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Men's Health > ClinMed > Flashcards

ClinMed Flashcards

1
Q

are testicular self exams recommended?

A

no

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2
Q

what are the CDC recommendations re: the HPV vaccine for males

A

males through 21 years

males 22-26 yo is individual basis

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3
Q

what is the recommendation for HPV vaccine for men with HIV or other immunocompromised condition?

A

through 26 years, 3 doses

same for men who have sex with men

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4
Q

what positions should the patient be in for hernia examination

A

standing then supine

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5
Q

what position should the patient be in for inguinal lymphatics

A

standing

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6
Q

cremasteric reflex evaluates what nerve

A

genitofemoral nerve (L1-L2)

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7
Q

normal cremasteric reflex will be

A

elevation of scrotum and testes

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8
Q

what position should the patient be in for rectum and prostrate exams?

A

left lateral decubitus or upright forward flexion

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9
Q

are screening DREs recommended?

A

nope

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10
Q

what are two congenital penile abnormalities?

A

hypospadias

cryptorchidism

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11
Q

risk of cryptorchidism puts the patient at increased risk for what two conditions?

A

testicular cancer

infertility

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12
Q

when is surgical intervention recommended for cryptorchidism?

A

as soon as possible after 6 months and definitely before 2 years old

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13
Q

what is hypospadias?

when is surgery recommended?

A

abnormal placement of the urethra.

surgery before 18 months

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14
Q

the most common cause of painless scrotal swelling

A

hydrocele

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15
Q

what will occur on PEx in a patient with hydrocele?

A

transillumination

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16
Q

where is the fluid in a hydrocele?

A

within the parietal and visceral layers of the tunica vaginalis

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17
Q

which type of hydrocele is more common in pediatrics?

A

communication (patent processus vaginalis)

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18
Q

bag of worms refers to

A

variocele

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19
Q

what is a variocele?

A

abnormal dilation of the veins of the pampiniform plexus

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20
Q

the most common cause of primary infertility in men

A

varicocele

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21
Q

what should always be on your differential for someone presenting with testicular pain?

A

testicular torsion

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22
Q

what side is the most common side for varicocele?

A

left side

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23
Q

a painless, cystic mass in the head of the epididymus that’s separate from the testicle and may contain sperm is often

A

spermatocele

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24
Q

most sensitive PEx finding for testicular torsion

A

absent cremasteric reflex

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25
Q

how quickly does detorsion of testicular torsion need to occur

A

6-8 hours

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26
Q

most common age group for testicular torsion?

A

10-20

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27
Q

clinical manifestation for testicular torsion

A

abrupt onset of scrotal, inguinal, lower abdominal pain and N/V often after trauma or workout

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28
Q

what is the best initial test for diagnosis of testicular torsion?

A

doppler US

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29
Q

what is the treatment for testicular torsion?

A

bilateral orchiopexy

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30
Q

pain that improves with scrotal elevation, think

A

epididymitis

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31
Q

milking urethra is often seen in what STI

A

chlamydia

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32
Q

if a patient has non-specific urethritis, what STI is assumed?

A

chlamydia

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33
Q

what are the two options for testing for GC and chlamydia

A

urethra swab procedure and urine

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34
Q

a single, painless chancre or papule is associated with what STI?

A

syphilis

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35
Q

secondary syphilis sxs include

A

skin (rash), mucous membranes, and lymph node involvement

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36
Q

tertiary syphillis sxs include

A

gummas, cardiac, ophthalamologic and auditory

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37
Q

what has a classic presentation of multiple, shallow, tender erythematous ulcers that may be vesicular? +/- dysuria

A

HSV

38
Q

bubo formation (enlarged lymph nodes) is associated with what?

A

chancroid

39
Q

lymphogranuloma venereum is different from other infections caused by c trachomatis because it affects?

A

lymphatic, not mucosal, tissue

40
Q

what is characterized by a small papule that quickly ulcerates to beefy-red? is it painless ?

A

granuloma inguinale, painless

41
Q

CDC recommendation for HIV screening

A

all adults and adolescents from 13–64 should be tested at least once

42
Q

orchitis is caused by

A

mumps

43
Q

who typically gets orchitis?

A

children > adults

44
Q

two most common SIS of orchitis

A

parotid tenderness and facial edema

45
Q

how long after onset parotitis does orchitis usually develop?

A

7-10 days

develops in 25-40%

46
Q

tx for orchitis?

A

symptomatic, scrotal elevation, cool compresses, analgesics

47
Q

what type of HIV prevention should be considered for high risk populations

A

PrEP

48
Q

4 risk factors for prostate cancer

A

age
ethnicity (AA)
high fat diet
family hx

49
Q

where does prostate cancer tend to metastasize?

