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GU Survey 9Q > GU Final > Flashcards

GU Final Flashcards

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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
How related to penile cancer is circumcision?
Circumcision decreases chance for penile cancer but since penile cancer has low incidence it is not a routine procedure and up to the parents
26
How related to penile cancer is HPV?
Low risk factor, only certain strains of HPV
27
How related to penile cancer is testicular cancer?
Cannot find information, but do not believe they are related
28
How related to penile cancer is prostate cancer?
Cannot find information, but do not believe they are related
29
What age group is most affected by penile cancer?
> 50 y/o
30
What are the AAP recommendations about male circumcision?
Medical benefits not sufficient to recommend routine circumcision
31
What is leukoplakia?
Hyperkeratotic, scaly, white patches of penile epithelium, biopsy necessary
32
What is condyloma?
A painless, enlarging, warty-like growth in HPV
33
What are squamous cell cancers of the penis?
Skin cancer
34
What is Bowen’s Dz?
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
What is priapism?
Neurotic sustained painful erection with acute onset
36
What is Peyronie’s?
Plaque’s /strands of dense fibrous tissue surrounding the corpus cavernosum -> deformity & painful erection; impotence
37
What is Posthitis?
Inflammation of the prepuce
38
What is Phimosis?
Condition where the male foreskin cannot be fully retracted from the head of the penis
39
What are the causes of male sexual dysfunction?
- Drugs - Blood flow abnormalities - Nerve abnormalities - Hormonal abnormalities - Psychological - Depression - Stress - Performance anxiety - Misinformation about sexuality
40
What is andropause?
Low androgen levels - Testosterone - Dehydroepiandrosterone - androstenedione
41
What is low in androgen deficiency?
- Testosterone - Dihydrotestosterone - Low DHEA
42
What is androgen deficiency not associated with?
Low FSH
43
What has an antiaromatase effect and decreases symptoms of andropause?
Zinc
44
What are the risk factors of UTI?
- Sexual Activity - Hygiene - Hormones - BMI - Low fluid intake - Delayed voiding - GU anomalies, stones, BPH - Catheterization
45
How do you prevent UTI’s in Women?
- Cranberry - Hydration - D-mannose - Lactobacillus - Topical E3
46
How do you prevent UTI’s in Men with BPH?
- Urinate frequently - Saw palmetto - Cranberry - Hydration - Lactobacillus
47
What is the treatment for UTI?
Antibiotics: - Macrobid, - Septra ds - ciprofloxacin
48
What is the treatment for cystitis?
- Bladder distention - Pentosan polysulfate sodium - Aspirin/ibuprofen - Tricyclic antidepresants - Antihistamines - Narcotic analgesic - Calcium channel blockers - Immune suppression - Heparin - Hyaluronic acid
49
What UA results are expected with a UTI?
``` A) Dipstick -RBC -Proteinuria -Leukocyte Esterase -Nitrites B) Microscopic ->10 wbc/hpf -Too numerous to count bacteria ```
50
What causes interstitial cystitis?
``` A)No known cause B)Theories -Infectious -Autoimmune -Mechanical injury -Mast cell activation -Alteration in bladder lining ```
51
Is surgery recommended for interstitial cystitis?
No
52
Do diet changes help some patients with interstitial cystitis?
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
What are the risk factors for urinary tract cancer?
-***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
What are the symptoms of UT cancer?
- ***Hematuria*** - Frequent urination - dysuria
55
What are the symptoms of pelvic prolapse?
- Menstrual cramps - Pulling in pelvis - Constipation - Urinary incontinence - Low back pain - Decrease in symptoms when lying
56
What hormone deficiency predisposes a person to pelvic prolapse?
Estrogen
57
What are the causes of incontinence?
Neurologic disorders from CNS, spinal cord & peripheral nerves
58
Which age groups does pelvic prolapse affect?
Postmenopausal
59
What conditions can a UA be used to screen?
- Kidney dz - UTI - Bladder Dz - Diabetes - Liver Dz - Starvation/diet - Illness/infection - Hepatitis
60
What does a UA detect?
- Color - pH - Specific gravity - Leukocyte Esterase - Ketones - Nitrite - Protein - Blood - Glucose - Bilirubin - Urobilinogen
61
How do u detect proteinuria?
UA
62
What is the next step after a single positive test for proteinuria?
- Wait two weeks and perform again, if confirmed then: | - CMP (Comprehensive metabolic panel), BUN, Creatinine, Albumin
63
What are the DDx’s for proteinuria?
A) Renal -UTI, nephrolithiasis, acute kidney failure, glomerulonephritis, nephrotic syndrome, renal METS B)Functional -Fever, exercise
64
Is proteinuria present with UTI’s?
sometimes
65
Hematuria is ________ unless proven otherwise.
cancer
66
If hematuria is found, when should you retest?
-2 weeks? -Further work up Microscopic Cystoscopy IVP CT/US
67
Hematuria is a symptom of what conditions?
- Stone - Infection - Trauma - Tumor - Medications
68
Urinary casts are associated with?
Kidney infection of some sort – there are many types and many casts
69
What are the stages of chronic renal disease?
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
What are the symptoms of chronic renal disease?
- Fatigue - Poor concentration - Poor appetite - Insomnia - Nocturnal muscle cramping - Peripheral & periocular edema - Dry, itchy, skin - Increased frequency, nocturia
71
What are the UA findings in chronic renal disease?
- Proteinuria - Hematuria - Creatinine clearance f’d up - GFR decreased
72
How is GFR calculated?
Via creatinine clearance
73
What systemic disease can cause kidney damage?
- DM | - Hypertension
74
What hormones are produced by the kidney?
- Erythropoietin - Renin - Calcitriol
75
What are the diet/lifestyle changes required for kidney disease?
- Limit protein - Limit cholesterol - Decrease smoking - Decrease sodium - Decrease potassium
76
What are the dietary recommendations for patients with kidney stones?
- Low purine diet - Low oxalate diet - Increase fluids
77
What is the treatment for kidney stones?
- Ultrasound - Wait (which sucks) - Surgery
78
What increases the risk of urinary stones?
- Pregnancy - Urinary tract abnormalities - Southern US Diet - Foods - Weight - Stress - Bedridden
79
What are the differences between male and female in reference to urinary stones?
1) Men DDx - Testicular torsion, pyelonephritis, acute prostatitis, appendicitis, pancreatitis, 2) Female - Ovarian cyst, ovarian torsion, ectopic pregnancy, pyelonephritis, appendicitis, pancreatitis
80
Do all urinary calculi require emergency intervention?
No
81
What are the symptoms of urinary calculi?
- 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
What imaging is used for urinary calculi?
- KUB (supine abdomen) - Non contrast Spiral CT - IVP
83
What is a KUB used for with calculi?
Determine size, shape and location

GU Survey 9Q (2 decks)

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