FPC: male GU exam Flashcards
What amount should we typically be able to void from the bladder?
50% of the volume
What is a suprapubic tube?
Tube that can go directly into the bladder to place a catheter if there is an inability to access the bladder otherwise
Who gets suprapubic tubes?
Those who need an easy catheter change, avoiding urethral erosion, low infection risk
What catheter has the highest infection risk?
Urethral catheter
What is the first step of the penile exam?
Check all surfaces of the penile skin, including retracting the foreskin
Where do most penile cancers occur?
The glans
What do penile cancers typically look like?
Non-healing ulcers
How do we treat HSV?
Valacyclovir
How do we test for HSV?
Swab the lesion
What is Peyronie’s disease?
Scar tissue on the corporal septum of the penis that causes a penile curvature/fibrosis
How do we treat Peyronie’s disease?
Inject collagenase into the scar, surgery putting stitches opposite to the curve, or cutting out the scar. May also just involve observation if the patient is unbothered
What is important during the testicular exam?
To bring the testicle up to the skin
What is a normal testicle size?
18-22 ccs
What is Klinefelter’s syndrome?
XXY chromosomes; testicular size is 6-8 ccs
What is orchitis?
25-28 ccs testicles
What is a varicocele?
Dilated veins in the spermatic cord of the scrotum
What is important in a varicocele exam?
They should be standing, and a Valsalva maneuver can be used to assess for the dilation
Why are varicoceles often on the left side?
The left renal vein can get compressed between the aorta and SMA
What is the issue with varicoceles?
They may alter the ability to control testicular temperature, impacting their function
What is a hydrocele?
Fluid between the tunica albuginea and tunica vaginalis
What is an exam finding of a hydrocele?
Inability to feel the testicle due to the fluid buildup
How do we diagnose hydrocele?
Ultrasound
How do we treat hydrocele?
Remove tunica vaginalis and sew it back onto itself
What is a spermatocele?
Fluid in the scrotum coming off the epididymis
How do we diagnose spermatocele?
We can feel the testicle as well as a pocket of fluid
What do we see on ultrasound in a testicular tumor?
A hypervascular region within the testicle
How do we treat testicular tumors?
Surgery, ideally within a week
What is testicular torsion?
Twisting of the spermatic cord that compromises blood flow to the testicle
What is the presentation of testicular torsion?
Nausea, vomiting, testicular pain
How do we treat testicular torsion?
Ultrasound immediately and untwisting/surgery asap
How do we treat epididymitis?
Antibiotics that can penetrate the testicle
How do we do an exam for an inguinal hernia?
Push through the cord and have the patient Valsalva. If they have one you should feel the bowel
When do we do a digital rectal exam?
Prostate cancer and BPH (PSA greater than 2)
When is phimosis normal?
In children up to age 8; we don’t really need to retract the foreskin in a kid
What should we assess for in pediatric GU exam?
Undescended testicles, NO rectal/prostate exam, skin abnormality, sacrum
At what point should the testicles be descended into the scrotum?
6 months
