Chapter 11: Urological and Gynecological Disorders Flashcards
Which ethnic group has the highest incidence of prostate cancer?
African Americans
Men with an initial PSA level below 2.5 ng/ml can reduce their screening frequency to what intervals?
Every 2 years
All of the following may be reasons associated with an elevated PSA besides prostate cancer except:
Urinary tract infection
In the diagnosis of acute bacterial prostatitis, a midstream urine culture is of benefit. To be diagnostic, the specimen should reveal how many white blood cells per high-power field?
Ten
In chronic bacterial prostatitis, what is the organism most commonly associated with the disease?
Escherichia coli
In acute prostatitis, an exam of the prostate may find the gland to be:
Swollen and tender
All of the following antimicrobials may be indicated in chronic bacterial prostatitis except:
Azithromycin
Age-related changes in the bladder, urethra, and ureters include all of the following in older women except:
Increased estrogen production’s influence on the bladder and ureter
Mr. Jones is a 68-year-old retired Air Force pilot that has been diagnosed with prostate cancer in the past week. He has never had a surgical procedure in his life and seeks clarification on the availability of treatments for prostate cancer. He asks the nurse practitioner to tell him the side effects of a radical prostatectomy. Which of the following is NOT a potential side effect of this procedure?
Selected low back pain
The nurse practitioner is evaluating a patient’s pelvic muscle strength by digital examination. This is performed when:
The nurse practitioner needs to confirm a cystocele or stress incontinence
A pelvic mass in a postmenopausal woman:
is highly suspicious for ovarian cancer.
A 79-year-old man is being evaluated for frequent urinary dribbling without burning. Physical examination reveals a smooth but slightly enlarged prostate gland. His PSA level is 3.3 ng/mL. The patient undergoes formal urodynamic studies, and findings are as follows: a decreased bladder capacity of 370 mL; a few involuntary detrusor contractions at a low bladder volume of 246 mL; an increased postvoid residual urine volume of 225 mL; and a slightly decreased urinary flow rate. Which of the following is not consistent with a normal age-associated change?
Increased postvoid residual urine volume
Mrs. Smith, a 65-year-old woman presents to clinic for the first time and complains of urinary incontinence and dyspareunia. She went through menopause 10 years ago without any hormone replacement therapy and had a hysterectomy for a fibroid. Her mother had a hip fracture at 82 years of age. The patient’s most recent mammogram was 5 years ago and no known family history of breast cancer. She is not taking any medications. Her physical examination is unremarkable except for findings consistent with atrophic vaginitis. You decide to begin topical hormone replacement therapy. Which of the following evaluations would be necessary prior to initiating hormone replacement therapy?
Mammogram
Mrs. L. Billings is a 77-year-old Caucasian female who has a history of breast cancer. She has been in remission for 6 years. As her primary care provider, you are seeing her for follow-up of her recent complaint of intermittent abdominal pain of a 3-month duration and some general malaise. Given the brief history above, what will you direct your assessment at during physical examination?
Thorough abdominal and gynecological exam to rule out masses and identify any tenderness.
A 78-year-old female comes to the office because she has pain when she urinates. She has been seen three times for this problem in the last 3 months. Each time she was told she had a UTI and was given antibiotics. She carefully followed the instructions but has had no relief of symptoms. Last sUA:
Perform a pelvic examination
