dif to remember

Question 1

Ischemic priapism - definition / etiology

Answer 1

painful sustained erection lasting more than 4 hours

etiology: 1 sickle cell anemia (trapped RBCs in vascular channels)
2. drugs (sildenafil, trazodone, prazosin,methylfainidate, cocaine)
3. cauda equina syndrome

Question 2

medications that causes erectile dysfunction

Answer 2

antihypertensives (esp b-lockers and thiazides), SSRIs, anti-androgen

Question 3

diagnosis of prostatitis - next step

Answer 3

culture of mid-stream urine sample

Question 4

BPH with atypical presentation (under 50 years old) or no response to medications - next step

Answer 4

urodynamic studies

Question 5

chronic prostatitis / chronic pelvic pain syndrome - symptoms

Answer 5

1. pain in pelvis, perineum, genitalia
2. irritateive voiding symptoms (urgencym hesitancy)
   hematospermia, pain with ejaculation
   MORE THAN 3 MONTHS

Question 6

chronic prostatitis/cronic pelvic pain syndrome - diagnosis

Answer 6

1. no or mild prostate teenderness
2. sterile urine culture
   NORMAL PSA

Question 7

chronic prostatitis / chronic pelvic pain syndrome - management

Answer 7

1. a-blocker
2. antibiotics (cipro) esp if history of UTI
3. 5a-reductase inh

Question 8

indications for cytoscopy

Answer 8

1. gross hematuria with no evidence of glomerular disease or infection
2. microscopic hematuria wiht no evidence of glomerular disease or infection but increased risk for malignancy
3. recurrent UTIs
4. obstructive symptoms with suspicion for stricture, stone
5. irritative symptoms without urinary infection
6. abnormal bladder imaging or urine cytoogy

Question 9

BPH vs cancer regarding RF

Answer 9

BPH: older than 50
cancer: older than 40, African american, family history

Question 10

Bladder cancer RFs

Answer 10

1. smoking (until up to 20 years after cessation)
2. occupational exposures
3. chronic cystitis
4. iatrogenic causes (cyclophosphamide)
5. pelvic radiation exposure

Question 11

acute vs chronic prostatitis regarding treatment

Answer 11

acute: TMP-SXM, fluoroquinolones (-6 wks)
chronic: fluoroquinolones