Brainscape's Knowledge GenomeTM

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


See full index

PANCE 2.0 > Genitourinary #3 > Flashcards

Genitourinary #3 Flashcards

1
Q

Prostatitis is prostate gland inflammation secondary to an ascending infection. What are the MC causes if the patient is > 35 years and < 35 years old?

A

> 35: E. Coli
< 35: Chlamydia and Gonorrhea

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

However, in children, the MCC of prostatitis is

A

Viral (Mumps)

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

Symptoms of prostatitis

A

Irritative voiding: dysuria, frequency, urgency
Obstructive voiding: hesitancy, dribbling, incomplete emptying, malaise, arthralgia

Acute: fever, chills, perineal pain. Lower back pain.

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

What symptoms does the patient usually have if the prostatitis is chronic in nature?

A

Recurrent UTIs or intermittent dysfunction
Fever NOT common in chronic

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

On physical exam for prostatitis, the prostate is usually boggy. What is the difference in prostate exam if the case is acute vs chronic

A

Acute: VERY tender, boggy
Chronic: contender, boggy

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

Explain the unique diagnostics of prostatitis

A

UA and urine culture: pyuria and bacteriuria in acute. Often negative in chronic so prostatic massage to increase bacterial yield. However, do NOT do massage in acute, can lead to bacteremia.

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

Treatment for prostatitis if the patient is > 35 years old

A

Fluoroquinolones or Trimethoprim-Sulfamethoxazole x 4-6 weeks

If inpatient, IV Fluoroquinolones with Aminoglycoside

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

If the patient is < 35 years old, then an STI is likely cause of prostatitis. Therefore the treatment is

A

Ceftriaxone + Doxycycline (or Azithromycin instead of Doxy)

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

If the prostatitis is refractory to other medications, you should do

A

Transurethral resection of the prostate (TURP)

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

MCC of epididymitis in males 14-35 years old

A

Chlamydia Trachomatis and Gonorrhea

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

In men > 35, the MCC of epididymitis is

A

E. Coli

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

Symptoms of epididymitis

A

Gradual onset of localized testicular pain and swelling (unilateral)

Groin, flank, or abdominal pain

May be associated with fever, chills, or irritative symptoms (dysuria, urgency, frequency)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is seen on physical exam of a patient with epididymitis?

A

-Scrotal swelling and tenderness
-Positive Prehn Sign (relief of pain with scrotal elevation)
-Positive cremasteric reflex: elevation of testicle after stroking inner thigh

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

What is the best initial test for epididymitis and what is seen on it?

A

Scrotal US: enlarged epididymis and increased testicular blood flow

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

However, what other test for epididymis should also be done and why?

A

NAAT to rule out Gonorrhea and Chlamydia

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

Conservative Management of epididymitis

A

Scrotal elevation, NSAIDs, cool compresses

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

Medical management of epididymitis

A

< 35 years: Doxycycline + Ceftriaxone (or Azithromycin instead of Doxycycline)

> 35 years: Fluoroquinolones (Ciprofloxacin, Ofloxacin, Levofloxacin) (Bactrim is an alternative)

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

MCC of orchitis

A

Viral (Mumps MC, Echovirus, Rubella, Coxsackie)

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

Symptoms of orchitis

A

-Scrotal pain, swelling, and tenderness
-Scrotal erythema and tenderness

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

Treatment for orchitis

A

-Symptomatic management: NSAIDs, bed rest, scrotal support, and cool packs.

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

Who is at highest risk for testicular torsion (2 groups)?

A

Males 10-20 years of age & Neonates

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Symptoms of testicular torsion

A

Abrupt onset of scrotal, inguinal, or lower abdominal pain (usually < 6 hours)

Nausea, vomiting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

If ____ and ___ are present, suspect torsion over epididymitis

A

Nausea and vomiting

24
Q

Physical exam findings of a patient with testicular torsion

A

-Swollen, tender, high-riding testicle that may have horizontal lie
-Negative Prehn Sign: no pain relief with elevation
-Negative cremasteric reflex

25
Q

Although testicular torsion is a clinical diagnosis, what study is most commonly done, but what other study gives a definitive diagnosis?

