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Medical Conditions II > Genitourinary System > Flashcards

Genitourinary System Flashcards

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USMLE® Step 1 flashcards
1
Q

Differentiation of male and female gonads occurs at:

A

-6 weeks after fertilization

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2
Q

Testes

A

-production of gametes and sex hormones

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3
Q

Epididymis

A

-conducts sperm from efferent tubules to vas dererens

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4
Q

Scrotum

A

-protects testes, epididymides, spermatic cord

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5
Q

Penis

A

-delivery of sperm to female vagina and elimination of urine

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6
Q

Sex Hormones (Male)

A

-Androgens

testosterone is primary sex hormone

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7
Q

Pathologies of Male Reproductive System

A
  • prostatitis
  • benign prostatic hyperplasia
  • prostate cancer
  • orchitis
  • epididymitis
  • testicular torsion
  • testicular cancer
  • impotence
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8
Q

Prostatitis

A
  • inflam/infection of prostate
  • acute/chronic
  • bacterial/nonbacterial
  • preceded by UTI
  • more pain than BPH
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9
Q

Diagnosis of Prostatitis

A
  • urinalysis
  • specimen analysis
  • DRE
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10
Q

Treatment of Prostatitis

A
  • meds

- TURP (Trans urethral prostatectomy)

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11
Q

Acute Prostatitis

A

-very painful

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12
Q

Chronic Prostatitis

A
  • wax/wane over time

- some meds

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13
Q

Most Common Type of Prostatitis

A

-nonbacterial

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14
Q

S/Sx of Prostatitis

A

-table 19-1 (p966)

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15
Q

BPH

A
  • benign prostatic hyperplasia
  • most common in older men (>50)
  • non-malignant enlargement of prostate gland
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16
Q

S/Sx BPH

A
  • related to effect on lumen of urethra
  • urine retention
  • trouble getting flow started
  • progress:
  • -to UTI
  • -hydroureter
  • -hydronephrosis
  • -renal failure
  • -death
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17
Q

Diagnosis of BPH

A
  • history
  • palpation
  • urodynamic tests
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18
Q

Treatment of BPH

A
  • based on level of obstruction
  • monitoring
  • TURP vs TUIP
  • meds
  • thermotherapy (microwave/laser to destroy prostate tissue)
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19
Q

TUIP

A

-Transurethra incision of prostate

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20
Q

TURP

A

-transurethral prostatectomy

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21
Q

Common Questions for BPH

A
  • do you urinate often (esp at night)?
  • trouble starting or continuing urine?
  • weak flow of urine or interrupted urine stream?
  • feel like bladder not emptying completely?

If yes (and unexplainedLBP, pelvis, hip, upper thigh pain), refer

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22
Q

Prostate cancer tends to start:

A
  • at outer edge of prostate

- gets bad before detecting b/c it starts away from urethra (silent for a while)

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23
Q

Most common cancer of US males

A
  • prostate cancer

- second most common cause of male death from cancer

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24
Q

S/Sx Prostate Cancer

A
  • variable
  • lymph nodes in groin
  • abdominal swelling
  • may show up as urinary S/Sx or constitutional S/Sx
  • asymptomatic until well-progressed
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25
Q

Prostate Cancer Metastasizes to:

A
  • bone (usually)
  • lungs
  • liver
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26
Q

Prostate Cancer Dx

A
  • DRE
  • PSA Serum assay after age 50
  • radiologic studies
  • biopsy
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27
Q

Primary Prevention of Prostate Cancer

A
  • increasing lycopene
  • vitamine E
  • selenium
  • decrease fat in diet
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28
Q

RT-PCR

A
  • reverse transcription-polymerase chain

- new test for Prostate Cancer

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29
Q

Prostate Cancer Treatment

A
  • observation
  • prostatectomy
  • radition
  • hormonal therapy (orchiectomy)
  • pelvic floor rehab after prostate resection
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30
Q

BPH Risk Factors

A
  • > 50 yo
  • west (USA)>east
  • Black>white
  • tobacco>alcohol
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31
Q

