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Clin Med: GU (block 3) > Penile & Testicular Disorders > Flashcards

Penile & Testicular Disorders Flashcards

(42 cards)

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1
Q

Peyronie Dz RFs

A
  • penile trauma
  • genetics
  • tobacco
  • excessive alcohol
  • pelvic surg (radical prostatectomy)
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2
Q

Describe penile pain in acute inflammatory phase of peyronie dz

A
  • often occurs w/ erection but can occur in flaccid state, w/ palpation, and/or during coitus
  • rarely severe but may interfere w/ sexual function
  • usually dissipates as inflammation settles (w/n 6-18 months)
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3
Q

Describe changes in penile shape seen in acute inflammatory phase of Peyronie dx

A
  • curvature
  • hinging
  • hourglass
  • narrowing
  • shortening
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4
Q

ED RFs

A
  • age
  • obesity
  • DM
  • dyslipidemia
  • metabolic syndrome
  • lack of exercise
  • smoking
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5
Q

Drug Associated w/ ED

A
  • Antihypertensives
  • Antidepressants
  • Recreational (Ethol, cocaine, mary)
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6
Q

Examples of antihypertensives associated with ED

A
  • CCB
  • Methyldopa
  • Clonidine
  • Reserpine
  • BB
  • Guanethidine
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7
Q

Examples of antidepressants associated with ED

A
  • SSRIs
  • Tricyclic antidepressants
  • Lithium
  • Monoamine oxidase inhibitors
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8
Q

Examples of recreational things associated with ED

A
  • alcohol
  • Cocaine
  • Marijuana
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9
Q

What do we look for in a patients Hx who presents w/ ED?

A
  • sexual orientation
  • previous & current relationship status
  • current emotional state
  • pts self-assessment of sexual perf.
  • pts attitude & knowledge of sex
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10
Q

What do ask about with patients who presents w/ ED?

A
  • morning or nighttime erections (presence may suggest psychogenic etiology)
  • symptom onset and duration
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11
Q

In ED, what are we looking for when evaluating the penis?

A
  • size
  • scars
  • fibrosis or plaques (Peyronie?)
  • urethral meatus
  • elasticity
  • curvature
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12
Q

In ED, what are we looking for when evaluating the scrotum?

A
  • testicular size (small testes suggests hypogonadism)
  • testicular consistency
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13
Q

Hypospadias RFs

A
  • FHx
  • maternal exposure to DES
  • advanced maternal age
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14
Q

What do we ask about in pts presenting w/ Hypospadias/Epispadias?

A
  • maternal intake of progestins, estrogens, & anti-androgenic compounds during preg
  • ## maternal illness during preg
  • FHx of Hypospadias/Epispadias
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15
Q

In Hypospadias/Epispadias, doing additional testing does what?

A

exclude disorders of sex development in infancy

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16
Q

Hypospadias/Epispadias hormonal testing including which hormones?

A
  • cortisol
  • estradiol
  • glucose
  • HCG
  • progesterone
  • testosterone
  • thyroid function
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17
Q

Hypospadias/Epispadias Tx

Study These Flashcards
A

Surgical repair by peds urologist

18
Q

Phimosis Tx

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A
  • < 2 no tx needed
  • physiologic (primary) phimosis
    usually resolves w/ time
    –> conservative tx w/ steroid ointment or cream
    –> circumcision
    –> don’t delay tx if recurrent balanitis or recurrent urinary tract infx

pathologic (secondary) phimosis
- consult peds urologist
- circumcisionis indicated tx in case of lichen sclerosis or scarred phimosis

19
Q

Paraphimosis Tx

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A
  • tx immediately; emergent
  • manually compress edematous tissue, then attempt to retract foreskin over glans penis
    –> If unable call Urology STAT
20
Q

What is balanitis?

Study These Flashcards
A

infx of glans penis

21
Q

Balanitis/
Balanoposthitis
RFs

Study These Flashcards
A
  • Uncircumcised status
  • Phimosis (can’t retract foreskin)
  • Poor hygiene
22
Q

Balanitis/
Balanoposthitis Tx

Study These Flashcards
A
  • proper hygiene, esp uncircumcised
    & diabetic men

-Abstinence from sexual activity during infx

Specific etiology:
Irritant: d/c the irritant + topical steroid
Candida: clotrimazole or miconazole cream
Anaerobic: topical metro
STD: test & tx appropriately

23
Q

Squamous Cell Carcinoma of the Penis RFs

Study These Flashcards
A
  1. HPV
  2. Lack of neonatal circumcision
  3. Smoking
  4. HIV
  5. Chronic Balanitis
24
Q

Squamous Cell Carcinoma of the Penis Tx

Study These Flashcards
A
  • Early stages: excision of tumor or penis amputation
  • Lymph node involvement: can resect lymph nodes
  • Later stages: chemotherapy, radiation
25
Cryptorchidism Tx
Surgery (orchidopexy)
26
Hydrocele Infant Tx
- Watchful waiting for 12 months - Surg if doesn't resolve, or if there is a hernia as well
27
Hydrocele Adult Tx
- period of watch & wait if small + asymp - further tx if persist >1yr or symp
28
Varicocele Tx
- Goal of treatment--> incr fertility/future fertility - In adults, tx if very painful or if trying to conceive In kids, tx is controversial, but may do surg if painful or if there is significant testicular atrophy
29
Spermatocele PE
US-->soft, smooth, & transilluminate
30
Is Testicular Torsion a medical emergency?
YES!!!
31
What is a "blue dot" sign?
tender nodule w/ blue discoloration on upper pole of testicle
32
Testicular Torsion Tx
- Can attempt manual de-torsion - Will req urgent surg exploration - Ischemic damage occurs in 4-8 hrs
33
When suspecting Orchitis, what else should be on your DDx?
Cancer, abscess, & Torsion
34
Orchitis Tx
- STD tx if likely cause: --> Ceftriaxone 250 mg IM PLUS --> Doxycycline* 100 mg BID for 10 days - enteric organisms (anaerobes) likely causes: --> Levofloxacin 500mg po daily for 10 days –OR— --> Ofloxacin 300mg po BID for 10 days
35
Describe acute epididymitis
inflammation of epididymis < 6 wks duration
36
Epididymitis age range?
20-30 yo
37
Epididymitis RFs
- Congenital abnormalities - Incr sexual activity/new or multiple partners - Anal intercourse - Urinary tract obstruction
38
Epididymitis Tx
- Don't delay txt for labs - tx empirically - STD tx if likely cause: --> Ceftriaxone 250 mg IM PLUS --> Doxycycline* 100 mg BID for 10 days - enteric organisms (anaerobes) likely causes: --> Levofloxacin 500mg po daily for 10 days –OR— --> Ofloxacin 300mg po BID for 10 days
39
Testicular Cancer RFs
- FHx - Genetic factors (Down Syndrome, Klinefelter Syndrome) - Cryptorchidism - Cannabis use
40
Other potential presentations of testicular cancer due to spread of the cancer include:
- back pain (kidneys) - Cough (lungs) - Hemoptysis (lungs) - Headaches (brain)
41
What are the serum tumor markers found in testicular cancer?
- beta-human chorionic gonadotropin (beta-hCG) - lactate dehydrogenase (LDH) - alpha fetoprotein (AFP
42
Testicular Cancer Tx
Dependent on TMN staging - Orchiectomy - chemo/radiation depending on staging

Clin Med: GU (block 3) (7 decks)

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