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Pathophysiology - Diseases > Diseases and Disorders of the Male Reproductive system > Flashcards

Diseases and Disorders of the Male Reproductive system Flashcards

1
Q

What is the function of the male reproductive system?

A

produces, trasfers and introduces sperm into female reproductive tract

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2
Q

What are the parts of the male reproductive system?

A

penis - deposits sperm into female reproductive tract (body of penis is called the shaft, slightly bulging head is called the glans penis, loos skin covering penis forms the prepuce or foreskin)
scrotum - saclike structure that hangs behind the penis

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3
Q

What doees the glands in the foreskin secrete?

A

waxy substance called smegma that collects btwn glans penis and the foreskin

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4
Q

What happens during sexual arousal?

A

3 cylinders of erectile tissue fill the shaft of the penis

during sexual arousal these tissues fill with blood, causing penis to enlarge and become erect

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5
Q

What testes do?

A

reside inside the scrotum and produce sperm

reside outside of body bc sperm production requires a temp lower than the rest of the body

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6
Q

What are the seminiferous tubules?

A

sperm-producing factories within the testes

travel via male reproductive duct system (epididymis, ductus deferns, and urethra)

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7
Q

What is semen?

A

viscous, white secretion with a slightly alkaline pH that contains sperm and accessory gland secretions

typical ejaculate contains abt 1 tsp of semen and contains btwn 40 and 100 million sperm

sperm live for 24-72 hrs in female reproductive tract

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8
Q

What do the accessory glands include?

A

(they produce the most semen)

seminal vesicles - paired sacs located at the base of the bladder and produce roughly 65% of the fliud part of semen (thick, yellowish fluid that nourishes and activates the sperm)

prostate gland - sits just below the bladder and encircle the urethra and produces roughly 30% of the fluid portion of smeen, secretes a thin, milky fluid that enchances sperm motility and neutralizes the acidity of the male urethra and of the woman’s vagina

bulbourethral gland - tiny glands located below the prostate gland and produce roughly 5% of the fluid portio of semen, secrete a clear fluid into urethra during sexual arousal that serves as a lubricant for sex and neutralizes the acidity of residual urien in the urethra

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9
Q

When does testosterone secretion begin?

A

begins approx 2 months after conception

during last 2 motnhs of gestation testosterone normally cause the testes to descend into the scrotum

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10
Q

when does puberty starts for guys

A

testerone is barely detected in bodys by the age of 4-6, puberty

puberty is at 13, started by secretion of GnRH by hypothalamus which triggers secretion of FSH and LH by the anterior pituary gland

LH prooompts the testes to secrete testerone (1st sign of puberty in males is enlargement of testes) and FSH stimulates sperm production

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11
Q

what does increased testosterone do?

A

e promotes the development of
secondary sex characteristics including pubic, axillary, and facial hair; darker and thicker
skin; increased activity of oil and sweat glands; deepening of the voice; enlargement of skeletal muscles; and an increase in bone growth and
density.

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12
Q

What does physical exam of the male reproductive system?

A

visual exam of the external genitalia

palpate tumor to determine the presence of tumor

digital rectal exam (DRE) allows physican to palpate the prostate gland

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13
Q

What are other tests that can be tested for the prostate?

A

Prostate-specific antigen (PSA) - cells of the prostate gland can be measured to determine the risk for prostate cancer and benign prostatic hyperplasia

urodynamic testing - assesses how well bladder and urethra r stroring and releasing urine

cytoscopy - used to view the urethra and bladder

biopsy, x-rays, MRI, CT scan and PET scan, urinalsysis and hormone testing

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14
Q

What is prostatitis?

A

inflammation or infection of the prostate gland

10-12% of men experience prostatisis-like symptoms

affects mostly young and middle age

caused by gonococci from pt with gonorrhea, Staphylococcus, Streptococcus or Pseudomonas

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14
Q

4 categories of prostatisis?

A
  1. acute bacterial prostatitis
  2. chronic bacterial prostatitis,
  3. chronic prostatitis (chronic pelvic pain syndrome)
  4. is asymptomatic inflammatory prostatitis
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15
Q

what are risk factors for prostatitis?

A

a past episode of prostatitis
an infection in the bladder or urethra
pelvic trauma
dehydration
using a urinary catheter
unprotected sexual intercourse
having HIV/AIDS.

