men's health review Flashcards Preview

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Flashcards in men's health review Deck (25):
1

priapism

prolonged painful erection
> risk is sickle cell
ischemic form is emergency

2

testicular cancer

new onset of hydrocele
painless/asymptomatic until metastasis
common in young white males

3

prostate cancer

NEW onset of LOW back pain/rectal area with 50yo, obese, black, family hx

4

testicular torsion

ABRUPT extremeley painful scrotum, n/v
affected testicle is higher
no cremasteric reflex
age 10-20

5

cremasteric reflex

testicle elevates toward body (dt stroking/pinching of inner thigh).
ABSENT with testicular torsion

6

cryptoorchidism

undescended testes
> risk of testicular cancer

7

spermatogenesis stimulated by what

LH
testosterone

8

prostate gland

produces PSA (prostate specific antigen) and prostatic fluid
helps sperm survive in vagina
50% of 50 yo males have BPH

9

epididymis

coiled tubular organ loacted posterior aspect of the testis. stores immature sperm for 3 months , these are cut during vasectomy

10

transillumination scrotum

beam of life behind the scrotum
Serous fluid- bright red glow (hyrocele)
blood/mass- dull or NO glow (cancerous tumor)

11

testicular cancer common in whom, s/s, labs

most common males 15-30 yo, white
s/s: testicle feels "heavier"
nodule
new hydrocele

labs: ultrasound, biopsy, refer to urologist
removal- orchiectomy

12

testicular torsion

definition and s/s

spermatic cord becomes twisted
blood supply interrupted
if not corrected within 24 hours, 100% of the testicles become gangrenous/surgical removed

classic case: 14 yo with SEVERE testicular pain, extremely red swollen, n/v.

call 911!, doppler sound, tx is manual reduction or surgery

13

prostate cancer
risk factors

risk factors:
>50 yo, AA, obese, family member (1st degree relative doubles the risk)
digital rectal exam (DRE) and PSA routine NOT recommended.
do exam based on pt's age and risk factor

14

prostate cancer s/s

PAINLESS nodule (hard/indurated)
Elevated PSA >4.0
screen: PSA with DRE, If 4.0 PSA

drug therapy: anti androgens (proscar), hormone blockers (lupron)

15

BPH

seen in 50% of males >50
urinary obstruction s/s
nocturne common

PSA is elevated (norm: 0-4)
enlargd prostate, symmetrical, rubbery

medictions:
Alpha andrenergic antagonist: Terazin (HYTRIN) )/tamsulosin/flomax

***5 alpha reductase inhibitors: Fiasteride (PROSCAR) (blocks testosterone)

avoid cold medications, antihistamine, caffeine
herbal: saw palmetto

16

how to determine effectiveness of proscar

MULTIPLE PSA by 2. value should be below baseline.

17

proscar

category X
teratogenic
should not be touched with bare hands by reproductive aged female

18

chronic bacterial prostatis

>6 wks
E.coli
UTI s/s
boggy prostate
NORMAL UA unless urine mixed with prostatic fluid= E. Coli

labs: urine/prostatic fuid. Use 3 tubes (urethra, bladder, urine)
PSA will elevated

medications: Bactrim (trimethoprim-sulfamethoxale)
Ofolzcin (floxin) or levofloxacin (levaquin)

19

acute prostatis

YOUNG male
enterobacter
UTI s/s, cloudy urine, fever
prostate WARM and TENDER
DO NOT massage virorously dt risk of infection

tx >35 yo fluoro

20

bacterial epidiymitis

bacteria ascends up the urethra (urethritis) and reaches epidymis
RULE OUT testiculor torsion
POSITIVE PHRENS SIGN (relief of pain with scrotal elevation)

tx: 35 levo
scrotal elevation, ice packs, bed rest.

21

erectile dysfunction rx

1st line: phosphodiesterase type 5
viagra/levitra on empty stomach 30-60 min before sex
other: intravernous injections (alpostadil or caverject)

contraindicatsion: nitrates, alpha blockers, post MI

22

peyronie's disease

penile pain during erection/nodles/crooked penile dt fibrotic plaques on the tunica albuginea.

no labs, refer to urologist

23

phimosis

foreskin cannot be pushed back dt edema ( seen in neonates)

24

varicocele

veins "bag of worms" in scrotal sac. new onset can be testiculr tumor

order ultrasound

25

>35 think E. coli

true