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Flashcards in Exam 2 - Men Deck (173):
1

If a patient comes in with an abnormal urethral orifice on the underside of the penis what is it

Hypospadias

2

If a patient comes in with an abnormal urethral orifice on the dorsal side of the penis what is it called

Epispadias

3

What other problem can result from an abnormal urethral orifice

Risk for obstruction or UTi

4

What is more common hypospadias or epispadias, and which is more severe

Hypospadias is mc and epispadias is more sever

5

How do you treat abnormal urethral orifice

Reconstruction

6

If a patient comes in with an accumulation of dead skin and moisture that causes penile inflamation what is this

Poor hygeine causing smegma

7

What can produce smegma

Trauma and infections

8

A patient comes in with penile inflammation of the glans what is it called

Balanitis

9

A patient comes in with penile inflammation of the prepuce (foreskin) what is the dx name

Balanoposthitis

10

Patient comes in with an inability to retract the foreskin what is this condition called

Phimosis

11

How does a patient usually get phimosis

Mc its acquired, rarely congenital

12

Where is the likely location of paraphimosis

Entrapped/retracted foreskin behind the coronal sulcus

13

What are the symptoms of paraphimosis

Erythema, pain, odor

14

What are the risks that come along with balanitis or phimosis

Poor hygiene, no circumcision

15

What type of penile neoplasm is most common

Squamos cell carcinoma

16

Who is most likely to get a penile neoplasm

>40 years, uncircumcised, poor hygeine, HPV 16/18, AIDS, smoking

17

Patient comes in with penile neoplasm SCC “in situ” (does not penetrate BM) which is solitary and on the shaft what is the condition

Bowen disease

18

Where does the penile neoplasm that is invasive SCC most likely located

Glans or prepuce

19

Patient comes in with an apparent neoplasm (irregular borders) on the glans/prepuce that is gray/crusted and raised/ulcerated

Invasive SCC penile neoplasm

20

Which penile neoplasm has lymphatic mets with <30% 5 year survival

Invasive SCC

21

What is the removal of invasive penile SCC called

Penectomy, perineal urethrostomy

22

What is the usual cause of inflammation of the scrotum

Fungal infex or dermatoses

23

What is the most common form of scrotum neoplasia

Rare but SCC is MC

24

Patient comes in with an increase in serous fluid in tunica vaginalis what is the condition

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