Exam 2 - Men Flashcards
(173 cards)
1
Q
If a patient comes in with an abnormal urethral orifice on the underside of the penis what is it
A
Hypospadias
2
Q
If a patient comes in with an abnormal urethral orifice on the dorsal side of the penis what is it called
A
Epispadias
3
Q
What other problem can result from an abnormal urethral orifice
A
Risk for obstruction or UTi
4
Q
What is more common hypospadias or epispadias, and which is more severe
A
Hypospadias is mc and epispadias is more sever
5
Q
How do you treat abnormal urethral orifice
A
Reconstruction
6
Q
If a patient comes in with an accumulation of dead skin and moisture that causes penile inflamation what is this
A
Poor hygeine causing smegma
7
Q
What can produce smegma
A
Trauma and infections
8
Q
A patient comes in with penile inflammation of the glans what is it called
A
Balanitis
9
Q
A patient comes in with penile inflammation of the prepuce (foreskin) what is the dx name
A
Balanoposthitis
10
Q
Patient comes in with an inability to retract the foreskin what is this condition called
A
Phimosis
11
Q
How does a patient usually get phimosis
A
Mc its acquired, rarely congenital
12
Q
Where is the likely location of paraphimosis
A
Entrapped/retracted foreskin behind the coronal sulcus
13
Q
What are the symptoms of paraphimosis
A
Erythema, pain, odor
14
Q
What are the risks that come along with balanitis or phimosis
A
Poor hygiene, no circumcision
15
Q
What type of penile neoplasm is most common
A
Squamos cell carcinoma
16
Q
Who is most likely to get a penile neoplasm
A
> 40 years, uncircumcised, poor hygeine, HPV 16/18, AIDS, smoking
17
Q
Patient comes in with penile neoplasm SCC “in situ” (does not penetrate BM) which is solitary and on the shaft what is the condition
A
Bowen disease
18
Q
Where does the penile neoplasm that is invasive SCC most likely located
A
Glans or prepuce
19
Q
Patient comes in with an apparent neoplasm (irregular borders) on the glans/prepuce that is gray/crusted and raised/ulcerated
A
Invasive SCC penile neoplasm
20
Q
Which penile neoplasm has lymphatic mets with <30% 5 year survival
A
Invasive SCC
21
Q
What is the removal of invasive penile SCC called
A
Penectomy, perineal urethrostomy
22
Q
What is the usual cause of inflammation of the scrotum
A
Fungal infex or dermatoses
23
Q
What is the most common form of scrotum neoplasia
A
Rare but SCC is MC
24
Q
Patient comes in with an increase in serous fluid in tunica vaginalis what is the condition
A
Hydrocele of the scrotum
25
What is the mc cause of scrotal enlargement
Hydrocele (increase in serous fluid in tunica vaginalis)
26
What are common causes of hydrocele of scrotum
Infx, tumor, idiopathic
27
How does one dx scrotum hydrocele
Transluminescence
28
What is the condition of blood in the scrotum
Hematocele
29
What is the condition of increased lymph in the scrotum
Chylocele
30
What is elephatiasis of the scrotum
Filariasis
31
How would one get filariasis of the scrotum
Flies, mosquitos, arthropods
32
What is the causitive organism of filariasis
Filariodea spp. (Round worms) = wuchereria bancroftii
33
A patient has a failure of a testicle to descend what is the condition
Cryptorchidism
34
Where is cryptorchidism mc
Mc in high scrotum and decreases liklihood up inguinal canal/abadomen
35
When is cryptorchidism liikley dx
At age 1 year
36
Is cryptorchidism likely to be bilateral
No only 10%
37
By age 5 what are consequences of cryptorchidism
Atrophy and sterility
38
What is tx of cryptorchidism
Repositioning (orchipexy) to decrease CA risk
39
What is CA risk of cryptorchidism
Risk for testicular CA = 3-5x risk
40
Why does cryptorchidism cause testicular atrophy
Ischemia, trauma, increased estrogen along with chemo/irradiation
41
What is inflammation of the testis called
Orchitis
42
What is inflammation of the epidiymis
Epididymitis
43
What can happen with orchitis
Pain, bloody ejaculation, edema
44
