GU

Question 1

Pyelonephritis UA and CBC findings

Answer 1

1. UA: WBC’s, WBC casts

2. Leukocytosis and Left shift

Question 2

Pyelonephritis CT Urogram findings

Answer 2

1. Perinephric stranding
2. Kidney Enlargement
3. Dilated Renal Collecting System

Question 3

Pyelonephritis abx treatment

Answer 3

Fluoroquinolone x7 days

Question 4

What should you consider if a pt in not improving with Pyelonephritis

Answer 4

1. Acute Bacterial Nephritis

2. Renal abscess

Question 5

Cystitis abx tx

Answer 5

1. Nitrofurantoin (Macrobid) x5 days
2. TMP-SMX (Bactrim) x 3 days
3. Cipro x 3 days

Question 6

Urethritis UA findings

Answer 6

1. Leukocyte esterase

2. >10 WBC/hpf

Question 7

Urethritis abx tx

Answer 7

1. Ceftriaxone 250 Mg IM x1 dose: Gonorrhea

2. Amoxicillin OR Doxycyline

Question 8

How do you diagnose Urethral trauma?

Answer 8

1. Retrograde Urethrography

2. Cystography: “pie in the sky”

Question 9

Causes of Priapsm

Answer 9

1. ED meds=Vasodilator
2. Cocaine=Vasodilator
3. Trazadone
4. Sickle cell dz/trait

Question 10

Define Phimosis. Tx?

Answer 10

Prepuce stuck DISTAL to glans

Manual reduction

Question 11

Define Paraphimosis

Answer 11

Prepuce stuck PROXIMAL to the glans

Question 12

Paraphimosis treatment

Answer 12

1. Push/pull to reduce

2. Dorsal slit or circumcision if unable to manually reduce

Question 13

What is a major complication of paraphimosis?

Answer 13

Fournier’s gangrene

Question 14

Testicular Torsion si/sx’s

Answer 14

1. Abrupt onset, severe testicular pain and swelling
2. High Riding (retracted) testicle
3. Horizontal lie
4. Absent cremasteric reflex
5. Negative Phren’s sign: No pain relief with scrotal elevation
6. Testicular Doppler US: Reduced blood flow

Question 15

Causes of Testicular Torsion

Answer 15

1. “Bell Clapper” deformity

2. Cryptorchyidism: undescended testis

Question 16

Testicular Torsion tx

Answer 16

1. Manual detorsion <6 hrs

2. Surgical exploration: Orchiopexy vs. Orchiectomy

Question 17

Causes of Epididymitis

Answer 17

1. Bechets dz
2. Amiodarone: accumulates in epididymis
3. Acute Bacterial infection: <35= Chlamydia, >35= E.coli

Question 18

Epididymitis si/sx’s

Answer 18

1. Gradual onset Testicular Pain & Swelling
2. Urethritis
3. Swollen, painful testicle
4. Fever
5. Hydrocele
6. • Phren’s sign
7. Normal cremasteric reflex

Question 19

Epididymitis UA findings

Answer 19

Pyuria (elevate WBC)/Bacteriuria

Question 20

Scrotal US findings in Epididymitis

Answer 20

Increased testicular blood flow

Question 21

Epididymitis abx treatment if you suspect STD

Answer 21

Ceftriaxone + Doxycyline

Question 22

Epididymitis abx treatment if you don’t suspect STD

Answer 22

Levofloxacin=Covers enteric E.coli

Question 23

DRE findings in Prostatitis

Answer 23

Warm, boggy, tender prostate

Question 24

What history would you find in a pt with BPH?

Answer 24

1. Recurrent UTI’s

2. Cystolithiasis

Question 25

BPH DRE findings

Answer 25

firm, boggy, RUBBERY prostate

Question 26

Cystoscopy findings in BPH

Answer 26

1. Obstructive prostate

2. “Kissing lobes”

Question 27

BPH pharmacotherapy

Answer 27

1. Phototherapy: Saw Palmetto
2. Alpha Blocker: Tamsulosin (flomaxx)= urinary sx’s tx
3. 5-ARI: Finasteride, Dutasteride
4. PDE-5-1: Tadalafil (cialis)= BPH + ED

Question 28

What is the gold standard surgical treatment in BPH?

Answer 28

TURP= Transurethral Resection of Prostate

Question 29

What must you caution your pt’s in if they are started on an Alpha Blocker for BPH?

Answer 29

Intra-Operative Floppy Iris Syndrome= can’t start if they have eye surgery