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16
Q

s/s of chronic bacterial prostatitis, chronic prostatitis, and asymptomatic inflammatory prostatis ?

A

• Chronic bacterial prostatitis:
- slow onset of signs and symptoms resembling acute
bacterial prostatitis that wax and wane
• Chronic prostatitis:
- resembles chronic bacterial prostatitis, without fever
• Asymptomatic inflammatory prostatitis:
- usually found during exam for
another condition and may not require treatment

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17
Q

s/s of acute bacterial prostatis prostatitis?

A

based on category

Acute bacterial prostatitis:
- sudden onset of fever and chills
- flulike symptoms
- pain in the prostate gland, lower back, or groin
- urinary problems (including increased urinary urgency and frequency, difficulty or pain when urinating, inability to completely empty the bladder, and blood-tinged urine
- painful ejaculation

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18
Q

How to diagnose and treat prostatitis?

A

diagnose - medical history, physical exam, DRE, culture, urinalysis, blood culture, WBC, ultrasonography, cytsoscopy and urodynamic testing

treat - OTC pain relievers, several wks of treatment with antibiotics (for bacterial prostatis), smooth muscle relaxants for urination problems for chronic prostatis

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19
Q

how to prevent prostatis?

A

practing good hygiene
maintianing adequate hydration
early diagnosis and treatment for infections

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20
Q

What is epididymitis?

A

inflammation of the epididymis

600,000 cases of epididymitis in men btwn age 18-35

etiology : STIs (gonorrhoeae, trachomatis), other infections )E. coli, pseudomonas), heart medication amiodarone, TB, urine in the epididymis ( UTIs), tuberuclosis, mumps, prostatectomy, trauma, prolonged use of indwelling catheter

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21
Q

risk factors for epididymitis?

A

multiple sex partners
personal history of an STI
past prostate or urinary tract infections
uncircumcised penis
anatomical abnormality of the urinary tract
prostate enlargement
medical procedures that affect the urinary tract (surgery, catheter, and cystoscopy)

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22
Q

s/s of epididymitis

A

tender, swollen, red or warm scrotum
testicle pain and tenderness (usually on one side)
painful urination or an urgent or frequent need to urinate
painful intercourse or ejaculation
chills or fever
lump on testicles
enlarged lymph nodes in groin
pain or discomfort in lower abd or pelvic area
discharge from penis
blood in semen

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23
Q

How to diagnose and treat epididymitis?

A

diagnose - physical exam, urinalysis, urine culture, urethral swabs for chlamydia and gonorrhea, elevated WBC count, DRE, STI testing, ultrasound, and PET scan of testicles

treatment - antibiotics, OTC pain relievers, bed rest, elevation and application of ice packs to scrotum to relive s/s and swelling

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24
Q

how to prevent epididymitis?

A
  • abstinence
  • monogamy
  • use of latex condoms
  • early diagnosis and treatment for infections
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25
Q

What is orchitis?

A

inflammation of the testes

occurs 20-35% of men with mumps (10% of these cases have condition in both testicles) (may follow epididmyitis)

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26
Q

risk factors for orchitis?

A

not being immunized against mumps, recurring urinary tract infections, surgery that involves genital or UT, being born with an abn in urinary tract, multiple sex partners, sex with a partner who has an STI, unprotected sex, personal history of STIs

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27
Q

s/s of orchitis?

A

testicular swelling on one or both sides, pain ranging from mild to severe, tenderness in 1 or both testicles, nausea, vomiting, fever, chills, general malaise, and penile discharge

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28
Q

how to diagnose and treat orchitis?

A

diagnose - physical exam, STI testing, urinalysis, ultrasound and PET scan (doppler ultrasonography)

treatment - symptomatic, OTC pain relivers, bed rest, elevation and application of cold packs to scrotum (if bacterial than antibiotics)

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29
Q

How to prevent orchitis?

A

vaccination against mumps, abstinence, monogamy, use of latex condom and early diagnosis and treatment for STIs

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30
Q

What is cryptorchidism?

