Male GU Disorders Flashcards

1
Q

Epididymitis categorization?

A

U infectious

1) STD: U 40yo, C trach or N gono
2) Non-STD: U old, G- rods

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2
Q

Epididymitis presentation?

A

Scrotal pain w/ P radiation to cord/flank
Fever
Swelling of epididymis
Tender prostate

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3
Q

Epididymitis labs?

A

CBC = L shift

Gram stain = N gono or WBC w/o visible org (chlamydia)

UA = pyuria, bacter, hemat

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4
Q

Epididymitis imaging?

A

scrotal US confirms dx

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5
Q

Prehn’s sign is?

A

lift scrotum -> elevation stops pain is epidid

pain won’t stop if torsion

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6
Q

Epididymitis tx?

A

scrotal elevation
NSAIDS
If STD: Rocephin + Doxy
Otherwise: Levoflox

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7
Q

Urethritis in men U caused by?

A

Gonorrhea

Chlamydia

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8
Q

Gonorrhea presentation: men?

A

dysuria

clear/yellow d/c

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9
Q

Gonorrhea presentation: women?

A

same but U less severe

+ chandelier sign (painful cervix)

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10
Q

Gonorrhea labs?

A

Men: cx, gram stain
Women: cx, gram not helpful

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11
Q

Gonorrhea tx?

A

Rocephin or Cefixime

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12
Q

Chlamydia presentation: men?

A

clear/white d/c

LAD

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13
Q

Chlamydia presentation: women?

A

Pelvic/cervical inflamm sxs

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14
Q

Chlamydia labs?

A

cx best but too slow

DNA probe, next best
immunoflour assay
enz-linked assay

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15
Q

Chlamydia tx?

A

Uncomplicated: zythro

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16
Q

Urinary Stone types? (5)

A

1) Ca2+ oxalate
2) Ca2+ phos
3) Struvite
4) Uric acid
5) Cystine

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17
Q

What type of stone is radiolucent?

A

Uric acid

*all others are radiopaque

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18
Q

Stone presentation?

A

severe pain

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19
Q

Erectile Dysfxn caused by?

A

Organic: neuro, vasculature
Psychogenic
Meds

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20
Q

Sign that ED is not organic?

A

nocturnal or a.m. erections

21
Q

ED hx should include? (7)

A
Hyperlipidemia
HTN
DM
Renal fail
Neuro dz
Thyroid/adrenal dz
Trauma/surgery
22
Q

ED exam should include?

A
2º sex characteristics
Neuro/vascular fxn
Genital scarring
Scrotal content
PROSTATE EXAM
23
Q

ED labs?

A
CBC
UA
Glu/Lipids
Testosterone
Prolactin
24
Q

ED pharm tx?

A

test inject
prostagl inject
prostagl suppository
viagra/cialis/levitra

25
Q

Viagra + what med (P) fatal?

A

nitrates

26
Q

Spermatogenesis takes how long?

A

74 days

27
Q

Causes of infertility: infections?

A

mumps
epididymitis
orchitis

28
Q

Causes of infertility: environment?

A

heat
radiation
chemo

29
Q

Causes of infertility: meds?

A
steroids
cimetidine (antacid)
spironolactone (aldost antag)
phenytoin (anti-convulsant)
sulfasalazine (abx colitis/crohns)
nitrofurantoin (abx UTI)
marijuana
ETOH
30
Q

Signs of pituitary tumor?

A

↓ libido
HA
visual disturbances

31
Q

Infertility physical exam should include?

A

2º sex characteristics
scrotum
prostate

32
Q

Infertility labs?

Imaging?

A

Semen (72 hrs post) = 60% normal morph and motility
Endocrine levels

scrotal US

33
Q

Retrograde ejaculation tx?

A

imipramine

34
Q

Testicular Torsion epidemiology?

A

10-20yo

U hx of strain or while sleeping

35
Q

Testicular Torsion presentation?

A

severe pain (constant or intermit)

*testicular pain always torsion till proven otherwise

36
Q

Testicular Torsion imaging?

A

doppler US

37
Q

Testicular Torsion tx?

A

emergency surgery

38
Q

Varicocele is?

A

varicose vv of spermatic cord

39
Q

Varicocele NOT a/w?

A

family hx

environmental risks

40
Q

Varicocele presentation on physical exam?

A

↓ when supine
↑ when standing/vasalva

*(P) mimics inguinal hernia

41
Q

Varicocele diagnostics?

A

No labs

Venogaphy if doesn’t resolve

42
Q

Varicocele tx?

A

watch/wait w/ scrotal support

surgical

43
Q

Direct Inguinal Hermia is?

A

hernia thru Hesselbach triangle (ingu lig, inf epigastric vessel, lat rectus adbominis)

U not incarcerate (can move back into abd)

44
Q

Indirect Inguinal Hermia is?

A

thru inguinal canal, lateral to epigast vessels

U incarcerated (do not move back into abd)

45
Q

Inguinal Hernia presentation?

A

U asympt (found on exam)
Incarcerated -> abrupt pain, N/V
Strangulated -> pt becomes toxic

*can present as LAD, hydrocele, torsion

46
Q

Primary cause of bowel obstruction?

Second cause?

A

postop adhesion

incarcerated hernia

47
Q

Inguinal Hernia labs?

A
CBC = (P) WBC L shift
Electro = abnorm
BUN = shows hydration/toxic status
48
Q

Inguinal Hernia imaging?

A

Acute abdominal series (r/o air, obstruction)

49
Q

Inguinal Hernia tx?

A

reduction ONLY if very recent onset
(don’t introduce dead bowels back into abdomen)

surgery