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Urgent Care Guide > GU 4 > Flashcards

GU 4 Flashcards

1
Q

bartholin’s cyst

A

cyst arising from Bartholin gland, caused by scarring, trauma, edema or idiopathic

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2
Q

bartholin’s cyst may become infected and

A

cause an abscess

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3
Q

bartholin’s cyst - pt may present w/
4

A
  1. most asymptomatic
  2. +/- vulvar irritation
  3. dyspareunia
  4. pain w/ sitting/walking
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4
Q

bartholin’s cyst - severe pain may indicate what

A

abscess

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5
Q

bartholin’s cyst - PE findings VS
1

A
  1. +/- fever (if abscess present)
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6
Q

bartholin’s cyst - cyst PE findings
4

A
  1. unilateral
  2. palpable
  3. near vaginal introitus and into labia major if large
  4. clear discharge
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7
Q

bartholin’s cyst - abscess PE findings
5

A
  1. severe unilateral pain
  2. swelling
  3. redness
  4. warm
  5. purulent drainage
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8
Q

bartholin’s cyst - img/testing
2

A
  1. none usually req
  2. if concerned for STI, possible cx
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9
Q

bartholin cyst tx for uncomplicated cyst
1st and 2 nd line

A
  1. first line sitz bath
  2. second line I/D w/ GYN f/u
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10
Q

bartholin cyst tx for abscess

A

ID w/ word catheter placement (4-6) weeks or gauze packing 48 hours + analgesia coverage

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11
Q

bartholin cyst abscess - always incise where

A

on mucosal surface

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12
Q

bartholin cyst abscess - abx information for I/D

A
  1. antimicrobial tx not usually required
  2. surrounding cellulitis, recurrent infections, immunosuppression, or STIs are indications for abx therapy
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13
Q

bartholin cyst - refer to GYN for
4

A

abscess
recurrent cysts
age >40 (think vulvar cancer)
size >5cm

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14
Q

bartholin cyst - when to refer to ER
3

A
  1. abscess w/ fever
  2. extensive cellulitis
  3. associated abd pain
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15
Q

prostatitis

A

inflammation of the prostate, +/- infection

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16
Q

prostatitis - pt may c/o pain where
6

A

low back
lower abd
testicular
penile
perineal
myalgias

17
Q

prostatitis - clinical pres
10

A
  1. pain
  2. urinary frequency
  3. urgency
  4. dysuria
  5. nocturia
  6. poor stream
  7. cloudy urine
  8. painful ejaculation
  9. fever
  10. acute vs chronic - more common >50yrs
18
Q

acute prostatitis - PE findings
6

A
  1. tender
  2. warm
  3. firm
  4. edematous prostate (don’t massage)
  5. +/- CVA tenderness
  6. +/- bladder distention
19
Q

prostatitis - risk factors
9

A

UTI
cystitis
urethral stricture
BPH
GU instrumentation
prostate cancer
prostate calculi
HIV
unprotected sex

20
Q

chronic prostatitis - PE findings
7

A
  1. prostate may be normal
  2. enlarged
  3. tender
  4. edematous
  5. nodular
  6. +/- CVA tenderness
  7. +/- bladder distention
21
Q

prostatitis - img/testing
2

A
  1. POC urine - if +, urine culture and sensitivity
  2. STI testing
22
Q

prostatitis - POC urine, urine may be sterile, negative UA

A

does not r/o prostatitis

23
Q

prostatitis - DD
6

A
  1. prostate abscess
  2. BPH
  3. prostate malignancy
  4. lower UTI, cystitis, urethritis
  5. pyelonephritis
  6. epididymitis
24
Q

prostatitis - overall tx disposition
4

A
  1. analgesia
  2. antipyretics
  3. possible STI testing
  4. refer to uro
25
Q

STI associated prostatitis tx

A

ceftriaxone 500 mg IM once + doxy 100 mg PO BID x 14 days

26
Q

non STI associated prostatitis tx duration

A

4-6 weeks and refer to PCP

27
Q

non STI associated prostatitis tx
3

A
  1. cipro 500 mg PO BID
  2. levofloxacin 500 mg PO once daily
  3. Bactrim DS 1 tab PO BID
28
Q

prostatitis - consider what med if concerns for urinary retention

A

alpha 1 blockers i.e. prazosin/Tamsulosin

29
Q

alpha 1 blockers i.e. prazosin/Tamsulosin - avoid in who

A

pts on multiple anti hypertensive meds or a fall risk

30
Q

prostatitis - when to refer to ER
1

A
  1. concern for sepsis or urinary obstruction
31
Q

testicular torsion

A

sudden onset of unilateral testicle pain d/t twisting of the spermatic cord and vascular pedicle resulting in testicular ischemia - uro emergency

32
Q

testicular torsion - patient may present w/
3

A
  1. acute onset of unilateral mod to severe testicular pain
  2. NV
  3. diffuse lower abd pain
33
Q

testicular torsion - may follow what
2

A

vigorous physical activity or trauma

34
Q

testicular torsion - often seen in who

A

infancy and adolescence but may affect all age groups

35
Q

testicular torsion - PE findings
2

A
  1. asymmetric, high riding testicle in the transverse plane
  2. scrotal swelling, erythema, tenderness
36
Q

testicular torsion - PE what two things are not considered reliable findings

A

cremasteric reflex
Prehn’s sign

37
Q

testicular torsion - img/testing

A

clinical dx
none

38
Q

testicular torsion - tx
2

A
  1. send to ER
  2. in resource limited area, consider manual detorsion using “open book” method - turn testicle away from midline 2-3 full rotations
39
Q

testicular torsion - when to refer to ER

A

all suspected cases

Urgent Care Guide (38 decks)

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