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Emed > # 11: Mens Health > Flashcards

# 11: Mens Health Flashcards

1
Q

testis twists on spermatic cord

A

Testicular torsion

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2
Q

Common Hx w/ Testicular Torsion (2 things)

A

Common Hx w/ Testicular Torsion

  1. trauma
  2. Cryptorchidism
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3
Q

Pt presents w/ sudden onset of severe unilateral testicular pain and swelling, N/V. Testis ttp, and high riding with absent cremesteric reflex

what is the best test for Dx it
most likely Dx

A

Test = URGENT US (see if flow present)

dx = Tesituclar torsion

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4
Q

Tx of Testicular torsion

  1. non-surgical
  2. surgical
A

Tx of Testicular torsion

  1. non-surgical = manual detorsion (open book)
  2. surgical detorsion and orchiplexy
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5
Q

erection > 4 hrs

A

Priaprism

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6
Q

Priaprism

  1. two main causes
  2. 2 types - which is MC and more emergent
A

Priaprism

  1. causes = SCD, meds
  2. types
    - ischemic = MC and more emergent
    - non-ischemic
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7
Q

Priaprism Med Causes

  • what 3 meds typically cause it
A

Priaprism Med causes (think ED drugs)

  1. NO
  2. PDE 5 Inhib
  3. Trazadone
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8
Q

Ischemic vs Non ishchemic Priaprism

  1. which a/w impaired relaxation of cavernosal smooth muscle
  2. which is a/w fistula formation, more gradual, trauma related
  3. which usu resolves on it own
A

Ischemic vs Non ishchemic Priaprism

  1. ischemic = a/w impaired relaxation of cavernosal smooth muscle
  2. non-ischemic = a/w fistula formation, more gradual, trauma related
  3. non-ischemic usu resolves on its own
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9
Q

Tx of ischemic priaprism

  • what is med given
  • what can also be done in addition to med
A

Tx of ischemic priaprism

  • med = phenylephrine (intracavernosal sympathomimetic)
    and/or aspiration
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10
Q

cant retract foreskin
vs
entrapment of foreskin behind glans (cant replace foreskin)

A

phimosis = cant retract foreskin

paraphimosis = entrapment of foreskin behind glans (cant replace foreskin)

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11
Q

Phimosis vs Paraphimosis

  1. which is a/w purulent d/c
  2. which is a/w eyrthema of glans
  3. which is emergency
A

Phimosis vs Paraphimosis

  1. Phimosis = a/w purulent d/c
  2. Paraphimosis = a/w eyrthema of glans
  3. PARAphimosis = EMERGENCY
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12
Q

Tx of phimosis

  1. main tx
  2. rare procedure
  3. infection –>
A

Tx of phimosis

  1. main tx = steroid creams
  2. rare procedure = circumcision
  3. infection –> antigfungals/ABXs
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13
Q

Tx of paraphimosis (emergent)

  1. 2 options
  2. what to consider after initial tx
A

Tx of paraphimosis (emergent)

  1. 2 options= manual or surgical reduction
  2. consider circumcision after initial tx
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14
Q

24 y/o pt presents w/ heaviness, L sided dull ache in scrotum, fever, chills, pain radiating up L flank. On exam you note a swollen/enlarged epididymis. UA shows pyuria, bacteria and cultures are +

Dx and 2 ABXs for Tx?

A

Dx = epididymitis

Tx = Ceftriaxone + Doxycyline

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15
Q

What is Tx for pts w/epididymitis who are older than 35

A

Tx for pts w/epididymitis > 35 y/o = Cipro

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16
Q

Orchitis

  1. what viral infxn is it a/w and what is tx
  2. if bacterial cause what do you treat it like
  3. presentation (3 things)
  4. how to Dx bacterial
A

Orchitis

  1. a/w MUMPS –> symptomatic Tx (ice, analgesia)
  2. if bacterial cause –> treat it like epididymitis
  3. unilateral testicular swelling/tenderness, fever, tachycardia
  4. Dx = UA (signs of bacteria infxn)
17
Q

fluid fluid remains of tunica vaginalis

A

hydrocele

18
Q

Pt presents w/soft NT fullness of hemiscrotum and pt says size waxes and wanes. On PE the mass transilluminates

Dx?
Tx - needed?