Prostate Cancer Risk Factors

A
  • > 50 yo
  • USA & Scandinavia
  • Black
  • Alcohol
  • Family History
  • high-fat diet
  • Environmental Cadmium
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32
Q

Epididymitis

A

-inflammatory condition of epididymis

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33
Q

Orchitis

A

-inflammatory condition of testes

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34
Q

Risk Factors for Orchitis & Epididymitis

A
  • sexually active men with multiple partners

- primary infections arising elsewhere in body (esp GU)

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35
Q

S/Sx of Orchitis

A

-low abdominal pain

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36
Q

S/Sx Epidiydimitis

A
  • low abdominal
  • groin
  • hip adductors
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37
Q

Treatment of Orchitis & Epididymitis

A
  • NSAIDS
  • antibiotics
  • bed rest
  • scrotal support
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38
Q

Orchitis & Epididymitis

A

-can be associated with pneumonia

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39
Q

Testicular Torsion

A
  • abnormal twisting of spermatic cord as testes rotates

- medical emergency (surgery needed to preserve testes within 3 hours)

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40
Q

Testicular Torsion often concurrent with:

A
  • congenital abnormalities

- males 8-18 years or neonates

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41
Q

S/Sx Testicular Torsion

A
  • abrupt pain
  • scrotal swelling
  • N/V
  • tachycardia
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42
Q

Testicular Cancer

A
  • most common cause of cancer in young men

- second most common in 35-39 yo

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43
Q

Caues of Testicular Cancer

A
  • unknown

- family history (genetic)

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44
Q

S/Sx Testicular Cancer

A
  • painless enlargement of testicle
  • lumbar pain
  • metastasis to lungs
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45
Q

Testicular Cancer Metastases

A
  • lungs

- -cough, dyspnea, bloody sputum

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46
Q

Early Detection of Testicular Cancer

A

-testicular self-exam

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47
Q

Diagnosis of Testicular Cancer

A
  • palpation
  • serumm assays
  • US
  • radiologic studies
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48
Q

Treatment of Testicular Cancer

A
  • removal of mass (radiation, chemo, surgery)

- relapse not common

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49
Q

Impotence/ED

A
  • increases with age
  • consider Kegel Exercises
  • can be warning of ischemic heart disease
50
Q

Vagina

A
  • epithelial cells responsive to hormonal changes
  • protection from infection
  • permits stretch during coitus/child birth
  • self-cleanses
51
Q

Cervix

A
  • neck of uterus

- projects into vagina

52
Q

Uterus

A
  • muscular organ

- anchors nad protects fertilized ovum

53
Q

Fallopian Tubes

A

-conduct ova from spaces around the ovaries to uterus

54
Q

Ovaries

A

-produce ova and female sex hormones

55
Q

Sex Hormones (Female)

A

-estrogens, progesterone, androgens

56
Q

Cancer Screening of Female Reproductive System

A
  • abnormal bleeding
  • pelvic pain
  • gastrointesintal disturbances
  • urinary disturbances
  • abnormal swelling
  • changes in vulva/vagina
  • LBP
57
Q

S/Sx of Endometriosis

A
  • pain
  • inflam
  • infertility
  • rectal bleeding
  • fatigue
58
Q

S/Sx Ovarian Cancer

A
  • silent
  • vague symptoms (abdominal bloating, discomfort, fatigue, malaise, flatulence, gastritis)
  • less common Sx: abn vaginal bleeding, leg pain, low back pain, pelvic pain,
59
Q

Risk Factor of Ovarian Cancer

A

-Family History

60
Q

Diagnosis of Endometriosis

A
  • laparoscopy
  • laparotomy
  • US
  • MRI (more sensitive)
61
Q

Treatment of Endometriosis

A
  • preservation of fertility
  • pain relief
  • ovulation inhibition
62
Q

Diagnosis of Ovarian Cancer

A
  • US

- Cervical smear

63
Q

Treatment of Ovarian Cancer

A
  • Surgery (local/regional)
  • chemotherapy (adjuvant)
  • under investigation (monoclonal antigodies, gene therapy, vaccines)
64
Q