What is a consequence of epididymis
Pain, fever, mc unilateral
45
How does inflammation of the testis/epididymis usually begin
Usually as UTI
46
A patient comes in complaining of testicular inflammation and mentions that a few days ago he had a UTI what happened
The UTI spread via vas deferens/lymphatics causing acute onset of neutrophils, edema, tender
47
What else can cause inflamm of testis/epididymis
STD’s, mumps, TB, autoimmune
48
What type of orchitis can cause necrosis and eventually sterility
Mumps virus in adults
49
What does TB do to testi/epididymis inflamm
Caseous granulomas
50
A patient comes in and you realize that there is engorgement, pain caused by spermatic cord twisting what is the condition
Testicular torsion
51
What condition can obstruct venous damage, has a risk for infarction and must be untwisted within 6 hours
Testicular torsion
52
What type of testicular torsion takes place in utero or perinatally
Neonatal testicular torsion
53
What effect anatomically does neonatal testicular torsion have
No anatomical defect
54
What type of testicular torsion is mc
Adult
55
What type of testicular torsion happens around age 12-18
Adult testicular orsion
56
What deformity comes as a result of adult testicular torsion
Bell clapper deformity
57
What is varicocele within the scrotum
Enlarged pampiniform venous plexus of the scrotum
58
What can cause a varicocele of the scrotum
Abdominal malignancy mc is renal cell carcinoma
59
Who is most likely impacted by testicular neoplasia
Ages 15-34 caucasians with family hx
60
What are other testicular neoplasia risks besides age 15-34, caucasian, family hx
Gonadal dysgenesis/androgen insensitivity, cryptorchidism in 10% of cases
61
Which testicular neoplasia is benign and is from sertoli and leydig cells
Sex cord stromal tumors
62
What is 95% of postpubertal testicular tumors
Germ cell tumors (GCT’s)
63
What type of testicular neoplasia is malignant and from intratubular germ cell neoplasia (in situ)
Germ cell tumors
64
What are two types of GCT’s
Seminomas, nonseminomatous GCT’s
65
What is the peak patient age of those with seminoma tumor
30-40 yrs
66
What type of GCT is 50% of all with a more favorable prognosis
Seminomas
67
Which GCT has 10% increase of hCG which is a tumor marker
Seminomas
68
What are the characteristics of seminomas mass
Soft, well demarcated, gray/white
69
What are characteristics of seminomas cells
Large, uniform, round nuclei, few lymphocytes
70
What type of testicular neoplasia is described as having large round cells, mass has distinct borders
Seminomas
71
What are types of nonseminomatous GCT’s
Embryonal carcinoma, yolk sac tumor, choriocarcinoma, teratoma
72
What type of nonseminomatous GCT is invasive, anaplastic with indistinct borders affecting ages 20-30 with no tumor marker
Embryonal carcinoma
73
3 year old Patient comes in with a large anaplastic mass that a doctor says is favorable what is it
Nonseminomatous GCT yolk sac tumor
74
What nonseminomatous GCT is a small mass and affects those from 20-30 with increased hCG
Choriocarcinoma
75
What type of GCT is a firm mass of all germ cell layers of all ages
Nonseminomatous Teratoma
76
What type of GCT is hemorrhagic
Nonseminomatous GCT (embryonal carcinoma) with undifferentiated indistinct borders
77
What type of testicular cancer is large and palpable indicated a well contained mass
Seminomas
78
What testicular cancer has late lymph mets and is radiosensitive
Seminomas
79
What type of testicular cancer is small and less palpable
Nonseminomatous GCT
80
What type of testicular cancer has a lymph/hemtaogenous mets and earlier mets of liver/lungs
Nonseminomatous GCT
81
What are features of testicular cancer
Painless mass, non translucent, blood in semen, dull achy pain in groin/abdomen
82
What is the treatment of testicular cancer
Radical orchiectomy, assumed malignancy
83
What pathology is usually located in the peripheral zone of a prostate
