GU Flashcards
Tx for Cystitis ([+] culture) in pregnancy
- Cephalexin, Cefpodoxine
- Amoxicillin
- Augmentin
- Bactrim (NO in 1st or 3rd trimester)
- Nitro (NO in 1st or 3rd trimester)
Inability to retract foreskin over the glans
Phimosis
MC form of Testicular Torsion
Intravag (bell-clap)
Dx for Primary Syphilis
Darkfield microscopy
Name of the painless ulcer found in Syphilis
Chancre
56 yo presents with painless hematuria. What is the next step in mgmt?
- Cystoscopy
- Check for Bladder CA
Tx for Uncomplicated Cystitis and for how many days?
How long do we Tx with comorbidities?
- Nitrofurantoin
- Bactrim
- FQ
- 3 to 5 days
- Comorbidities: 7 days
Tx for BPH, class and meds
- Alpha-blockers: Terazosin, Tamsulosin
- 5-reductase inhibitors: Finasteride [Proscar]
What do 5-reductase inhibitors do?
Block Testosterone
MCC acute urinary obstruction in women
Prolapse of pelvic organs and pelvic tumors
Dx for Stress Incontinence
Bladder stress test
Painful testicle (more when elevated), foreshortening and no cremasteric reflex. Dx?
Testicular Torsion
Dx for Nephrolithiasis
Helical CT
MCC Cystitis
E. coli
MC patho of Syphilis
Treponema pallidum (spirochete)
MC patho type of Bladder CA
Urothelial (transitional cell) carcinoma
What presents with inguinal bubo and painful penile sores?
Chancroid
Dx for Testicular Torsion
Doppler US
Common presentation/complaint seen in Bladder CA
Painless hematuria
Dx for Testicular CA, initial and definitive
Initial: US
Definitive: Radical inguinal orchiectomy
MC site for Nephrolithiasis
Uretero-Vesiclular junction (UVJ)
Definitive Dx for Cystitis
Urine culture
Undescended testicle name:
Cryptorchidism
MCC and Tx for Prostatitis and Epididymitis <35 yo
- Gono, Chlamydia
- Ceftriaxone (or Ofloxacin) + Doxycycline
Nephrolithiasis Tx by size
< 5mm: IVF, Toradol (pain), antiemetics, Tamsulosin
> 7mm: Lithotripsy
> 10mm: Percutaneous nephrolithotomy
Tx for Urge Incontinence, class and med
Anticholinergics: Oxybutynin
Med that’s CI in 2nd and 3rd trimesters of pregnancy. Why?
- Sulfonamides (Sulfamethoxazole)
- Cause jaundice
Dx for BPH and finding
- Digital rectal exam
- Smooth, firm, mobile prostate, NO nodules
What is seen on Doppler US for Epididymitis?
Increased color flow
MC RF for Testicular CA
Cryptorchidism (undescended testicle)
MCC and Tx for Prostatitis and Epididymitis >35 yo
- E. coli (also Pseudomonas in Epididymitis)
- Cipro or Bactrim
Male presents with painless genital ulcer and inguinal lymphadenopathy. Dx? Patho?
- Lymphogranuloma venereum (LGV)
- Chlamydia trachomatis
What PE is CI in Prostatitis and why?
- Vigorous prostate exam
- Risk of septicemia
Why must a Bx be avoided in probable Testicular CA?
May result in tumor seeding.
What common drug used for Cystitis is NOT used in Pyelonephritis?
Nitrofurantoin
Which has a gradual onset, Epididymitis or Torsion?
Epididymitis
3 lab findings in Testicular CA
- ↑ beta-hCG
- ↑ Alpha-Fetoprotein (AFP),
- ↑ Lactate Dehydrogenase (LDH)
What is the sign of relief with testicular elevation and what is the Dx?
- Prehn’s sign
- Epididymitis
Pt. presents with sudden strong need to urinate and large amounts of urine. Dx?
Urge Incontinence
What is a PE of Testicular CA?