A

no disease but is a failure of testes to descend from abd cavity (where they develop) into scrotum

3% of full-term male newborns have undescended testicles at birth

30% of premature male newborns have at least 1 undescended testicle (testicles descend during abt 8th month of gestation)

etiology is unknown but hormones r suspected

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31
Q

In over ___% of people being seen for cryptorchidism, the testes descend by the third month, and by age 1, ___% of all undescended testes have descended into the scrotum

A

50

80

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32
Q

major s/s, risk factors, and etiolgy of cryptorchidism

A

s/s - not being able to feel 1 or both testicles in scrotum

risk factors - low birth wt and premature birth

etiology - abn testicular development (testicles have short spermatic artery, poor blood supply or both)

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33
Q

how to diagnose and treat cryptorchidism?

A

visual exam, palpating the scrotum and abd to locate the testicles, ultrasound, MRI, laparoscopy and hormone and genetic testing

treat - often descend spontaneously during 1st yr of life, if not by 4 then surgical manipulation (orchiopexy) or hormonal drug therapy (beta-human choriionic gonadotropic (b-hCG) or testosterone)

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34
Q

What is testicular cancer?

A

cancer in or both testicles

most common in men 20-35 (33 is avg)

risk factors: crytporchidism, abn testes development, family or personal history of testicular cancer

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35
Q

testicular cancer stats?

A

2013: 7,920 cases of testicular cancer will be diagnosed
and 370 men will die from testicular cancer
in the United States

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36
Q

s/s and etiology of testicular cancer?

A

lump on a testicle that is painless
testicular enlargement or swelling
sensation of heaviness or achinig in lower and or scrotum
few have acute pain or gynecomastia
symptoms of advanced disease include enlarged lymph nodes in neck, dyspnea or cough, anorexia, bone pain, lower extremity swelling

etiology - cryptorchidism, historyt of testicular cancer, previous GCT(s), infertiltiy, HIV infection, Down and Klinefelter syndrome

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37
Q

how to diagnose and treat testicular cancer?

A

diagnose - medical history, physical exam, ultrasound, CT, chest radiography, radical orchiectomy, serum tumor marker tests (alpha-fetoprotein, lactate dehydrogenase, beta-human chorionic gonadotropin), radical inguinal orchiectomy (surgery to remove a testicle) and biopsy, imaging tests

treat - surgery, radiation therapy, chemo (NSGCTs r chemosensitive and Seminomas r radiosensitive) and stem cell transplant

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38
Q

survival rate?

A

5 yr relative survival is 95%

if cancer has not metastasized outside the testicle than 5 yr survival rate is 99%

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39
Q

what happens to males as they grow older?

A

pubic hair thins and grays

external reproductive genitalia acquire a wrinkled and sagging appearance due to decrease in elasticity

testerone levels decline = estes decrease in size

sperm count decreased

increased stimulation needed for erection

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40
Q

What is a common problem in older males?

A

enlargement of the prostate glands (benign prostatic hyperplasia (BPH))

affects 60% of men in 60s and 80-90% of men in 70s and 80s

risk factors r age, family history of enlarged prostate

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41
Q

s/s BPH?

A

less than 1/2 of all men with BPH r symptomatic

dribbling at the end of urinating
inability to urinate
incomplete emptying of the bladder
incontinence
needing to urinate two or more times per night
pain with urination
bloody urine
slowed or delayed start of the urinary stream
straining to urinate
strong and sudden urge to urinate
weak urine stream

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42
Q

WHat is a metabolite of testosterone?

A

Dihydrotesterone

BPH is directy dependent on DHT

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43
Q

How to diagnose and treat BPH

A

diagnose - medical history, DRE, urine analysis, culture, PSA blood test, ultrasound, urodynamic testing & cystoscopy

treatment - watchful waiting, meds such as alpha blocker to relax smooth muscle in prostate and increase urinary flow, hormone therapy to block conversion of testosterone to DHT and surgery

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44
Q

What is prostate cancer?

A

malignant tumor that forms in tissue of the prostate gland

etiology is idiopathic (testosterone stimulates growth of prostate tumor cells)

45
Q

prostate cancer stats?

A

in 2013 approximately 238,590 cases of prostate cancer will be diagnosed
29,720 men will die from prostate cancer in the United
States.
An estimated 1.1 million men were diagnosed with prostate cancer
307,000 died of prostate cancer worldwide in 2012

46
Q

What is the 2nd leading cause of cancer death in men?

A

prostate cancer (behind lung cancer)

47
Q

risk factors for prostate cancer?

A

age (over 65), family history of prostate cancer, race (more common in AA), certain prostatic changes (prostatic intraepithelial neoplasia), mutations in BRCA1 or BRCA2 and diet high in animal fat

48
Q

s/s of prostate cancer?