Carcinomas
84
What pathology is usually located in the transitional zone of the prostate
Hyperplasia = BPH
85
What is the examination technique for the prostate
Digital rectal examination
86
What type of prostatis is infection with common uropathogens
Bacterial prostatitis
87
What are symmptoms of bacterial prostatis
LBP, dysuria, pyrexia/chills, tender DRE
88
What prostatis is 90-95% of the tme
Chronic nonbacterial aka chronic pelvic pain syndrome/ prostatodynia
89
What type of prostatis is evaluated with DRE, sequential specimens, NIH outcome measures
Chronic non bacterial
90
What type of prostatis is of unknown prevalence that has leukocytes in prostatic secretions
Asymptomatic
91
Patient comes in complaining of prostate issues and its said they have andorgen dependent growth what is it
Benign prostatic hyperplasia
92
Who is likely to get BPH
>40 years old, 90% are .70 years old
93
What are the possible BPH symptoms within the 10% symptomatic ones
Urethral obstruction, difficulty starting/maintaining stream, increase frequency/urgency, nocturia
94
Patient comes in with glandular hyperplasia and nodules that are well circumscribed
BPH (more advanced)
95
What are common treatments of BPH
Watchful waiting (MC), DHT inhibition, smooth muscle relaxants, TURP
96
What treatment of BPH is abbreviated TURP
Transurethral resection of prostate
97
What does TURP used for
Incontinence, erectile dysfunx
98
What is nearly 1/3 of all male CA diagnosies
Carcinoma of the prostate
99
What is the 2nd MC cause of CA related death in males
Carcinoma of prostate
100
What is the carcinoma of the prostate that is a firm mass with ill defined borders and may/maynot be palpable
Adenocarcinoma
101
What are the risk factors for carcinoma of the prostate
>50 (mc 65-75), increased androgens, AA or asian descent
102
What is the aggressiveness like of carcinomas in the prostate
Mc indolent
103
Where are most carcinomas of the prostate located
80% in peripheral zone
104
Where can carcinoma of the prostate mets to
Spine and is osteoblastic
105
What is an indicator of carcinoma of the prostate
Increase PSA
106
What info is needed for online risk assessment for prostate ca
>55 years old, no past prostate CA, DRE and PSA results of past year
107
What condition is a dilation of the renal pelvis/calyces
Hydronephrosis
108
What causes the dilation of hydronephrosis
Obstruction blocks the urine =dilation = decrease funx, possible atrophy
109
What type of hydronephrosis is mc and is atresia in male infants
Congenital
110
What type of hydronephrosis has stones, BPH, prostate ca
Acquired
111
Is a unilateral obstruction of hydronephrosis significant
No
112
What does bilateral obstruction of ureters mean
Polyuria (incomplete) or anuria (complete)
113
What is the mc cause of renal calculus
Calcium oxalate
114
What are symptoms of renal calculus
Ureter pain = flank pain to groin that is intermittent and severe
115
Who is at risk for renal calculus
Male, fam hx, dehydration, uti’s, gout
116
A decrease in what vitamin can be a risk for renal calculus
Decrease in vitamin A
117
How long does a renal calculus take to pass
Within 2 weeks
118
What is an upper urinary tract stone that is massive and cast of renal pelvis
Staghorn calculus
119
What is staghorn calculi mc from
Mc from recurrent uti’s
120
What stones make up staghorn calculi
Magnesium ammonium phosphate
121
What does a vitamin A deficiency produce
Kidney stones and bitot spots
122
What condition has a blind ended pouch in the bladder wall that is usually small and asymptomatic but carries an infection risk
Diverticulum
123
How does one get urinary bladder diverticulum
Mc obstruction from Urethral obstruction
124
What condition is inflammation of the urinary bladder caused by bacterial infx (ecoli), chemo
Cystitis
125
What are symptoms of cystitis
Suprapubic pain, urinary frequency, painful sex
126