Ovarian Cystic Disease

A

-most are benign
-most common form of ovarian tumor
-4 Types (S/Sx dep on size/location of cyst)
-

65
Q

S/Sx Ovarian Cystic Disease

A
  • abdominal pressure, pain
  • bloating
  • painful urination
  • bowel movements
  • intercourse
  • chronic pelvic pain
  • episodic pain in abdomen, groin, buttocks, LBP
66
Q

PCOS

A

-polycystic ovary syndrome

67
Q

PCOS Manifestations

A
  • obesity
  • prominent facial/body hair
  • severe acne
  • thinning hair
  • infertility
  • dysmenorrhea
  • impaired glucose tolerance
  • obstructive sleep apnea
  • fibrocystic breasts
68
Q

Diagnosis of Ovarian Cystic Disease

A
  • pelvic exam
  • ultrasound
  • laparoscopy
  • lab tests
69
Q

Treatment of Ovarian Cystic Disease

A

-based on age and Sx

  • drainage of cyst
  • surgical excision
  • hormonal therapy
  • DM management techniques
70
Q

Uterine Fibroids

A
  • painful growths of uterus

- primary reason TAH (total abdominal hysterectomy)

71
Q

S/Sx Uterine Fibroids

A
  • pain
  • increased bleeding
  • urinary frequency
  • asymptomatic
72
Q

Treatment of Uterine Fibroids

A
  • meds
  • surgery
  • fibroid embolization ablation
  • diet
73
Q

Most Common Cancer of Reproductive Organs

A

Uterine Cancer

74
Q

Risk Factors of Uterine Cancer

A
  • age
  • HTN
  • DM
  • Social/lifestyle (exercise is good)
75
Q

S/Sx Uterine Cancer

A
  • abnormal bleeding

- LE swelling

76
Q

Treatment of Uterine Cancer

A
  • BSO (bilateral sypingo-oophorectomy)
  • TAH
  • Hormonal Therapy
  • radiation/chemo
77
Q

Diagnosis of Uterine Cancer

A
  • endometrial sampling

- US

78
Q

Cervical cancer

A
  • pap smear drastically reduced mortality rate

- primary cause: HPV

79
Q

S/Sx Cervical cancer

A
  • abnormal bleeding
  • bowel/bladder dysfunction

(Late disease Sx)

80
Q

Cervical cancer Diagnosis

A
  • pap smear
  • sentinal lymph node assessment
  • CT scan
81
Q

Cervical CancerTreatment

A
  • Excision (local/regional)
  • radiation
  • chemo
82
Q

Ectopic Pregnancy

A

-gynecological emergency

-

83
Q

Risk Factors of Ectopic Pregnancy

A

-fallopian tubes

84
Q

S/Sx Ectopic Pregnancy

A
  • lower abdominal quadrant/pelvic pain
  • possible Kehr’s sign
  • irregular bleeding
85
Q

Diagnosis of Ectopic Pregnancy

A
  • physical exam
  • US
  • lab tests
  • laparoscopy
86
Q

treatment of Ectopic Pregnancy

A
  • laparoscopy
  • laparotomy
  • possible chemo (to get rid of damaged/abnormal tissue)
87
Q

Kehr’s Sign

A
  • Left shoulder pain with splenic irritation

- usually with peritonitis

88
Q

Rupture of Right Ovary refers to

A

-right shoulder (irritates liver)

89
Q

Effects of Pregnancy

A
  • relaxin
  • center of gravity shift
  • pressure on vascular structures
  • increased cardiac demand/output
  • increased need for folic acid
90
Q

Primary Dysmenorrhea Pathophys

A

-excessive endometrial prostaglandin production

91
Q

S/Sx Primary Dysmenorrhea

A

-pelvic pain with onset of menses, backage, anorexia, vomiting, diarrhea, syncope, headache

92
Q

Eval/treatment of Primary Dysmenorrhea

A
  • medical Hx
  • pelvic exam
  • hormonal contraceptives may relieve pn
  • TENS to relieve pn
93
Q

