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Men's Health Flashcards

(83 cards)

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1
Q

Priapism

A

Long, painful erection

>2-3 hours

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2
Q

People at highest risk for priapism

A

sickle cell anemia

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3
Q

Risks for priapism

A
  • high doses of ED medication
  • cocaine
  • quadripelgia
  • etc
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4
Q

Which form of priapism is a medical emergency

A

ischemic

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5
Q

People at risk for testicular cancer

A
  • teenage to young adult (15-30)

- White males

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6
Q

Testicular cancer presentation

A
  • nodule
  • sensation of heaviness or aching
  • one larger testicle
  • tenderness
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7
Q

Prostate cancer presentation

A
  • low back pain
  • rectal area/perineal pain
  • obstructive voiding symptoms
  • may be asymptomatic
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8
Q

Highest risk for prostate cancer

A
  • > 50
  • obese
  • Black
  • family history
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9
Q

Blue dot sign indicates

A

torsion of appendix testes

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10
Q

Torsion of appendix testes occurs in..

A

school age

-infarction

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11
Q

Testicular torsion presentation

A
  • acute onset
  • affected testicle higher and closer to body
  • negative cremasteric reflex
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12
Q

where is sperm produced

A

seminiferous tubules of testes

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13
Q

cryptochordism increases risk for what

A

testicular CA

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14
Q

Spermatogenesis is stimulated by

A

testosterone

FSH

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15
Q

Which testicle usually hangs lower

A

left hangs lower than right

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16
Q

Function of prostate fluid

A
  • alkaline pH

- helps sperm survive in vagina

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17
Q

Where is immature sperm stored

A

epididymis

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18
Q

What transports sperm from epididymis to urethra

A

vas deferens

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19
Q

What structure is clipped during a vasectomy

A

vas deferens

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20
Q

Where is cremasteric reflex illicted

A

-stroke ipsilateral inner thigh

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21
Q

What condition with testes will transluminate

A

-hydrocele

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22
Q

Gold standard for testicular CA

A

biopsy

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23
Q

Testicular CA treatment plan

A
  • US

- Urology referral for biopsy

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24
Q

When will permanent testicular damage occur with testicular tosion

A

<6 hours

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25
Is digital rectal exam with PSA (Screening) recommended?
no
26
Diagnostic test for prostate cancer
biopsy
27
PSA level for prostate CA
>4
28
Prostate CA plan
- Refer to urology if PSA >4 | - individualize screening
29
BPH presentation
- elevated PSA - prostate is rubbery and enlarged - gradual urinary obstructive symptoms
30
Alpha-adrenergic antagonist
Terazosin (Hytrin) | Tamsulosin (Flomax)
31
5-alpha reductase inhibitors
Finasteride (Proscar)
32
What herbal remedy may be used for BPH
- saw palmetto - mild benefit - not effective for everyone
33
adverse effect of alpha blockers
orthostatic hypotension
34
Male with BPH and HTN
- start with alpha-adrenergic antagonist (Flomax) | - relaxes smooth muscles on prostate gland and bladder neck
35
Mechanism of Finasteride
blocks androgen receptor - temporarily shrinks prostate - will return to original size if medication stopped
36
Chronic bacterial prostatis duration
>6 months
37
Organisms that cause chronic bacterial prostatitis
- E.coli | - proteus
38
Chronic bacterial prostatitis presentation
- elderly - several weeks of suprapubic or perineal discomfort - dysuria - nocturia - frequency - no systemic symptoms
39
