ClDx Flashcards
Stones due to primary hyperparthyroidism (sx, process etc)
flank pain radiating to groin, sharp/crampy (colic), nausea, CaPO stone (even tho most are CaOxalate)
-hyperPTH elevates calcium (from adenoma), the hypercalcemia causes moans/groans(constip)/bones/stones
Peyronie’s disease
Scars and plaques on tunica albugenia, caused by trauma, genetics or drugs (B blockers, pheny/interferon etc), potential Txs, surgery
Priapism
Abnormal sustained erection >4 hr
Can be caused by cocaine and/or Viagra
EMERGENCY- surgery req so penis doesnt become necrotic
Hydrocele (Congenital and Acquired)
Fluid in scrotum, benign, acquired caused by trauma disrupting tissue causing accum of transudate plasma (will be transilluminated)
- dx with ultrasound
- tx with cold compression and elevation of scrotum so fluid is reabs
- congenital is in infants due to incomplete oblit of processes vag, may resolve early
Candida infxn with balanitis
Balanitis is inflam of foreskin and head of penis
- sx: swelling in genital area, ITCHING, cannot retract foreskin (PHIMOSIS, paraphimosis is opposite), red rash
- risks: DM, immunocomp, candida (from yeast)
- compl: can lead to secondary bacterial infxn, can cause penile ischemia
- tx: catheter and elevate scrotum
Testicular Cancer
pres, pop, cure rate, risks, tx?
firm painless mass on testicle, testicle enlarged/firm/nontender
- common in 20-30 y.o men, caucasians, germ cell tumors, high cure rate
- risks: undescended testis, orchitis
- tx: orchioectomy
ADPKD (AD adult polycystic kidney disease)
- enlarged kidney (multiple myeloma w amyloid can also do this) with cysts and foci on echo, can also be in liver
- sx: aching back, abd pain, HTN, hematuria, CVA tenderness bilaterally (det by percussion)
- common cause of ESRD (also DM, HTN)
- mutation in PKD, tx with ACEIs and ARBs for HTN
Testicular torsion
Spermatic cord twists and compromises blood flow
- sx: acute severe pain in a testicle often brought on by cold, nauseated/weak, absent cremaster reflex, asymmetric testicles
- most caused by bell-clapper congen deformity where testicle floats in tunica vag
- dx with doppler ultrasound to assess blood flow, can be ok if de-torision within 6 hr
Epididymis
sx, relief, STI causes, what is condyloma
- sx: testicle tederness (nut hurts) esp along scrotal area, green-yellow discharge, pain relieved when elevate scrotum (unlike torsion), tenderness/firmness of epid
- can be from GONORRHEA–gram neg intracell diplococci or CHLYMIDIA–intracell inclusion bodies
- condyloma accuminata from HPV can cause verruca lesions
Genital herpes
which virus, pres, biopsy, tx
HSV2 is genital, painful, latent in sacral ganglia, red vesicle on skin, multinucleated giant cells on Tzank smear, Tx with -cyclovir
Syphilis genital issues
painless sore (chancre) on penis, heals, primary syphilis—use darkfield microscopy for T pallidum; but secondary will have rash on palsm and soles and can do + VDRL, tertiary has gummas on skin/organs/bone and aortic anuerysms, congenital has facial abnormalities
Uremia
Itchiness from iron deficiency anemia, can be from ibuprofen (NSAID mixed with longstanding DM), can cause failing kidneys, stopped dialysis
Renal Cell Carcinoma (RCC)
microscopic hematuria
- risks: smoking, older men, genetics
- tx surgical resection
- complication: high risk of thrombosis/metastases (eg bone involvement causing hypercalcemia)
Causes of ARF
Prerenal: obstruction (or drop in bp/shock) of blood flow TO kidney
INtrarenal: direct dmg to kidney (inflam, toxins, drugs, infxn, reduced blood supply)
Postrenal: sudden obstruction of urine outflow (eg enlarged prostate, stones etc)