A

may be asymptomatic

not being able to pass urine
having a hard time starting or stopping the urine flow needing to urinate often
especially at night
weak flow of urine
urine flow that starts and stops
pain or burning during urination
difficulty having an erection
blood in the urine or semen
frequent pain in the lower back, hips, or upper thighs

49
Q

how to diagnose and treat prostatic cancer?

A

diagnose - DRE, PSA, ultrasound and biopsy

treatment - prostate cancer grows v. slowly so some men don’t need treatment (active surveillance), other options r surgery (radical prostatectomy, orchiectomy), radiation therapy brachytherapy (direct implantation f radiation source into prostate) and chemo, Androgen deprivation therapy (ADT), surgical or medical orchiectomy,

need to decrease testerone (orchiectomy), meds to decrease testerone, block uptake of testerone by tumor cells or stop testosterone production by adrenal glands

50
Q

What is the 5 yr survival rate for prostate cancer?

A

100% for local and regional prostate cancer

31% for distant prostate cancer

51
Q

What is erectile dysfunction (ED)?

A

impotence, aka inability of male to achieve and maintain an erection sufficient for sex

primary ED - man has never been able to complete sex successfully

secondary - man has been able to have intercourse at least once

52
Q

stats of ED?

A

More than 18 million men in the United States age 20 and
over suffer from ED.
As men age, their risk for ED increases dramatically: 70% of men age 70 or over report erectile problems, compared with
5% of men age 20–40.

53
Q

etiology of ED?

A

sexual arousal increases bloodflow to penis and compresses veins carrying blood away from penis, causing reection

caused by medical conditions that restrict blood flow to penis such as diabetes, kidney disease, neurological disease, vascular disease, smoking, hypercholsterolemia, and prostate cancer treatment, neurologic elements may interput impulse transmission btwn CNS and penis

54
Q

how to diagnose and treat ED?

A

diagnose - medical history, physical exam, blood tests (CBC, liver and kidney function test, lipid panel, thyroid function test, blood hormone studies), urinalysis, ultrasound, overnight erection test, psychological exam

treat - meds to increase blood flow to erectile tissue by relaxing smooth muscle of the penis, other treatments r testeosterone therapy, surgery, penis pump or implant, external vacuum devices, penile injection therpay, therapy, and treatment for underlying condition

55
Q

What are STIs?

A

sexual transmitted infections (STIs) r infections spread by sexual contact (includes unprotected oral, anal or vaginal intercourse)

caused by bacteria, viruses and protozoans

56
Q

STIs stats?

A

The CDC estimates 20 million new STIs occur
each year in the United States, almost half of
them among people ages 15–24.

STIs cost the United States health
care system an estimated $16 billion annually.

57
Q

what can undetected STIs do?

A

have serious consequences like infertility, PID, cervical cancer, and adverse pregnancy outcome

58
Q

risk factors of STIs?

A

unprotected sex, muliple sex partners, a history of STIs, being under 25, sexual contact under influence of drugs or alc

59
Q

how to prevent + diagnose STIs?

A

prevent : abstinence, monogmay, condom use

diagnose : staining, culture, DNA test, and antigen or antibody testing

60
Q

Gonorrhea?

A

transmitted through sexual contact and during childbirth

etiology - gram-negative coccus bacterium Neiserria gonorrheae

61
Q

gonorrhea stats?

A

Less than half of these infections are reported to the CDC (334,826 in 2012).
WHO estimates 62 million people are infected with gonorrhea annually worldwide

62
Q

s/s for gonorrhea?

A

50% of men and women r asypmtomatic

men - burning sensation when urinating, a white, yellow or green discharge from the penis, or painful or swollen testicles

women - painful or burning sensation when urinating, increased vaginal discharge or vaginal bleeding btwn periods

63
Q

What can gonorrhea do to a person?

A

women - common cause of PID

men - epididymitis (can lead to infertility)

newborn - blindness, joint infection, or a life-threatening blood infection (to prevent erythromycin is routinely placed in the eyes of newborn babies)

64
Q

how to diagnose and treat gonorrhea?

A

DNA testing (nucleic acid amplification, nucleic acid hybridization), culture from infected site, enzyme-linked immunosorbent assay, or Gram stain

treat - injection of antibiotic + oral antibiotic

65
Q

what is syphilis?