Painless, hard, fixed mass
Chlamydia Cervicitis Tx
Single dose Azithromycin
A febrile infant with 1st UTI should undergo what other evaluation?
Renal and bladder US (RBUS)
Which incontinence shows elevated postvoid residual?
Overflow incontinence
What is a PE of Prostatitis?
Warm, exquisitely tender prostate
What causes Testicular Torsion?
Cryptorchidism (d/t maldevelopment of fixation between the enveloping tunica vaginalis and posterior scrotal wall)
Pyelonephritis Tx
FQ or Bactrim
Scoring system used to grade Prostate CA prognosis. What is the range and risk?
- Gleason
- Ranges 2 to 10, with 7 being medium risk.
What intervention is CI in Prostatitis?
Urethral cath
MCC Cervicitis
Chlamydia
Congenital D/O characterized by the absence of 1 or both kidneys. Dx?
Renal agenesis
UA findings in Nephrolithiasis
Hematuria
-NO WBCs
Tx for Pyelonephritis inpatient and pregnancy
- Ampicillin + Gentamicin
- 3rd gen Cephalosporin
Dx for Chlamydia Cervicitis
Nucleic acid amplification testing (NAAT) PCR
Tamsulosin common SE
Dizzy
MCC bladder calculi
Infection of residual bladder urine with urea-splitting organisms
MCC Bacterial Vaginosis
Decrease in Lactobacilli which leads to increase in Gardnerella vaginalis
Chronic heme condition often associated with priapism
SCD
Urologic ER: Foreskin becomes trapped behind corona of glans and forms tight band, constricting penile tissues.
Paraphimosis
“se fue PARA alla!”
MC stone in Nephrolithiasis
Calcium oxalate
Prolonged painful erection
Priapism
Swelling of a kidney d/t build-up of urine
Hydronephrosis
Nephrolithiasis vs Urolithiasis
N: kidney calculi or stones
U: urinary tract calculi or stones
Painful genital ulcers and bubo formation. Patho and Dx?
- Haemophilus ducreyi
- Chancroid
Tx order for Paraphimosis
1st: Manual reduction
2nd: Dorsal slit (reduction unsuccessful)
3rd: Circumcise
With any type of incontinence, what test must be done 1st to R/O?
UTI
MC diagnosis inan adult with Nephrotic syndrome. What do we worry about?
- DM
- Hypercoagulability (clots) → send home on ASA
Burning and itching of penis with foul smell. PE: erythema and inflammation with scant, thick, white discharge. Dx?
Balanoposthitis D/T Candida
Tx of Balanoposthitis
Top. antifungal → Clotrimazole cream
What is the most likely PE finding in a patient with Peyronie’s disease?
Fibrous band on lateral portion of the penis
A young man is involved in a MVA. On secondary survey, it is noted that there is blood at the meatus and the patient is suspected of having a pelvic fracture. The patient is otherwise stable. Which of the following tests should be done to evaluate the urinary system?
Urethrogram (x-ray used to image the integrity of the urethra)
Post-op fever on day 3-5 would likely be D/T:
UTI
What is the MC complication of circumcision?
Bleed
How long do we Tx Prostatitis for?
4-6 wks
What is the best mgmt for a 6 mo with undescended testes (cryptorchidism)?
Referral for Orchiopexy
Pt. presents with his wife and reports they are having trouble conceiving. Wife was checked and has no issues. What is the biggest RF for his infertility?
Varicocele
In males, what is the cause for most cases of viral mumps infection?
Orchitis (testes inflamed)
What is a common site for prostate cancer to metastasize to?
Bone
4 yo presents with HTN. What is the likely cause?
Wilms tumor (kidney tumor)
57 yo male with Hx of HTN. He has generalized weakness and low GFR. Cr of 8. What med is he likely taking? What should he take instead?
- ACE-I for renal artery stenosis
- ARB (after switching, do renal US)
MCC renal failure
DM
When Tx erectile dysfunction with a PD5 inhibitor (Sildenafil), what is CI that can be used for chest pain?
Nitroglycerin
What can cause Testicular CA?
Cryptorchidism