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Block 6 > CM > Flashcards

CM Flashcards

1
Q

complications of hypospadias vs epispadias

A

infxn, fistula, cosmetic defect vs incontin, sexual dysfxn, dep/psych

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2
Q

is para/phimosis considered a uro emergency?

A

phimosis = no unless urinary block, pain, hematuria. paraphimosis = yes

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3
Q

cause of hydrocele? structures involved in communicating? if you can’t transilluminate it, what’s next step? how to tx?

A

fluid in tunica vaginalis. peritoneum, processus vaginalis, scrotum. US. reassurance b/c it’ll resolve by 1-2yo; if persists -> uro

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4
Q

causes of inguinal hernia? dx?

A

premature, connective tissue dz, abd wall defects, fhx. PE -> bowel sounds in scrotum, silk glove sign, US distinguish hydrocele from inguinal hernia

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5
Q

indirect vs direct inguinal hernia. how to tx?

A

fail to close internal inguinal ring after testicle goes thru it vs actual abd wall defect. surgeon referral; incarcerate & strangulated -> med emergency

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6
Q

3 types of cryptorchidism. dx? complications? tx?

A

abd vs ectopic vs inguinal. PE -> milking technique to chk testicle in inguinal canal; DO TESTICULAR EXAM FOR NEWBORNS. hernia, testicular ca, infertile, torsion. surg referral by 6mo old, hCG for testosterone, orchiopexy

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7
Q

causes of 2ndary hypogonad per Hardee. tx? cause of BPH? tx?

A

pit tumors/defect, hemochromatosis, OSA. PDE5-I, lifestyle, testosterone replace, surg. testost to DHT -> prostate growth; anticholinergic meds give BPH side effects. alpha blockers, 5a-reductase inhib (if >40g), PDE5-I, anticholinergics

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8
Q

USPTF prostate screen guidelines

A

screen 40-55yo, C for 55-69yo, D for >70, I for >75yo

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9
Q

where does tunica vaginalis originate and go to? 3 aa for spermatic fascia blood supply

A

peritoneum & descend down to surround testes. cremaster, testicular, vasal

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10
Q

penile ca cause swelling of which LN? what about scrotal infxn?

A

bil inguinal LN. ipsi inguinal LN

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11
Q

communicating hydrocele also known as per Chun? noncommunicating hydrocele for what age group; any hernia involved; tx?

A

congen ped indirect hernia. men >40yo; no; Lord’s procedure

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12
Q

how to tx varicocele? complications? neonatal torsion = ?

A

gonadal v embol; ligation (retroperitoneal, microsurg, lap). hydrocele formation, testicular atrophy. extravaginal torsion (tunica vaginalis & testicle twist around spermatic cord)

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13
Q

how to tx epididymitis for <35 vs >35 yo? tx Fournier’s gangrene?

A

rest x3d, NsAIDs, scrotal support. doxy, ceft x2wks vs FLQ x2-4wks. broad abx (PCN-G, AG, clinda, 3rd gen ceph), debride, reconstruction

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14
Q

how to tx urethral strictures. key features for penile fx?

A

incision/dilation, urethroplasty, suprapubic tube, urinary diversion. vigorous intercourse -> pop/snap -> eggplant deformity & detumescence

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15
Q

key features of priapism

A

high vs low flow; irreversible corporal dmg if lasting >6h, sickle cell or leukemia

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16
Q

castrate-resistant prostate ca can lead to what type of mets? tx for it?

A

bone mets -> IV bisphos, subq RANK ligand, radium (alpha particle mimicking Ca2+ complex breaking DNA -> mild myelo)

17
Q

frontline prostatic ca mets tx?

A

ADT; lupron/GnRH agonist, anti-androgen biclutamide, bil orchiectomy; the others listed in goodnotes

18
Q

testicular ca early vs late stage sxs. how to dx?

A

painless swelling, gynecomastia vs neck mass, cough/dyspnea, LBP, bone pain (mets), C/PNS sxs, uni/bil LE swelling (thrombosis). transcrotal doppler US, orchiectomy, NEVER BX; tumor markers for nonseminoma (HCG, AFP, LDH)

19
Q

seminoma vs nonseminoma

A

40yo, no tumor markers, chemo or rad vs <40yo, yes tumor markers, CD30 pos, chemo, more aggressive

20
Q

how to tx spermatocele? how to tx testicular ca?

A

remove whole cyst intact. sperm bank, orchiectomy, testicular prosthesis, retroperitoneal LN dissection if >3cm, resect lung mets

21
Q

surg indic for varicocele? risk factors of epididymitis? risk factors for Fournier’s?

A

chronic scrotal pain, testicular size discrepancy >20%, infertile/abnl semen. underlying anomaly, sTI, prostatitis, recent urinary instrument. immunocomp, recent GI/U procedure, urethral stricture, perianal abscess

Block 6 (13 decks)

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