GU Flashcards
hematuria
5+ RBCs on 3/3 specimens one week apart
most common UTI pathogen
E. coli
UTI exam findings
fever, tachycardia
flank pain/CVA tenderness
suprapubic tenderness
inguinal adenopathy
UTI diagnostics
UA
pyuria (WBC >10,0000/ml) - most reliable
leukocyte esterase > nitrites
uncomplicated cystitis treatment
nitrofurantoin (Macrobid)
trimethoprim/sulfamethoxazole (Bactrim
second line - fluoroquinolones
acute pyelonephritis treatment
hospitalized - gentamycin & ampicillin OR ceftriaxone OR ciprofloxacin
outpatient - ciprofloxacin, ceftriaxone, or gentamicin IV then PO
varicocele vs hydrocele presentation
variocele - venous dilation
bag of worms, pain, testicular atrophy, infertility
hydrocele - fluid collection
fullness, painless
how to differentiate between hydrocele and varicocele
hydrocele will transilluminate
ultrasound if needed
varicocele treatment
surgery - embolization, ligation
hydrocele treatment
scrotal supports
NSAIDs
possibly surgery if symptomatic
acute bacterial prostatitis s/s
UTI symptoms + pain at the tip of the penis
firm, tender prostate
bacterial prostatitis treatment
TMP/SMX - acute
ciprofloxacin - acute/chronic
acute - 2-6 week extended treatment!
chronic - 4-12 week treatment
alpha blocker for retention
chronic bacterial prostatitis diagnosis
semen culture with 10+ WBCs
acute epididymitis s/s
gradual onset unilateral scrotal pain
negative Phrens sign - relief of pain when elevating affected testicle
acute epididymitis antibiotics based on cause
chlamydia/gonorrhea - ceftriaxone IM & doxy
anal sex - ceftriaxone IM & levofloxacin
enteric organisms - levofloxacin
testicular torsion s/s
sudden onset unilateral pain
hard, swollen, high-riding testis
loss of cremasteric reflex, positive Phrens sign (pain w elevation)
testicular torsion treatment
surgery!!!! within 6 hours
ED treatment
phosphodiesterase-5 inhibitors
CI in men taking nitrates ->fatal hypotension
purpose of PSA
screening for prostate cancer
BPH treatment
surgery - TURP - relieves bladder outlet obstruction
alpha blockers
prostate cancer diagnosis
PSA
needle biopsy -> Gleason score
risk factor for bladder cancer
tobacco use
s/s of bladder cancer
painless hematuria
irritative voiding symptoms
s/s of testicular cancer
nodule or painless swelling of one testicle
dull, achy lower abdomen, perineum, or scrotum
ovoid hard, firm, fixed mass
testicular cancer diagnostics
alphafetoprotein (AFP), beta human chorionic gonadotropin (bHCG), and lactate dehydrogenase (LDH) are elevated in 80% of testicular cancer (GCTs)
testicular cancer treatment
radical orchiectomy (testicle removal) w sperm banking
relative contraindications to oral contraception
smoking
CV disease
hypertension
primary dysmenorrhea
prostaglandins causing uterine contractions
associated with menstrual cycle
secondary amenorrhea
3 months without menstrual cycle, or 6 months without in a woman with previously irregular cycles
must rule out pregnancy
menorrhagia
heavy bleeding
metrorrhagia
light, irregular bleeding between periods
menometrorrhagia
heavy, irregular bleeding
salpingitis
inflammation of the fallopian tubes, caused by bacterial infection
most common microbes of salpingitis
N. gonorrhoeae
C. trachomatis
PID exam findings
chandelier sign - marked tenderness of the cervix, uterus, and adnexa
discharge, friable cervix, pain
PID diagnosis
sexually active with uterine/adnexal tenderness OR cervical motion tenderness
may have temp, discharge, elevated ESR/CRP, evidence of gonococcal or chlamydial infection, leukocytosis
definitive - endometrial biopsy, TVUS, laparoscopic abnormalities
complication of PID
Fitz-Hugh curtis syndrome (liver inflammation)
BV diagnosis
clue cells on wet mount
amsel criteria
for BV
3 of the following:
- vaginal pH >4.5
- > 20% clue cells
- positive aime/whiff test
- milky, white discharge
BV treatment
metronidazole or clindamycin
vulvovaginal candidiasis diagnosis
pseudo Hyphae and/or budding yeast
vulvovaginal candidiasis treatment
antifungals - fluconazole, miconazole
trichomonas treatment
metronidazole
trichomonas pathogen
trichomonads vaginalis
trichomonas presentation
strawberry cervix, frothy yellow discharge
chlamydia presentation
many asymptomatic women
men may have some discharge/pain
chlamydia diagnosis
NAAT
chlamydia treatment
doxycycline
gonorrhea presentation
women - asymptomatic
men - PERFUSE thick yellow discharge
gonorrhea tratment
ceftriaxone IM once
HSV type 1
cold sores
HSV type 2
genital lesions
HSV dianositcs
HSV culture, ELISA or western blot
HSV treatment
acyclovir, valacyclovir, famciclovir
syphilis pathogen
treponema pallidum
syphilis presentation
primary - chancre (painless, indurated ulcer)
secondary - flu symptoms, rash
latent - asymptomatic
tertiary - systemic complications (neurosyphilis)
syphilis treatment
penicillin
testing for sexual assault
initial - HIV/STIs
6wk-3mo later - STI, HIV
sexual assault abx
women - doxy, metronidazole, CTX
men - CTX, doxy
normal PSA
<6.5