A

Common: testicular doppler US
Definitive: Surgical exploration

26
Q

Treatment for testicular torsion

A

Urgent detorsion and orchiopexy within 6 hours of pain onset

(Irreversible damage of ischemia after 12 hours)

27
Q

What is cryptorchidism?

A

Testicle that has not descended into the scrotum by 4 months of age

28
Q

Name 3 facts about cryptorchidism

A

-Most resolve spontaneously
-Most are right-sided
-Most commonly found just outside the external ring, inguinal canal, or abdomen

29
Q

Risk factors for cryptorchidism

A

Prematurity
Low birth weight
Maternal obesity
Maternal Diabetes

30
Q

Treatment for cryptorchidism

A

Orchiopexy as early as 4-6 months old, before 2 years old

31
Q

What are four major complications of cryptorchidism

A

Increased risk of testicular cancer
Decreased fertility
Testicular torsion
Inguinal hernia

32
Q

True or False: Testicular cancer is the MC solid tumor in young men 15-35 years old

A

True

33
Q

Most significant risk factor for testicular cancer

A

Cryptorchidism

34
Q

Other risk factors for testicular cancer

A

Caucasians
Klinefelter’s Syndrome
Hypospadias

35
Q

What type of testicular cancer type is the MC?

A

Germinal cell tumors (Nonseminomas and Seminomas)

36
Q

Nonseminomas, the MC type of testicular cancer, is associated with what 2 labs and….

A

-Increased serum alpha-fetoprotein and beta-HcG

Resistance to radiation

37
Q

What are the 4 S’s of Seminomas?

A

-Simple (lacks tumor marker alpha-fetoprotein)
-Sensitive (sensitive to radiation)
-Slower growing
-Stepwise spread

38
Q

Symptoms of testicular cancer

A

-Painless testicular mass (MC)
-May have dull pain or testicular fullness
-Firm, hard, fixed mass that does not transilluminate

39
Q

Initial test of choice for testicular cancer

A

Scrotal US

40
Q

On scrotal US, what is seen with a nonseminoma?

A

Cystic, non homogenous mass

41
Q

On scrotal US, what is seen with a seminoma?

A

Hypoechoic mass

42
Q

What tumor markers are present in nonseminomas?

A

Increased alpha-fetoprotein and beta-hCG

43
Q

For staging of testicular cancer, what diagnostic is done

A

CT of the abdomen, pelvis, and chest

44
Q

What is the prognosis usually like with testicular cancer?

A

Excellent (5 year survival rate > 95%)

45
Q

If the testicular cancer is low-grade seminoma vs high-grade seminoma, what’s the treatment?

A

Low grade: radical orchiectomy. May need radiation
High grade: chemotherapy followed by orchiectomy and radiation

46
Q

What is a hydrocele?

A

Serous fluid collection within the layers of the tunica vaginalis of the scrotum

47
Q

A hydrocele is the MCC of

A

painless scrotal swelling

48
Q

MCC of a hydrocele

A

Idiopathic

49
Q

Symptoms of a hydrocele

A

Painless scrotal swelling (may increase throughout the day)

Dull ache or heavy sensation with increasing size

50
Q

Initial test of choice for a hydrocele

A

Testicular US

51
Q

What is unique about a hydrocele on physical exam?

A

It transilluminates

52
Q

Treatment for a hydrocele

A

watchful waiting (often resolves within first 12 months of life)

Surgical if persists beyond 1 year in age or communicating (link to peritoneum) to reduce risk of hernia

53
Q

What is a spermatocele?

A

Epididymal cyst that contains sperm

54
Q

Physical exam findings of a patient with a spermatocele

A

Round, soft mass at the head of the epididymis that is superior, posterior, and separate from the testes

Freely movable and transilluminates

55
Q

Even though scrotal US is done for a spermatocele, what is the treatment?

A

No treatment usually necessary, but surgical excision if chronic pain (rare)

PANCE 2.0 (62 decks)

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