What bladder cancer is mc urothelial carcinoma or squamos cell carcinoma
Urothelial carcinoma (90%)
127
What bladder cancer is common in egypt
Schistosoma infections of squamos cell carcinoma
128
What are risks of bladder cancer
Male 50-80, chronic infx, smoke, urban environments, occupational carcinogens
129
What mutation is associated with bladder cancer
Acquired tP53 mutation, not familial
130
What condition of the bladder has a high recurrence and painless hematuria
Bladder ca
131
How do you dx bladder cancer
Cytoscopy
132
What can decrease the risk of progression/recurrence of bladder cancer
Smoking cessation
133
What is the mc std within us
1. Genital herpes and 2. Hpv (do not require CDC notification)
134
What std is caused by treponema pallidium
Syphilis
135
What happens in someone that has syphilis about 9-90 days after contact
Chancre (stage 1)
136
What are the risks of syphilis
AA, homosexual males
137
What happens in tertiary syphilis
Neurosyphilis
138
How long does syphilis take to resolve
4-6 weeks
139
What is a skin symptom of secondry syphilis
Mucocutaneous lesions
140
What part of syphilis has coagulative necrosis, leukocytes and impact bones, skin, airways
Gummas
141
How does a baby get congential syphilis
Crosses placenta
142
If left untreated what happens with congenital syphilis
40% lethality in utero
143
What congenital syphilis has skeletal deformation, hepatomegaly, pancreatic fibrosis, pneumonitis, spirochetes in all tissues
Stillbirth
144
What congenital syphilis impacts cutaneous, visceral and skeletal
Infantile
145
What congenital syphilis impacts facial, dental, skeletal/periosteal
Tardive
146
What deformities are common with congenital syphilis
Saddle nose deformity, periostitis (saber shin)
147
What teeth deformities is associated with congenital syphilis
Hutchinson’s teeth, mulberry molars
148
What is the 2nd mc reportable std
Gonorrhea
149
What organism causes gonorrhea
Neisseria gonnorhoeae
150
When does gonorrhea take hold
2-7 days post infx
151
What are symptoms of gonorrhea in males
Urethritis, epididymitis, orchitis, prostatitis
152
What are symptoms of gonorrhea in women
Lower pelvic pain, vaginal discharge, salpingitis
153
Who has less obvious features of gonorrhea
Females
154
What does disseminated infex of gonorrhea do
Arthritis, tenosynovitis, skin lesions, rarely endocarditis/meningitis
155
Transcervical infection from gonorrhea can lead to what
Neonatal conjunctivitis
156
What can gonorrhea cause that is a risk of blindness in newborns
Neonatal conjunctivitis
157
What is caused by flagellated protozoa trichomonas vaginalis
Trichomoniasis
158
What are symptoms of trichomoniasis
Urethritis, prostatitis, balanitis with yellow/green discharge, laodorous
159
Who are more likely to be symptomatic from trichomoniasis
Females
160
What is the mc bacterial std in the U.S. and what causes it
Chlamydia and chlamydia trachomatis
161
What can chlamydia stimulate
Reactive arthritis (+HLA-B27)
162
What type of std can produce regional lymphadenopathy within 1st month
Lymphogranuloma venereum
163
What causes lymphogranuloma venereum
Chlamydia trachomatis
164
What does haemophilus ducreyi cause
Chancroid
165
What is the latency of chancroid
4-7 days
166
What std is associated with prostitues and hiv within africa, SE asia
Chancroid
167
What std is caused by klebsiella granulomatis
Granuloma inguinale (aka donovanosis)
168
What are symptoms of granuloma inguinale
Painless ulcerations for 10-40 days post infx
169
Who gets granuloma inguinale
Mc in tropics, multiple sex partners
170
What can happen if a granuloma inguiinale is left untreated
Lymphatic fibrosis/obstruction
171
What type of HPV affects the penis, vulva, cervical, or anus
HPV 6/11
172
What type of std is commonly presented with squamos cell proliferatins, pre neoplastic lesions of condylomata acuminata
HPV
173
How is HPV transmitted
Oral or transcervical infx
