GU Flashcards
A 55y/o male presents with increased urinary frequency, nocturia, hesitancy, and a weak stream – dx? How do you confirm?
BPH
Confirm with PSA and UA
If a male has BPH symptoms and HTN how would you treat?
Alpha Blockers
What are the most common causes of erectile dysfunction?
Vascular, diabetes, SSRI’s, and psychogenics
What should we always remember about phosphodiesterace inhibitors?
They are contraindicated in pts takin nitrates!
How do we treat urge incontinence?
Oxybutynin
How do we treat stress incontinence?
Vaginal estrogen
What are the 3 MC types of stones that cause nephrolithiasis?
Calcium Oxylate
Cystine – autosomal disorder, can’t absorb amino acid cysteine.
Struvite – urea splitting bacteria
What’s the gold standard diagnostic for nephrolithiasis?
UA shows hematuria
*Non-contrast helical CT
How do we treat kidney stones?
Hydrate, NSAIDs
- Stones less than 10mm – Tamulosin
- Stones greater than 10mm – lithotripsy
What types of foods should someone with chronic kidney stones avoid?
Oxalate rich foods (nuts, bran, spinach, and vit C)
If a pt has painless intermittent hematuria – what should you always think of? Dx? And Tx?
Bladder CA
Dx – Cystoscopy and CT
Tx – TURBT
How do we handle prostate cancer?
Risk stratify patients with PSA
What is the MC malignancy in young males? How do we dx and tx?
Testicular CA
Dx – U/S DO NOT BIOPSY and CT
Tx – Radical inguinal orchiectomy
What’s the difference between a hydrocele and a varicocele?
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
If you are concerned about testicular torsion, what special signs might you see? How do you diagnose?
ABSENT creamasteric reflex
Negative Phren sign (no pain relief with lifting the testicle)
Dx – Dopper U/S or OR STAT
What are the MC causes of cystitis?
E. coli, staph, proteus, and klebsiella
What would make a complicated UTI?
Preggo, male, foley cath, DM, immunocompromised, or structural abnormality
What finding in a UA is most specific to an infection?
Nitrites
How do we treat an uncomplicated vs complicated UTI?
Uncomplicated: Nitrofurantoin, TMP-SMX
Complicated: TMP-SMX, Cipro or levo
*If a man, does NOT improve after 7 days, think prostatitis
What is prostatitis? What would you see on PE?
Inflammation of the prostate (from e. coli)
The prostate feels tender, warm, and edematous
How do you treat prostatitis?
Floro or trimethoprim-sulfameth.
What would you see on PE with pyelonephritis?
Cystitis PLUS fever, chills, flank pain, and CVA tenderness
What would you see on UA with pyelonephritis?
Same as cystitis PLUS WBC’s and casts
How do we treat pyelo?
Floroquinolones – ciprofloxacin
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?
Known as – Orchitis
Occurs with epididymitis
Occurs alone think MUMPS
How do we diagnose epididymitis? Tx?
NAAT + U/A and culture
If over 35 tx with floroquinolone
If a male has dysuria and penile discharge, the gram-stain is positive for gonorrhea – dx? Confirm? Tx?
Urethritis
Dx – NAAT for gonorrhea
Tx – Ceftriaxone + azith or doxy *Must treat all partners regardless of sxs
What type of herpes causes oral components vs genital?
HSV1 = oral
HSV2 = genital
How do we diagnose and treat herpes?
Dx – PCR
Tx – Acyclovir or valavivlovir (within 72 hours)
How do we diagnose and treat Gonorrhea?
Dx – NAAT
Tx – Ceftriaxone
How do we diagnose and treat Chlamydia?
Dx – NAAT
Tx – Doxy or Azith
How do we diagnose and treat Trichomonas?
Dx – Naat
Tx – Metronidazole
What causes syphilis?
Treponema pallidum
If a pt has painless genital ulcers, what stage of syphilis would they be in? Dx? Tx?
Primary
Dx – Dark field microscopy, possible RPR, or VDRL
Tx – Azith or ceftriaxone or Pen G
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?
Secondary syphilis (weeks to months after genital ulcer)
Dx – RPR or VDRL (confirm with FTA-ABS)
Tx – Pen G
A pt presents with a HA, N/V, and neck stiffness, and a new murmur – dx? Confirm? Tx?
Tertiary syphilis
Dx - RPR or VDRL (confirm with FTA-ABS)
Tx – IV Pen G x 10-14 days
What’s the new murmur often associated with tertiary syphilis?
Aortitis – aortic regurg
