GU Final Flashcards
1) Hormone Review
Hypothalamus → GnRH → Anterior Pituitary gland → -------LH & FSH
↓ ↓
Leydig Cell ↓
↓ ↓
Testosterone → Spermb) Penile Disorders
i) Balanitis:
Inflammation of glans penis
b) Penile Disorders
Phimosis
Constriction of the orifice of the prepuce so as to prevent the foreskin from being drawn back to uncover the glans penis.
b) Penile Disorders
iii) Paraphimosis:
Cannot retract the foreskin → becomes inflamed
b) Penile Disorders
iv) Prosthitis:
Inflammation of the retracted foreskin of the penis; usually caused by bacterial infection
b) Penile Disorders
v) Hypospadias:
Urethral opening on the ventral surface. More common
b) Penile Disorders
vi) Epispadias:
Urethral opening on the dorsal surface. Not as common
b) Penile Disorders
vii) Priapism:
Nonerotic sustained painful erection with acute onset
b) Penile Disorders
viii) Peyronie’s Disease:
Plaque’s/strands of dense fibrous tissue surrounding the corpus cavernosum Curved deformity & painful erection; impotence
ix) Penile Cancer:
- Occurs almost entirely in uncircumcised; rarely in circumcised.
- Low risk with HPV
- Prostate Cancer is 100 x’s more likely than penile cancer.
- Age = > 50 y.o.
c) Penile Lesions
i) Condyloma:
HPV; painless, enlarging warts
c) Penile Lesions
ii) Squamous Cell Cancers:
Skin cancer, melanoma
c) Penile Lesions
iii) Leukoplakia:
Hyperkeratotic, scaly white patches of penile epithelium
c) Penile Lesions
iv) Bowen’s Disease:
An intraepidermal (pre)cancerous indurated erythematous plaque; pink or brown papules covered with thickened horny layer.
When is a biopsy needed for a Penile lesion?
• Biopsy is needed for Bowen’s Disease and Leukoplakia
i) Male Sexual Dysfunction:
• Causes:
o Physical: Drugs, blood flow abnormality, Nerve or hormonal (andropause, testosterone)
o Psychological: Depression, Stress, Performance Anxiety, Misinformation about sexuality
i) Male Sexual Dysfunction:
•• Risk Factors:
o > 40 y.o.
o Decreased libido
o Ejaculatory disturbances
o Erectile dysfunction (most common)
ii) Cryptorchidism:
Enters into the inguinal canal to the abdomen
iii) Ectopia:
Undescended testis goes either inguinal or perineal.
iv) Inguinal Hernia:
• Protrusion of abdominal contents (usually the small bowel) through a weak point of the abdominal wall (usually where the vas deferens passes through).
Inguinal Hernia
Signs and Symptoms
o Bulge in groin area that may extend into the scrotum.
o Painful or uncomfortable
Testicular Torsion?
What is it and is it emergent?
• Signs & Symptoms: o Sudden severe pain o Swollen o Erythema o Lower abdominal pain, N/V o Worse with lifting of the testicle
- EMERGENT MEDICAL REFERRAL TO ER
- DDX: Epididymitis
vi) Hydrocele:
• Collection of fluid in the sheath that holds the testicles
Cause: excess fluid production or decreased fluid absorption
Can develop rapidly due to: Trauma, radiation therapy, Inflammation, congenital
Hydrocele Signs and Symptoms
• Signs & Symptoms:
o Often painless
o Swollen
o Soft uni or bilateral mass
o —–>WILL transilluminate
o Most often in older men
Hydrocel DDX
• DDX: Varicocele
Varicocele:
• Benign painless scrotal swelling of blood that backs up in the veins leading from the testicles due to valve dysfunction
Varocelle Signs and Symptoms
• Signs & Symptoms:
o Age 15-25 y.o. o More common on the left side o May feel heavy o Better with lying down o Achy o Testicular atrophy o Infertility o Visibly enlarged vein, o Will NOT transilluminate
Varicocele: DDX
- Can reoccur 5-20 %
* DDX: Hydrocele
Epididymitis
viii) Epididymitis:
• Infection in the tubular coil (complication of Chlamydia/gonorrhea)
o Enterobacteria or pseudomonas • Signs & Symptoms: o Generally severe and insidious pain o Fever o Swelling • Treatment: Antibiotics
ix) Orchitis:
• Inflammation of the testes
o Often d/t bacterial infection or the mumps virus.
• May be concurrent with prostatitis or epididymitis
• Signs & Symptoms:
o Pain
o Swelling
o Heaviness
• Can cause permanent damage
x) Testicular masses:
• Signs & Symptoms:
o Firm
o Solid
o Painless
o Does NOT transilluminate
• Usually MALIGNANT
xi) Scrotal Masses (spermatocord, and epididymis):
• Causes of Scrotal Masses
o
Cysts o Infection o Inflammation o Hernia (undescended testes) o Tumors (often malignant within testes)
• Testicular Cancer
o Risk Factors:
Cryptorchidism: Treatment reduces risk Genetic Klinefelter’s Syndrome Chromosome 12 abnormality Caucasian—4-5 x’s increase incidence Family History (2%) HIV
o
Testicular Cancer
Signs and Symptoms
NO increased risk with injury or vasectomy
o Signs & Symptoms:
Unilateral enlargement or change in way it feels
Painless lump or swelling or collection of fluid
Dull ache in back, groin or lower abdomen
Gynecomastia &/or mastalgia
Testicular discomfort/pain or feeling of heaviness
Occasionally, initial symptoms are related to metastasis in the lungs, pelvis, abdomen or brain
o NOTE: There may be no signs and/or symptoms
Stage 1 Kidney Damage:
kidney damage with normal GFR (90 or above)
Stage 2 Kidney damage
Kidney damage with mild decrease of GFR ( 60-89)
Stage 3 Kidney Disease
Moderate decrease in GFR (30-59)
CKD at this stage = anemia & bone problems