A

transmitted through sexual contact, direct contact with a syphilis chancre and during childbirth

primary stage is appearance of 1 or more chancres where Treponema pallidum enter body (chancres r small, painless, firm, round lesions lasting 3-6 wks and heal w/o treatment)

secondary stage is when priamry lesions heal and spirochete Treponema pallidum disseminiates through the body, nonitchy, widespread rash that may appears rough, red, or reddish-brown spots

late syphilis appears 10-15 yrs after infection (brain, nerves, eyes, heart, bv, liver, bones, and joints r damaged)

66
Q

syphilis stats?

A

In 2012, 15,667 cases of primary and secondary
syphilis were reported to the CDC

In the United States, men having sex with men accounts
for 75% of syphilis cases.

The WHO estimates that more than 12 million people are infected with syphilis annually worldwide

67
Q

s/s of secondary syphilis

A

fever, fatigue, headache, sore throat, patchy hair loss, wt loss, muscle aches, fatigue, swollen lymph nodes

68
Q

s/s of late stage of syphilis?

A

gummas (lesions) have invaded body organs and systems, causing widespread damage to point of being debilitating and life threatening
difficulty corrdinating muscle movements
paralysis
numbness
gradual blindness
dementia

69
Q

congenital syphilis?

A

transmitted to the fetus via the placenta

50% of these pregnancies result in stillbirth or neonatal death

kills more than 1M each yr worldwide

70
Q

s/s of congenital syphilis?

A

rash, fever, irritabilty, failure to thrive, saddle nose

71
Q

syphilis etiology?

A

gram-negative spirochete bacterium Treponema pallidum

72
Q

how to diagnose and treat syphilis?

A

diagnose - darkfield microscopic visualization of the bacterium from chancre scrapings and antibody testing (veneral disease research lab test, rapid plasm regain test, enzyme immunoassay test, fluorescent treponemal antibody absorption test, and Treponema pallidum particle agglutination assay)

treat - antibiotics (kills bacterium and prevents further damage but cant repair damage already done)

73
Q

stats of chlamydia?

A

In 2012, 1,422,976 cases of chlamydia werereported to the CDC, but most people with chlamydia are not aware of their infections.

WHO estimates that more than 92 million chlamydial infections occur annually worldwide

74
Q

What is clamydia?

A

transmitted by sexual contact and vaginal disease

known as “silent” disease bc most ppl with it are asymptomatic

causes urehtritis in men and urethritis and cervicitis in women

75
Q

s/s of chlamydia?

A

women: (high % of women have no symptoms)
- abnormal vaginal discharge
- a burning sensation when urinating
- lower abd pain
- low back pain
- nausea
- fever
-pain during intercourse (dyspareunia)
- bleeding btwn menstrual periods

men: (75% of men have symtpoms 1 to 3 weeks after exposure)
- penile discharge
- burning sensation when urinating, burning and itching around the urethral orfice

76
Q

complication for chlymadia (split by ppl)

A

Women
1. untreated infection can spread into uterus or fallopian tubes and caused PID (10-15% of women w/ untreated chlamydia)
2. female sterility
Pregnant Women
1. can lead to premature delivery
2. babies can have chlamydial infections in eyes and respiratory ract
3. cause early infant penumonia and conjuntivits in newborns
Men
1. rare but sometimes infection spreads to epididymis, causing pain, fever, and infrequently serility
(can sometimes cause arthritis that can be accompanied by skin lesions and inflammation fo eye and urethra known as Reiter’s syndrome)

77
Q

etiology of chlamydia?

A

gram negative coccus bacterium Chlamydia trachomatis

78
Q

diagnose and treat chlamydia?

A

diagnose - culture, DNA probe testing (nucleic acid amplification test, nucleic acid hybridization test), and antigen testing (direct fluorescent antibody test)
treat - antibiotics (injection then oral antibiotics)

79
Q

What is etiology of trichomoniasis?

A

protozoal infection of lower genitourinary tract (usually vaginal for females and urethral in males)

etiolgoy is protozoan Trichomoas vaginalis

80
Q

trichomoniasis stats?

A

There are an estimated 7.4 million trichomoniasis cases annually in the United States,
with over 180 million cases reported annually
worldwide.

Only about 30% of those infected
develop signs and symptoms of trichomoniasis.