A

Dx = Hydrocele

tx - usu not needed (go away in 1 yr)
- can do elective surg

19
Q

Pt presents w/ venous varicosity w/in pampiniform plexus on L. On exam the mass is NT, does not illuminate and looks like a bag of worms

dx?
when is Tx needed? and what is it

A

Dx = variocele

Tx needed if causing infertility or Sxs (surg)

20
Q
  1. Nephrolithiasis
  2. cystitis + pyelonephritis
  3. Acute/CKD
  4. vigorous exercise/trauma (rhabdo)
  5. CA (bladder, prostate, kidney)

Are causes of _______

A

causes of hematuria

  1. Nephrolithiasis
  2. cystitis + pyelonephritis
  3. Acute/CKD
  4. vigorous exercise/trauma (rhabdo)
  5. CA (bladder, prostate, kidney)
21
Q

Things that look like hematuria but arent (3)

A

Things that look like hematuria but arent

  1. beets
  2. food dye
  3. Phenazopyridine
22
Q

Hematuria and Bladder CA

  1. what is MC sx
  2. best test to Dx it
A

Hematuria and Bladder CA

  1. what is MC sx = PAINLESS Hematuria
  2. best test to Dx it = Cystoscopy
23
Q

Pt presents w/ hematuria, flank pain, abd mass and wt loss. pt also has paraneoplastic syndromes

1) Dx
2) what tests best to Dx? stage?

A

dx = Renal Cell Carcinoma

Test to Dx = MRI/CT
stage = bone scan

24
Q

Pt presents w/ dysuria, pruritus, burning,and discharge at urethral meatus. You see PMNs on gram stain and leuk esterases on first void urine.

  1. What test is best to confirm Dx
  2. Dx?
  3. what is most likely cause
A

Test to confirm Dx = NAAT testing

Dx = Urethritis

most likely cause = G/C (STI)

25
Q

Urethritis

  1. tx for G/C
  2. Tx if not G/C
A

Urethritis

  1. tx for G/C = Ceftriaxone + Azithromycin
  2. Tx if not G/C = Azithro or Doxy
26
Q

Pt presents w/ urinary freq, urgency, dsuria, fever, rigors low back/perineal pain, and pain/bleeding w/ejaculation.

Dx?

A

dx = prostatitis

27
Q

Prostatitis

  1. findings on prostate exam
  2. finding on UA
  3. Tx
A

Prostatitis

  1. findings on prostate exam = swollen, tender + boggy prostate
  2. finding on UA = pyuria
  3. Tx = Fluoroquinolone or Bactrim
28
Q

Nephro/urolithiasis

  1. what type is MC
  2. when is it considered an emergency (2 situations) b/c it can lead to __________
  3. BEST imaging study
A

Nephro/urolithiasis

  1. MC = calcium (opaque)
  2. emergency if infected or complete obstruction –> hydronephrosis
  3. BEST imaging study = NON contrast abd + pelvic CT
29
Q

Pt presents w/ severe sudden onset of unilateral, stabbing flank pain. Vitals: RR 22, HR 110 and BP 110/78, PE findings are CVAT and restlessness b/c pt cant get comfortable. UA shows hematuria.

dx?

A

Kidney stone

30
Q

Sxs of kidney stones by location

  1. flank pain, N/V
  2. abd pain w/ classic renal colic
  3. urinary freq, dysuria, pain radiate to groin
A

Sxs of kidney stones by location

  1. flank pain, N/V = prox ureter/ renal pelvis
  2. abd pain w/ classic renal colic = mid ureter
  3. urinary freq, dysuria, pain radiate to groin = distal ureter
31
Q
  1. trauma
  2. infxn
  3. torsion
  4. hernia
  5. testicular CA

are causes of

A

causes of scrotal pain

  1. trauma
  2. infxn
  3. torsion
  4. hernia
  5. testicular CA
32
Q

Most serious cause of scrotal pain (emergent)

A

Fournier’s gangrene

33
Q

Necrotizing fasciitis of perineum, often involves scrotum

A

Fournier’s gangrene

34
Q

Pt presents w/ fever, tachycardia, HoTN, Blisters/bullae of perineum, crepitus and subQ emphysema

dx?
tx? (2 things)

A

Dx = Fournier’s gangrene

Tx = surgical debridement and ABXs
- DONT DELAY Tx FOR IMAGING

Emed (10 decks)

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