Chronic bacterial prostatitis treatment
-Bactrim 4-6 weeks
40
Screening tool for BPH severity
American Urologic Assessment Prostate Symptom Score
41
Duration of treatment needed to see 5alpha reductase effects
6-12 months
42
Which BPH medication works the fastest
-alpha adrenergic antagonists
43
PDE-5 inhibitor for BPH
Tadalafil (Cialis)
44
Patient education for alpha-adrenergic antagonists
- take at bedtime - orthostatic hypotension - may feel lightheaded in am
45
Acute prostatitis presentation
-fever -chills pain at tip of penis -enlarged, boggy, tender prostate -urinary symptoms -pain with BM -elevated PSA
46
Acute prostatitis management
-urine dip with C&S
47
Acute prostatitis treatment
- Bactrim, cipro, levofloxacin for 6 weeks - if <35, consider STD's - stool softeners - fluids - if symptoms do not improve in 2-3 days, refer to urologist
48
When should prostate cancer screening conversations begin
age 40-45 | -screen if at least 10 year life expectancy with PSA alone
49
PSA value that rules out prostate CA
none
50
Which medication can alter PSA levels
5-alpha reductase inhibitors
51
When to consider urology referral with BPH
- PSA >4 - rise in PSA while on 5-alpha reductase inhibitor - abnormal DRE
52
Acute prostatitis labs
- leukocytosis with left shift (bandemia) | - UA: pyuria, hematuria
53
SSRI with highest risk of ED
paroxetine (Paxil)
54
Acute bacterial epididymitis affects which groups
- <35 more likely to be infected with STI | - >35: usually E.coli
55
Acute bacterial epididymitis presentation
- swollen red scrotum - tenderness - urethral discharge - induration of posterior epididymitis - UTI symptoms - possible fever - positive Prehn's sign
56
Positive Phren sign
- relief of pain with scrotal elevation | - indicates epididymitis vs. testicular torsion
57
Acute bacterial epididymitis treatment
- <35: doxycycline PO x 10 days plus ceftriaxone IM - >35: ofloxacin (Floxin) or levofloxacin x 7-10 days - scrotal elevation and ice packs - stool softeners if constipated - ED if septic or severe pain
58
Erectile dysfunction causes
- vascular insufficiency - neuropathy - medications - smoking - alcohol - hypogonadism
59
First line treatment for ED
- PDE-5 inhibitors - Take Viagra on empty stomach for optimal effectiveness - 30-60 minutes before sex - Tadalafil can be take for combined BPH and ED
60
PDE-5 inhibitor contraindications
- concomitant nitrates - alpha blockers - recent MI - post-cerebrovascular accident - major surgery - any condition in which exertion is contraindicated
61
Can a hydrocele be present with testicular CA
yes
62
Conditions with acute scrotum
- epididymitits | - testicular torsion
63
Acute onset of testicular pain with negative cremasteric reflex
-testicular torsion
64
Acute or chronic testicular pain with positive cremasteric reflex
-epididymitis
65
Etiology of noninfectious epididymitis
- relfux of urine - prolonged sitting - underlying congenital defect
66
Management of noninfectious testicular pain
- conservative treatment - scrotal support - NSAIDs/tylenol
67
Gradual onset of ED indicates what
organic disease
68
Hydrocele is common in..
- newborns, usually disappears by age 1 | - older boys and adults due to inflam or injury
69
Nonpainful hydrocele diff dx
- spermatocele - varicocele - hematocele - inguinal hernia - testicular tumor
70
Painful hydrocele diff dx
- infection - epididymo--orchitis - hematoma - testicular torsion - trauma - thrombosis
71
Varicocele
-enlargement of veins within scrotum
72
Varicocele risks
- low sperm production - decreased sperm quality - infertility
73
Varicocele treatment
- pain killers | - surgery
74
Peyronie's disease
- inflammatory disorder of penis - fibrotic plaques on tunica albuginea - penile pain primarily during erection - palpable nodules and penile deformity (crooked erections) - may resolve spontaneously - surgical correction if needed
75
Balanitis
-candidal infection of glans
76
Balanitis is more common in
-uncircumcised -diabetic -IC use of SGLT2 inhibitors
77
Balanitis treatment
- topical OTC azoles | - treat partner if they also have symptoms
78
Phimosis
foreskin unretractable due to edema
79
Varicocele also called
bag of worms
80
New onset varicocele can indicate what
testicular tumor | mass that is impeding venous drainage
81
Where does fluid collect in hydrocele
-tunica vaginalis
82
Treatment for adult with enlargin or new onest hydrocele
US and urology referral
83
PSA level when patient is on Finasteride
multiple PSA by 2

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