81
Q

s/s of trichomoniasis?

A

most are asymptotomatic

men
- itching or irritation inside penis
- burning after urination or ejaculation
- penile discharge
Women
- itching
- burning
-redness or soreness of genitals
- discomfort with urination
- thin discharge with an unusual smell that can be clear, white, yellowish or greenish
- strawberry cervix

82
Q

Diagnose and treat of trichomoniasis?

A

diagnose - potassium hydroxide whiff test (KOH is added to vaginal discharge, strong fishy odor is postiive result), wet- mount microscopic visualization, Pap test, culture, DNA testing (nucleic acid hybridization, nucleic acid amplification) and trichomonas antigen test, cervix exame for strawberry cervix

treat - antiparasitic meds (antiprotozoal drugs (never take alc w/ meds))

83
Q

Who does the CD recommend get chlamydia testing yrly

A

older women with risk
factors for chlamydial infections (those who have
a new sex partner or multiple sex partners), and
all pregnant women

84
Q

What is Genital herpes?

A

STI caused by herpes simplex virus (HSV), most specifically (HSV-2) which can be spread through secretions from the moiuth or genitals

incurable, recurrent infection of skin of genital area, ulcerations spread through direct skin-to-skin contact, causing painful genital sores similar to cold sores

85
Q

What is HSV-1?

A

usually afffects mouth and lips, causing cold sores or fever blisters

spread from mouth to genital during oral sex

86
Q

genital herpes stats?

A

The CDC estimates in the United States 16.2%, or about one out of six, people
age 14–49 have a HSV-2 infection

WHO estimates worldwide 536 million people age 15–49
have a HSV-2 infection

Genital HSV-2 infection is more common in women (approx one out of five women age 14–49) than in men
(approximately one out of nine men age 14–49).

87
Q

HSV-2 s/s

A

most ppl r asymptomatic

signs are one or more painful blisters on around the gentials (blisters rupture = ulcersa that take up to 4 wks to heal)

goes latent and becomes active timre from time = outbreak of blisters (decrease in frequency over time)

first episode is accompained by systemic influzena symtpoms: swollen glands, fever, headache, painful urination

88
Q

what happens to babies born to herpes infected mothers?

A

can be exposed to virus during birthing process

may result in brain damage, blindness, or death for newborn

if woman has active genital herpes at delviery C section

89
Q

How to diagnose and treat HSV-2?

A

diagnose - medical histroy, physical exam, culture, nucleic acid amplification and antibody testing

testing - no treatment bu antiviral meds to shorten outbreaks and make them less severe (monitor women with herpes for cervical cancer w/ Pap smear every 6 months)

90
Q

What are genital warts?

A

benign neoplastic growths on epidermis of genitals

single or multiple growths or bumps that appear in genital areas & r sometimes shaped like cauliflowers

can appear on vulva, in or around vagina, scrotum, anus, cervix, penis, groin or thigh

91
Q

Gential warts stats?

A

According to the CDC, approx 6.2 million new cases of sexually transmitted human papillomavirus (HPV)
infections occur annually in the United States.

At least 20 million people in the United Statesare already infected with HPV

At least 50% of sexually active men and women acquire genital HPV infection at some point in their lives

By age 50, at least 80% of women will have acquired
genital HPV infection

The WHO estimates the prevalence of genital HPV
nfection in the world to be 440 million

92
Q

Approximately ___% of genital warts are caused by
HPV 6 and HPV 11

A

90

93
Q

Diagnose and treat genital herpes?

A

diagnose - appear within wks after sexual contat with infected partner, might not develop for several months, diagnosed by physical exam, biopsy to rule out carcinoma

treat - immune system usually clears it in 90% of cases within 2 yr, also can be removed by meds that erode wart tissue (keratolytic agent, antiviral cream) , electrocautery, cryosurgery and laser surgery (no cure)

94
Q

What is chancroid?

A
  • aka soft chancre
  • bacterial infection of genitalia that causes a necrotizing ulceration and lymphadenopathy
  • caused by Haemophilus ducreyi
95
Q

s/s of chancroid?

A
  • shallow and painless lesion appears pn skin or mucous membrane at site of entry, 7-10 days after sexual contact with infected person
  • tender, superative inguinal adenoapthy is noted on physical examination
  • ulcer usually deepens and becomes purulent and can be spread to other areas of body via autoinculation
96
Q

how to diagnose and treat chancroid?

