Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

3: MED2 Y3 - Renal and Urinary [17] > Epididymitis > Flashcards

Epididymitis Flashcards

1
Q

What is epididymitis?

A

Inflammation of epididymis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What age is epididymitis most common?

A

Bimodal age distribution - 15-30 years and >60 years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What commonly occurs with epididmyitis?

A

Orchitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Is epididymitis or epididymo-orchitis more commoN?

A

Epididymitis (most cases are soley this)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Is sole orchitis common?

A

No, very rare (mostly viral origin)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is epididymo-orchitis usually caused by?

A

Local extension of infection from the lower urinary tract (bladder and urethra)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What can cause infection of the lower urinary tract leading to epididymo-orchitis?

A
  • Enteric, i.e. classic UTI

- Non-enteric, i.e. sexually transmitted

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the most likely mechanism of epididymo-orchitis in men <35 years old?

A

STI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the most common organisations causing STI epididymo-orchitis?

A
  • N. gonorrhoeae

- C. trachomatis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is a common cause of STI epididymo-orchitis in men who have anal intercourse?

A

Enteric organisms such as E. Coli

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the most likely mechanism of epidiymo-orchitis in men >35 years old

A

Enteric organisms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the most common organisms causing enteric epididymo-orchitis?

A
  • E. Coli
  • Proteus
  • Klebsiella
  • Pseudomonas
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What might mumps occur as a common complication of?

A

Mumps viral infectio n

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What % of post-pubertal with mumps infection get orchitis?

A

40%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How does mumps orchitis present?

A

As unilateral or bilateral orchitis, typically with fever around 4-8 days after onset of mumps parotiditis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How long does mumps orchitis last?

A

Self-resolves within a week

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Is any management required for mumps orchitis?

A

Supportive management only

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

How complications can mumps orchitis cause?

A
  • Testicular atrophy

- Infertility

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What investigation should be done if mumps is suspected?

A

IgM/IgG serology

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What clerical thing needs to be done in cases of mumps?

A

Notifiable disease - local Health Protection Team must be informed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What do the risk factors for epididymo-orchitis depend on?

A

The underlying cause - STI or UTI

22
Q

What are the risk factors for non-enteric epididymo-orchitis?

A
  • MSM
  • Multiple sexual partners
  • Known contract of gonorrhoea
23
Q

What are the risk factors for enteric epididymo-orchitis?

A
  • Recent instrumentation or catheterisation
  • Bladder outlet obstruction
  • Immunocompromised
24
Q

How does epididymitis usually present?

A

Unilateral scrotal pain and swelling.

Fever and rigors can also be present

25
Q

What other symptoms may be present with epididymo-orchitis?

A

Symptoms secondary to underlying cause, e.g. dysuria, storage LUTS, urethral discharge

26
Q

What may be found on examination in epididymo-orchitis?

A

Epididymis +/- testis will be very tender on palpation, and may be associated hydrocele

27
Q

What specific tests can be used in epididymitis?

A
  • Cremasteric reflex

- Prehn’s sign

28
Q

What happens to the cremastic reflex in epidiymitis?

A

Nothing - it is in tact

29
Q

What does a positive Prehn’s sign in epididymitis?

A

Suggestive of epididymitis

30
Q

How is Prehn’s sign elicited?

A

The patient is supine and scrotum is elevated by examiner - positive is when pain is relieved by elevation

31
Q

What is the main differential of epididymitis?

A

Testicular torsion

32
Q

How does the presentation of testicular torsion differ from epididymitis?

A

In torsion, pain is more sudden onset and severe, and absence of LUTS

33
Q

What can aid in the diagnosis of testicular torsion?

A

Dopper US (but if any significant suspicion of torsion, urgent scrotal exploration)

34
Q

What are the other differentials for epididymitis?

A
  • Testicular trauma
  • Testicular abscess
  • Epididymal cyst
  • Hydrocoele
  • Testicular tumour
35
Q

What investigations may be done in suspected epididymitis?

A
  • Urine dipstick
  • First void urine sent for NAAT
  • Routine bloods
36
Q

When should first-void urine be done in suspected epididymitis?

A

Suspected non-enteric epididymitis

37
Q

What may be warranted depending on history in suspected non-enteric epididymitis?

A

Further STI screening

38
Q

What routine bloods should be done in epididymitis?

A
  • FBC

- CRP

39
Q

Describe the role of ultrasound imaging in suspected epididymitis?

A

Diagnosis is usually clinical oen, but ultrasound imaging of testes via US doppler may be useful to confirm diagnosis and rule out any complications, e.g. testicualr abscess

40
Q

On what basis can the majority of patients with epididymitis be managed?

A

Outpatient

41
Q

When may patients with epididymitis need to be managed as inpatient?

A
  • Evidence of systemic infection
  • Uncontrolled pain
  • Needs further investigation
42
Q

What should be involved in the initial management of epididymitis?

A
  • Appropriate antibiotic therapy
  • Sufficient analgesia
  • Bed rest
  • Scrotal support
  • Abstain from sexual activity
43
Q

What is the first line antibiotic for enteric epididymitis?

A

Ofloxacin PO BD for 14 days

44
Q

What is the first line antibiotic for STI epididymitis?

A

Ceftriaxone 500mg IM single dose

45
Q

How long should patients with epididymitis abstain from sexual activity?

A

Until antibiotic course is completed and symptoms resolve

46
Q

What counselling should patients with STI epididymitis get?

A

Appropriate barrier contraception to reduce the risk of sexually transmitted infections

47
Q

What follow up is required with epididymitis?

A

Routine follow up not typically recommended, but patient should seek further assessment if symptoms do not resolve or deteriorate

48
Q

What may be required for management of chronic epididymitis?

A

Orchiectomy

49
Q

How quickly do symptoms typically resolve in epididymitis?

A

Within 48 hours of starting abx

50
Q

What complications may arise from epididymitis?

A
  • Reactive hydrocele formation
  • Abscess formation
  • Testicular infarction

3: MED2 Y3 - Renal and Urinary [17] (17 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions