Week 1 Urology Flashcards Preview

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Flashcards in Week 1 Urology Deck (34)
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Hematospermia

Source could be epididymis, seminal vesicle, prostate, bulbourethral glands

Red flag: sxs > 1 month, palpable mass, hematuria, obstructive sx

1

Epispadias

Congenital malformation of urethral meatus on dorsal side of the penis

2

Hypospadias

Congenital malformation of urethral meatus on ventral side of penis

3

Balanitis

Inflammation of glans penis

4

Posthitis

Inflammation of the foreskin

5

Balanoposthitis

Inflammation of glans and foreskin

Due to candida, GC, CT, scabies, contact derm, psoriasis, poor hygiene, diabetics

Sequelae: meatal stricture, phimosis, para phimosis, cancer

6

Phimosis

Foreskin cannot be retracted back away from glans penis
Pathologic or physiologic

7

Paraphimosis

Foreskin stuck in retracted position, becomes inflamed--> reduced blood flow --> necrosis

8

Peyronie's Disease

Scarring of tunica albuginea --> painful erection with dorsal curvature

9

Chancre

Due to syphilis. Solitary, painless ulcer
Non exudative, indurated edge

10

Chancroid

Painful, shallow non indurated ulcers, irregular edges and red borders
Gray or yellow purulent exudate
Infection of H. ducreyi
Regional tender adenopathy, may abscess

11

SCC of the penis

More common in uncircumcised males with poor hygiene
HPV 16 and 18
fungating, non painful sore that does not heal
Dx by biopsy

12

Priapism

Prolonged, painful erection > 4 hours. Emergency due to ischemia

Dx by color Doppler US, assessment of corporal blood gases

13

Orchitis

Inflammation of testicle due to infection, usu viral/mumps

14

Acute Epididymitis

Usu bacterial infection

Could be urine reflux/chemical irritation into ejaculatoru ducts from heavy lifting /trauma

Positive Prehn's sign
Scrotal US to rule out torsion

15

Chronic epididymitis

Inflammation with no infection present, enlarged, thickened, non tender epididymis

16

Hematocele

Blood filled, secondary to trauma. Does not transilluminate

17

Hydrocele

Non tender, serous filled
Acute-- between 2-5yrs, due to inflammation
Chronic--middle age men from inflammation or injury

18

Variocele

Due to gravity pulling on venous valves. Bag of worms. Worse with valsalva and standing

**Development of a new variocele: on L--tumor or mass. On R--occlusion of vena cava

19

Testicular torsion

Emergency! De-torse <6 hours

Color Doppler US.

20

Spermatocele

Small, painless cyst. Benign. With dead spermatozoa. Dx by US or aspiration.

21

Cryptorchidism

Failure of testicles to descend into scrotum during infancy

High risk of developing infertility or testicular cancer later in life

22

Testicular cancer

Most common solid a cancer in 15-34yrs

Risk factors: cryptorchidism, exogenous estrogen, trauma, gonadal dysgenesis, Klinefelter syndrome

23

Rubbery prostate

BPH

24

Boggy prostate

Congested

25

Induration on prostate

Malignancy. Nodules

26

Prostate labs

Serum PSA, PSA velocity, free/bound PSA

27

BPH

Progressive urinary freq, urgency, nocturia, dribbling

PE: enlarged, rubbery. Smooth, symmetric. May be distended bladder

Lab: increased BUN, UA, PSA

28

Acute bacterial prostatitis

Fever, chills, malaise, dysuria
+ E. coli, klebsiella, proteus, pseudomonas, enterobacter

Lab: CBC left shift. UA shows WBCs, elevated CRP

29

Contraindication for prostate massage

If acutely inflamed... Sepsis!!

30

Chronic bacterial prostatitis

Sxs: recurrent UTIs, fatigue, pain, sexual dysfunction, ejaculatory pain

PE: DRE--tender, boggy, enlarged, soft prostate

Lab: post massage urine culture and sensitivity

31

Chronic prostatitis/Prostadynia

Criteria: no objective cause, Sxs related to prostate area, refractory to tx

Etiology: psych stress, low T, infection from normal bacteria, genetic

32

Prostadynia Sxs and PE

Sxs: pain in pelvis > 3 mos, dysuria, urgency, low back/perineal pain, sexual dysfunction, post ejaculation pain, IBS, chronic fatigue

PE: DRE--mildly tender, boggy, enlarged

Lab: UA, urine culture and sensitivity, CBC

*may need to rule out CT/GC

33

Prostate cancer

Commonly adenocarcinoma.

Risk factors: age, African American, family hx, obesity, SAD, meds, vasectomy

Sxs: sexual dysfunction, incontinence, irritative/obstructive sxs, bone pain, weight loss

PE: non tender prostate, firm, stony hard, irregular nodules

Labs: PSA velocity (>.75ng/ml/year), total PSA 4-10/>10 ng/ml
CMP, inc alk phos

Dx: transrectal US with biopsy using Gleason score for grading
Axial CT/MRI for staging