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ICA > Men’s Health - Urology > Flashcards

Men’s Health - Urology Flashcards

1
Q

What is phimosis?

A

Foreskin/prepuce cannot be fully retracted in adult

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2
Q

What is paraphimosis?

A

Painful constriction of glans penis by retracted prepuce proximal to corona

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3
Q

What is prepuce?

A

Foreskin

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4
Q

Common causes of paraphimosis

A

Phimosis
Catherisation
Penile cancer

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5
Q

What is posthitis?

A

Inflamed foreskin

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6
Q

Treatment of paraphimosis

A

Needs reduction

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7
Q

Best treatment of phimosis

A

Circumcision

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8
Q

What type of cancer is penile cancer?

A

Squamous cell carcinoma

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9
Q

Risk factors of penile cancer

A
  • Phimosis > poor hygiene + build up of smegma
  • HPV 16/18
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10
Q

Key indications of circumcision in children

A

Religion
Recurrent balantitis/UTIs

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11
Q

Key indications of circumcision in adults

A
  • recurrent balanitis
  • phimosis
  • recurrent paraphimosis
  • balanitis xerotica obliterans
  • penile cancer
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12
Q

What is balanitis?

A

Inflammation of glands of penis

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13
Q

What is balanitis xerotica obliterans?

A

Thin white scaly patch on foreskin

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14
Q

Causes of acute scrotal pain

A
  • testicular torsion
  • epididymitis/epididymo-orchitis due to UTI/STI/mumps
  • trauma
  • ureteric calculate (rare) due to referred pain
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15
Q

Common history of testicular torsion

A
  • younger patient <30
  • sudden onset
  • unilateral pain
  • possible nausea + vomiting
  • no lower urinary tract symptoms
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16
Q

Common exam findings of testicular torsion

A
  • testis is very tender
  • lying high in scrotum with horizontal line
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17
Q

Treatment of testicular torsion?

A

Emergency scrotal exploration

18
Q

What are the common causes of epididymitis-orchitis in younger vs older people?

A
  • 20-40/50: STIs e.g. chlamydia
  • 40/50+: UTI e.g. E.coli
19
Q

Common history of epididymo-orchitis

A
  • gradual onset
  • unilateral
  • recent history of UTI, unprotected sex, catheter, mumps
20
Q

Common exam findings in epididymo-orchitis

A
  • pyrexial
  • scrotum erythematous
  • testis/epididymis enlarged + tender
  • reactive hydrocoele
  • fournier’s gangrene (rare)
21
Q

Treatment of epidiymo-orchitis

A
  • Antibiotics
  • Surgically drain abscess if present
  • energy debridement + antibitoics if fournier’s gangrene
22
Q

What could a non tender, painless scrotal lump be?

A
  • testicular tumour
  • epididymyal cancer
  • hydrocoele
  • reducible inguino-scrotal hernia
23
Q

If a man presents with a scrotal lump that you can’t ‘get above’, what is it likely to be?

A

Hernia

24
Q

Common exam findings of hydrocoele?

A
  • testis not palpabale separately
  • can get above
  • transilluminates
25
Q

Describe a hydrocoele

A

Scrotal swelling due to imbalance of fluid production + resorption between tunica albuginea + tunica vaginalis

26
Q

Common exam findings of epidiymal cyst

A
  • painless
  • separate from testis
  • can get above
  • transilluminates
27
Q

If a man presents with a scrotal lump with a dull ache at the end of day, what is it likely to be?

A

Varicocele

28
Q

Common exam findings of Varicocele

A
  • feels like bag of worms above testis
  • not tender
29
Q

Treatment of testicular tumour

A

Inguinal orchidectomy
Removal of testicle through an incision in inguinal region

30
Q

Treatment of epidiymal cyst

A

Reassure
Excise if large

31
Q

Treatment of adult hydrocoele

A

Reassure
Remove is large or symptomatic

32
Q

Causes of urinary retention

A
  • BPH or prostatic cancer
  • phimosis, meatal stenosis
  • urethral stricture
  • drugs
  • UTI
  • over distension
  • following surgery
  • neurological
33
Q

What do older men with nocturnal enuresis have until proven otherwise?

A

Chronic retention with overflow incontinence

34
Q

What could be causing voiding symptoms?

A

Bladder outflow obstruction
Reduced contractility

35
Q

Types of physical bladder outflow obstructions

A

Phimosis
Urethral stricture
BPH

36
Q

What does spraying of urine suggest?

A

Urethral stricture

37
Q

Managment of BPH

A
  • reduce caffeine intake + fizzy drinks
  • no need to drink >2.5L per day
  • a blockers e.g. tamsulosin
  • 5a reductase inhibitors e.g. finasteride
38
Q

Why are alpha blockers used in Managment of BPH?
Example

A
  • relax smooth muscle within prostate + bladder neck > symptoms relief
  • e.g. tamsulosin
39
Q

Why are 5a reductase inhibitors used in management of BPH?
Example

A
  • act by ‘shrinking’ prostate via androgen deprivation
  • slow progression + reduces risk of retention
  • e.g. finasteride
40
Q

List two drugs used in BPH management + their drug class

A

tamsulosin - a blocker
finasteride - 5a reductase inhibitor

41
Q

Indications of surgical treatment of BPH

A
  • Failed lifestyle + medical management
  • Urinary retention needs innervation
42
Q

What surgical treatment is used in BPH?

A

Transurethral resection of prostate

ICA (13 decks)

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