A

diagnose - clinical appearance of lesions, Gram staining, rule out syphiliis or HSV

treatment - antiobiotic therapy, drain lesions surgically, good personal hygeine is advised, keep infected areas clean anddry and to refrain from sexual contact

97
Q

With regular unprotected intercourses abt __% of couples conceive within 1 year. In about __% of cases, male causes infertility, in another __% of cases females caue infertility?

A

90
40
40

98
Q

causes of infertility in men?

A
  • most common cause is idiopathic (40-50%)
  • testicular dysfunction, congenital disorders of the testes, certain developmental disorders, chromosomal abnormalities, varioceles (= 30-40%)
  • disorders of sperm transport and diseases of hypothalamus or pituary gland
  • environmental factors such as certain drugs, radiaion, smoking or pollutant
99
Q

cause of infertility in women?

A
  • ovulatory dysfunction or failure to ovulate
  • endometriosis
  • scar tissue from infection, ectopic pregnancy or surgery
  • blocked fallopian tubes, caused by PID from STDs
  • congenital structural or chromosomal disorders
  • tumors
  • antisperm antibodies in female vaginal secretions
  • medications that compromise fertilty
  • psychological distress
100
Q

how to diagnose infertility?

A

men - history w/ special attention to childhood diseases, phyiscal exam for structural abn, personal or familial genetic or endocrine disorders, semen analysis, chromosome and testosterone testing,

women - charting of menstrual cycle, hormone levels r studies through blood tests, fallopian tubes, uterine cavity r visualized through hysterosalpingography to determine tubal patency, laparoscopy

101
Q

how to treat infertility?

A
  • unless condition is untreatable
  • course of action to achieve pregancy may include treatment of infection, surgery o remove blockage, the use opf fertility drugs (FSH, intrauterine insemination (IUI), vitro fertilization (IVF)
102
Q

What is torsion of the testicle

A
  • one testicle is twisted out of its normal position
  • bv supplying testicles become kinked = prevention of blood flow
  • spontaneous or caused by trauma
  • s/s r sudden, severe pain in 1 testicle, can cause N&V, usually constant, scrotum becomes swollen, red and tender
103
Q

Diagnose and treat torsion of testicle

A

diagnose - pt history, physical exam (testicle usually has abn horinzotanl lie in scrotum), Doppler ultrasonography (shows little or no blood flow)

treat - surgical intervention, bilateral orchiopexy

104
Q

What is variocele

A
  • veins of one of the testicles becomes abn distended, causing swelling around the testicle that expands within scrotal sac
  • more uncomfortable than painful (esp during hot weather, after exercise and can be relieved temporarily by lying down)
  • increased presence of venous blood raises temp within scrotum = lower sperm count (more common left side)
105
Q

diagnose and treat variocele

A

diagnose - pt history, physical symptoms, examination by physician

treat - wearing of tight-fitting underwear, use of athletic supporter, surgery to remove distended veins if variocele affects fertility

106
Q

What is benign prostatic hyperplasia?

A
  • nonmalignant, noninflammatory hypertrophy of prostate gland
  • thought to be caused by aging process and hormonal and metabolic changes
107
Q

s.s of benign prostatic hyperplasia?

A
  • mostly found in men older than 50
  • compression of urethra with urinary obstruction and resulting urianry retention
  • difficulty starting urination
  • weak stream of urine
  • inability to empty the bladder completely
  • urinary frequency
  • nocturia
  • in severe cases: inflammation and symptoms of renal disease
108
Q

diagnose and treat BPH?

A

diagosne - pt history, rectal exam, urinarlysis, urine culture, renal function studies, prostate-specific antigen (PSA) serum level (help differentiate BPH from other possible lower Urianry tract symptoms), international prostate symptom score

treat - control of fluid intake before bed, avoid meds that cause urinary retention, drugs that tighten muscles inside the prostate, 5-alpha-reductase inhibitors which reduce the size of the prostate by 30%, transurethral resection of prostate (TURP0 when s/s bb3ecome moderate to severe

109
Q

nearly all testicular teumors are ___________, equally distributed btwn 2 main types: _________ and __________

A

Germ cell tumors (GCTs)
seminomas and nonseminomatous germ cell tumors (NSGCTs)

Pathophysiology - Diseases (22 decks)

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