Quiz #4 Male Genitourinary

Question 1

Production of sperm in the aging adult

Answer 1

Begins to decrease around 40, but continues into the 80s and 90s

Question 2

Testosterone production in the aging adult

Answer 2

Begins to decrease after age 30, but gradual- resulting physical changes are not evident until later

Question 3

What happens as a result of decreased tone of the dartos muscle in the aging adult?

Answer 3

Scrotal contents hang lower, rugae decrease, scrotum looks pendulous

Question 4

Changes in testes in the aging adult

Answer 4

decrease in size, less firm to palpation

Question 5

sexual response in the aging adult

Answer 5

slower, less intense

Question 6

Why might a man withdraw from sexual activity?

Answer 6

1. loss of spouse
2. depression
3. preoccupation with work
4. marital or family conflict
5. side effects of medications (anti HTN, psychotropic, antispasmodics, sedatives, narcotics, estrogens)
6. heavy alcohol use
7. lack of privacy
8. economic or emotional stess
9. poor nutrition
10. fatigue

Question 7

subjective data for male genitourinary

Answer 7

1. Frequency, urgency, nocturia
2. Dysuria
3. Hesitancy and straining
4. Urine color
5. Past genitourinary hx
6. Penis pain, lesions, or discharge
7. Scrotum and self-care
8. Sexual activity and contraceptive use
9. STI contact

Question 8

rapid detumescence

Answer 8

Penis rapidly becomes flaccid after ejaculation in the aging adult

Question 9

rapid detumescence

Answer 9

Penis rapidly becomes flaccid after ejaculation in the aging adult

Question 10

Two major causes of chronic kidney disease

Answer 10

HTN and DM

Question 11

How many times does the average adult void urine a day?

Answer 11

5-6 times

Question 12

Oliguria

Answer 12

Diminished urine- <400mL/day

Question 13

Dysuria is common with

Answer 13

acute cystitis, prostatitis, urethritis

Question 14

Hesitancy, straining, terminal dribbling, and decreased urine flow suggest…

Answer 14

BPH

Question 15

Urge incontinence

Answer 15

involuntary urine loss due to overactive bladder detrusor muscle

Question 16

Stress incontinence

Answer 16

Involuntary urine loss with physical strain, sneezing, or coughing caused by weakness of the pelvic floor

Question 17

Additional subjective hx for aging adult

Answer 17

1. Difficulty urinating, hesitancy, weakened force of stream, dribbling, incomplete emptying?
2. Do you ever leak water/urine when you don’t want to? use pads/tissues?
3. Nocturia? Med use? PM fluids?
4. Sexual function

Question 18

Nocturia causes

Answer 18

Diuretics
medication
habit
fluid ingestion 3 hrs before bedtime- especially coffee and alcohol
fluid retention from HF or varicose veins- recumbency at night mobilizes fluid

Question 19

Nocturnal enuresis

Answer 19

Bedwetting after 5-6 years of age

Question 20

Objective data for male genitourinary

Answer 20

Inspect and palpate the penis
Retract the foreskin, check for phimosis, paraphimosis, hypospadias, epispadias
check for scrotal swelling and inflammation
Assess urine color, clarity, and pH

Question 21

Normal urine pH

Answer 21

4.5-8.0

Question 22

Phimosis

Answer 22

narrowed opening of prepuce— foreskin cannot retract

Question 23

Paraphimosis

Answer 23

Painful constriction of the glans by a retracted foreskin

Question 24

Hypospadia

Answer 24

ventral location of the meatus

Question 25

Epispadia

Answer 25

dorsal location of the meatus

Question 26

stricture

Answer 26

narrowed opening of the meatus

Question 27

urethritis S&S

Answer 27

edges that are red, everted, edematous, with purulent discharge

Question 28

Causes of taut, pitting scrotal swelling

Answer 28

CHF, renal failure, local inflammation

Question 29

Sebaceous cyst

Answer 29

Yellow, 1 cm nodules on scrotum. Firm, nontender, and often multiple. Common and benign

Question 30

Nodules on teses or epididymides call for

Answer 30

ultrasound imaging

Question 31

Indurated, swollen, tender epididymis indicates

Answer 31

epididymitis

Question 32

Varicocele

Answer 32

Soft, swollen, torturous spermatic cord

Question 33

Transillumination of scrotum

Answer 33

Darken the room and shine a flashlight- normal scrotal contents do not illuminate. Serous fluid transilluminates and shows as red glow, indicates hydrocele or spermatocele. Hernia, epididymitis, and tumor do not illuminate.

Question 34

Testicular Self-Examination

Answer 34

Should begin at age 13-14 Timing— once a month S— shower- warm water relaxes scrotal sac E— examine, report changes immediately

Question 35

Testicular cancer most common in ages

Answer 35

15-35

Question 36

Proteinuria indicates

Answer 36

glomerular disease in the nephron

Question 37

Glucosuria suggests

Answer 37

hyperglycemia with diabetes

Question 38

Increased RBCs in the urine occur with

Answer 38

``` UTI Glomerulonephritis Renal calculi Trauma Cancer ```

Question 39

Normal creatinine levels

Answer 39

.70-1.5mg/dL. Measures GFR

Question 40

Normal BUN

Answer 40

10-20mg/dL

Question 41

How many men experience BPH?

Answer 41

more than 1/2 of men in their 60s and 90% of men in their 70s have symptoms.

Question 42

What two groups of men have increased risk of prostate cancer?

Answer 42

African American men and men whose first degree relatives had prostate cancer.

Question 43

How is prostate cancer detected?

Answer 43

PSA test or DRE (less effective)