PMS Pathophys

A
  • abnormal tissue response to normal change of menstrual cycle triggered by fluctuating estrogen and progesterone levels
  • asssociated with genetic predisposition
94
Q

S/Sx PMS

A

-over 200 physical, emotional, behavioral Sx

95
Q

Pelvic Inflammatory Disease Pathophys

A

-pelvic infection caused by microbes ascending through cervix to infect uterus

96
Q

S/Sx PID

A

-range from sudden and severe abdominal pain to no Sx at all, pain onset may be slow and steady or exacerbated by walking, jumping, or intercourse

97
Q

PID

A

pelvic inflammatory disease

98
Q

PID Eval

A
  • diagnosis based on pt Hx
  • Sx
  • evidence of infective agents
99
Q

PID Treatment

A
  • bed rest
  • avoid intercourse
  • antibiotic therapy
  • surgery required if pelvic adhesion
100
Q

Breast cancer: more masses in____

A

-axillary tail than any other part of breast

101
Q

female breast

A

-function is to provide nourishment for newborn

102
Q

breast nobes

A

-15-20 per breast

103
Q

nipple

A

deliver breast milk

104
Q

breast nodules

A

-20-40 lobules per lobe

105
Q

breast acini

A

-lined with epithelial cells capable of contracting to secrete milk

106
Q

Sub-areolar structures

A
  • fatty/fibrous tissue

- few duct-like structures in sub-areolar area

107
Q

Fibrocystic Disease & Fibroadenoma

A

-benign changes/tumors in breast

108
Q

S/Sx of Fibrocystic Disease & Fibroadenoma

A
  • Cysts
  • fibrous tissue
  • bilateral pain/tenderness
  • (especially as menstruation approaches)
109
Q

Risk Factors for Fibrocystic Disease & Fibroadenoma

A
  • age
  • menstrual Hx
  • pregnancy Hx
  • prior breast biposies
110
Q

Diagnosis of Fibrocystic Disease & Fibroadenoma

A
  • physical exam
  • mammography
  • biopsy
  • US
111
Q

Treatment of Fibrocystic Disease & Fibroadenoma

A
  • palliative
  • reduce caffeine/xanthines
  • low-fat diet
  • analgesics
  • adequate undergarment support
  • synthetic androgen for severe pain
  • surgical excision
112
Q

Breast Cancer: Females

A
  • most common female cancer in US
  • Same risk factors as Fibrocystic Disease & Fibroadenoma
  • 6 types of cancer
113
Q

Breast Cancer Etiology

female

A
  • has some genetic basse but largely unknown

- estrogen seems to be key factor in promoting disease

114
Q

S/Sx Breast Cancer

A
  • painless lump
  • dimpling/retraction of breast
  • nipple discharge
  • local rash/ulceration
  • palpable lymph nodes in axila
  • bone pain (metastases in vertebrae)
115
Q

Breast Cancer Diagnosis

A
  • clinical exam
  • mammography
  • percutaneous needle aspiration
  • biopsy
  • US
  • ductal lavage
  • hormone receptor assays
116
Q

Treatment Breast Cancer

A
  • based on stage
  • surgery
  • radiation
  • hormone therapy
  • biologic therapy
  • biologic therapy
  • bone marrow transplantation in cases of metastases
117
Q

Prevention of Breast Cancer

A
  • BSE (breast self-exam) monthly
  • periodic dr. performed breast exams
  • mammogram every 1-2 years after 40 yo
118
Q

Male Breast Cancer S/Sx

A
  • nipple discharge
  • skin retraction
  • ulceration of skin over tumor
  • axillary node involvement
  • pattern of metastases same as females
119
Q

Gynecomastia Pathophys

A
  • overdevelopment of breast tissue in males
  • 32-40% of male population
  • can be made of: fat, glandular or combination
120
Q

Glandular characteristics

A

-small button or small fingers spreading into chest fat

121
Q

Eval/Treat Gynecomastia

A
  • diagnosis on phyical exam
  • monitor for malignancy
  • reconstructive surgery

Medical Conditions II (34 decks)

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