy

Question 104

What is variocele

Answer 104

- veins of one of the testicles becomes abn distended, causing swelling around the testicle that expands within scrotal sac - more uncomfortable than painful (esp during hot weather, after exercise and can be relieved temporarily by lying down) - increased presence of venous blood raises temp within scrotum = lower sperm count (more common left side)

Question 105

diagnose and treat variocele

Answer 105

diagnose - pt history, physical symptoms, examination by physician treat - wearing of tight-fitting underwear, use of athletic supporter, surgery to remove distended veins if variocele affects fertility

Question 106

What is benign prostatic hyperplasia?

Answer 106

- nonmalignant, noninflammatory hypertrophy of prostate gland - thought to be caused by aging process and hormonal and metabolic changes

Question 107

s.s of benign prostatic hyperplasia?

Answer 107

- mostly found in men older than 50 - compression of urethra with urinary obstruction and resulting urianry retention - difficulty starting urination - weak stream of urine - inability to empty the bladder completely - urinary frequency - nocturia - in severe cases: inflammation and symptoms of renal disease

Question 108

diagnose and treat BPH?

Answer 108

diagosne - pt history, rectal exam, urinarlysis, urine culture, renal function studies, prostate-specific antigen (PSA) serum level (help differentiate BPH from other possible lower Urianry tract symptoms), international prostate symptom score treat - control of fluid intake before bed, avoid meds that cause urinary retention, drugs that tighten muscles inside the prostate, 5-alpha-reductase inhibitors which reduce the size of the prostate by 30%, transurethral resection of prostate (TURP0 when s/s bb3ecome moderate to severe

Question 109

nearly all testicular teumors are ___________, equally distributed btwn 2 main types: _________ and __________

Answer 109

Germ cell tumors (GCTs) seminomas and nonseminomatous germ cell tumors (NSGCTs)