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FM MED II GENERAL > GU > Flashcards

GU Flashcards

1
Q

A 55y/o male presents with increased urinary frequency, nocturia, hesitancy, and a weak stream – dx? How do you confirm?

A

BPH

Confirm with PSA and UA

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2
Q

If a male has BPH symptoms and HTN how would you treat?

A

Alpha Blockers

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3
Q

What are the most common causes of erectile dysfunction?

A

Vascular, diabetes, SSRI’s, and psychogenics

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4
Q

What should we always remember about phosphodiesterace inhibitors?

A

They are contraindicated in pts takin nitrates!

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5
Q

How do we treat urge incontinence?

A

Oxybutynin

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6
Q

How do we treat stress incontinence?

A

Vaginal estrogen

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7
Q

What are the 3 MC types of stones that cause nephrolithiasis?

A

Calcium Oxylate
Cystine – autosomal disorder, can’t absorb amino acid cysteine.
Struvite – urea splitting bacteria

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8
Q

What’s the gold standard diagnostic for nephrolithiasis?

A

UA shows hematuria

*Non-contrast helical CT

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9
Q

How do we treat kidney stones?

A

Hydrate, NSAIDs

  • Stones less than 10mm – Tamulosin
  • Stones greater than 10mm – lithotripsy
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10
Q

What types of foods should someone with chronic kidney stones avoid?

A

Oxalate rich foods (nuts, bran, spinach, and vit C)

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11
Q

If a pt has painless intermittent hematuria – what should you always think of? Dx? And Tx?

A

Bladder CA

Dx – Cystoscopy and CT

Tx – TURBT

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12
Q

How do we handle prostate cancer?

A

Risk stratify patients with PSA

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13
Q

What is the MC malignancy in young males? How do we dx and tx?

A

Testicular CA

Dx – U/S DO NOT BIOPSY and CT

Tx – Radical inguinal orchiectomy

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14
Q

What’s the difference between a hydrocele and a varicocele?

A 
Hydrocele = painless swelling with transillumination.                Dx: with U/S
Varicocele = abnormal dilation of the spermatic veins.  Painless MASS that “feels like a bag o worms”.                Tx = observation or surgical
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15
Q

If you are concerned about testicular torsion, what special signs might you see? How do you diagnose?

A

ABSENT creamasteric reflex

Negative Phren sign (no pain relief with lifting the testicle)

Dx – Dopper U/S or OR STAT

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16
Q

What are the MC causes of cystitis?

A

E. coli, staph, proteus, and klebsiella

17
Q

What would make a complicated UTI?

A

Preggo, male, foley cath, DM, immunocompromised, or structural abnormality

18
Q

What finding in a UA is most specific to an infection?

A

Nitrites

19
Q

How do we treat an uncomplicated vs complicated UTI?

A

Uncomplicated: Nitrofurantoin, TMP-SMX
Complicated: TMP-SMX, Cipro or levo
*If a man, does NOT improve after 7 days, think prostatitis

20
Q

What is prostatitis? What would you see on PE?

A

Inflammation of the prostate (from e. coli)

The prostate feels tender, warm, and edematous

21
Q

How do you treat prostatitis?

A

Floro or trimethoprim-sulfameth.

22
Q

What would you see on PE with pyelonephritis?

A

Cystitis PLUS fever, chills, flank pain, and CVA tenderness

23
Q

What would you see on UA with pyelonephritis?

A

Same as cystitis PLUS WBC’s and casts

24
Q

How do we treat pyelo?

A

Floroquinolones – ciprofloxacin

25
Q

f we see testicular pain, erythema, and swelling – what is it called? What does it usually occur with? If it occurs alone, what should we think of?

A

Known as – Orchitis

Occurs with epididymitis

Occurs alone think MUMPS

26
Q

How do we diagnose epididymitis? Tx?

A

NAAT + U/A and culture

If over 35 tx with floroquinolone

27
Q

If a male has dysuria and penile discharge, the gram-stain is positive for gonorrhea – dx? Confirm? Tx?

A

Urethritis

Dx – NAAT for gonorrhea

Tx – Ceftriaxone + azith or doxy *Must treat all partners regardless of sxs

28
Q

What type of herpes causes oral components vs genital?

A

HSV1 = oral

HSV2 = genital

29
Q

How do we diagnose and treat herpes?

A

Dx – PCR

Tx – Acyclovir or valavivlovir (within 72 hours)

30
Q

How do we diagnose and treat Gonorrhea?

A

Dx – NAAT

Tx – Ceftriaxone

31
Q

How do we diagnose and treat Chlamydia?

A

Dx – NAAT

Tx – Doxy or Azith

32
Q

How do we diagnose and treat Trichomonas?

A

Dx – Naat

Tx – Metronidazole

33
Q

What causes syphilis?

A

Treponema pallidum

34
Q

If a pt has painless genital ulcers, what stage of syphilis would they be in? Dx? Tx?

A

Primary

Dx – Dark field microscopy, possible RPR, or VDRL

Tx – Azith or ceftriaxone or Pen G

35
Q

A pt presents with a diffuse rash over the palms and soles of the feet, some fever, and grey/white mucous patches – dx? Confirm? Tx?

A

Secondary syphilis (weeks to months after genital ulcer)

Dx – RPR or VDRL (confirm with FTA-ABS)

Tx – Pen G

36
Q

A pt presents with a HA, N/V, and neck stiffness, and a new murmur – dx? Confirm? Tx?

A

Tertiary syphilis

Dx - RPR or VDRL (confirm with FTA-ABS)

Tx – IV Pen G x 10-14 days

37
Q

What’s the new murmur often associated with tertiary syphilis?

A

Aortitis – aortic regurg

FM MED II GENERAL (6 decks)

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