A

bones

sxs: neuro (spinal cord compression) and back pain or pathological fractures

50
Q

DRE detection rate for prostate cx

A

1.5-7%

51
Q

is serum PSA diagnostic of cancer

A

nope

52
Q

what else can cause an increase in serum PSA besides cx?

A

inflammation or BPH

53
Q

when is transrectal US used in the world of prostate cancer

A

for staging and guidance for bx (NOT screening)

54
Q

what is the recommendation from USPSTF for PSA-based screening?

A

Recommends against routine PSA-based screening for prostate cancer for average risk regardless of age (Grade D)

55
Q

what is the bottom line for screening with PSA?

A

discuss pt re: risks and benefits

age 50 for average risk
age 40-45 for high risk
10+ year life expectancy

56
Q

your pt decides to be screened for prostate cx. he has a normal DRE and a PSA <1 ng/mL. when should you repeat the screening?

A

repeat 2-4 yrs

57
Q

your pt decides to be screened for prostate cx. he has a normal DRE and a PSA 1-3 ng/mL. when should you repeat the screening?

A

1-2 years

58
Q

when should you consider bx or close follow up (6 mon) or additional biomarkers after PS cx screening

A

PSA > 3 or abnl DRE

59
Q

on TRUS, PS cancer will have what type of appearance?

A

hypoechoic appearance

60
Q

how many cores are taken in bx for PS cancer?

A

8-12

61
Q

describe the roles of MRI, CT and bone scan in diagnosis of ps cx?

A

MRI: limited role (can detect lymphadenopathy)
CT: no role in initial staging, but can identify mets
bone scan: detects bone mets

62
Q

when should you consider a bone scan during the dx portion of ps cx?

A

consider if PSA >20, high grade histology, bone pain

63
Q

what is the staging system for prostate cx?

A

gleason system

64
Q

what is the tx for localized prostate cx and less than 10 yr life expectancy

A

active surveillance

65
Q

what is the mainstay tx for advanced and metastatic ps cx?

A

androgen deprivation therapy (LHRH or anti-androgens)

via surgical (bilateral orchiectomy) or medical castration

66
Q

what does prostate cancer that becomes refractory to hormone therapy indicate?

A

poor prognosis

67
Q

3 risk factors for penile cancer

A

lack of neonatal circumcision
HPV 16 & 18 infection
tobacco use

68
Q

MC histology of penile cancer

A

squamous

69
Q

MC solid tumor in men age 15-34 is

A

testicular cancer

70
Q

MC histology of testicular cancer

A

germ cell tumors

71
Q

cryptorchidism is a risk factor in what type of cancer? which side is MC

A

testicular

right side

72
Q

a firm, painless unilateral mass in testis, think

A

testicular cancer

73
Q

dx of testicular cancer is made with what 2 modalities

A

scrotal US!

confirmed by bx w inguinal orchiectomy (don’t do FNA, worry about seeding)

74
Q

what tumor markers are used for testicular cancer?

A

hCG, AFP, LDH

75
Q

staging for testicular cancer?

A

TNMS

s for serum tumor markers

76
Q

official dx of androgen deficiency includes low serum testosterone and how many symptoms?

A

3

77
Q

what do you need to check prior to starting testosterone therapy?

A

CBC and PSA

78
Q

testosterone can worsen what two other comorbid disorders?

A

OSA, CHF

79
Q

men with ED have a greater risk for what?

A

cardiovascular events

80
Q

mainstay tx for ED

A

PDE-5 inhibitor

81
Q

CI for PDE-5 inhibitors

A

nitrates, severe CV disease

82
Q

transition vs peripheral zone.

where does BPH occur most often?

A

transition zone

prostate cx in peripheral zone

83
Q

symptoms of bph fall into what two main categories

A

obstructive or irritative

84
Q

what two tests should you order when you are working up BPH?

A

UA and PSA

85
Q

two pharm bph tx

A
  1. 5 alpha reductase inhibitors

2. selective alpha-1 blockers

86
Q

AUA scoring

A

1-7: mild
8-19: moderate
20-35: severe

87
Q

you are evaluating back pain in a patient. what dx should be on your differential?

A

acute prostatitis

88
Q

MC organism in prostatitis

A

e.coli

89
Q

which two organisms are MC in sexually active young men?

A

n. gonorrhea and c. trachomatis

90
Q

exquisitely tender, normal or hot, boggy prostatitis

A

acute prostatitis

91
Q

first line tx acute prostatitis? how long?

A

FQs or TMP/SMZ for 4-6 weeks

Men's Health (1 decks)

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