GU infections/inflammatory conditions

Question 1

what is the most likely diagnosis?

male
pain - back/perineum/penis 
obstructive/voiding symptoms 
fevers 
boggy/tender prostate on DRE

Answer 1

prostatitis

Question 2

management for prostatitis?

Answer 2

14 day quinolone (ciprofloxacin etc)

consider STI screen

Question 3

what is the most likely diagnosis?

fairly asymptomatic
urethral discharge or dysuria

Answer 3

non-gonococcal
7/7 oral doxycycline
OR
single oral dose of azithromycin

gonococcal
both oral doxy and azithromycin

Question 4

what is the most likely diagnosis?

unilateral testicular swelling and pain
urethral discharge
prehn’s sign positive

Answer 4

Epididmyo-orchitis

Question 5

Ix to do is suspecting Epididmyo-orchitis ?

Answer 5

STI screen

urinanalysis - espcially urine dip

Question 6

Mx for Epididmyo-orchitis ?

Answer 6

IM ceftriaxone (500mg) + 10-14/7 100mg oral Doxy BD

Question 7

acute onset of itchy foreskin, white discharge and typically happening after sexual intercourse

Answer 7

candidal balanitis

Question 8

mx of candidal balanitis

Answer 8

topical clotrimazole (2 weeks)

Question 9

acute painful and itchy foreskin, yellow non-urethral discharge

Answer 9

bacterial balanitis

Question 10

mx of bacterial balanitis

Answer 10

flucloxacillin or clarithromycin

Question 11

acute, itchy foreskin, clear non-urethral discharge

Answer 11

dermatitis- related balanitis

Question 12

acute painful itchy foreskin, not associated with any discharge

Answer 12

eczema-psoriasis related balanitis

Question 13

itchy foreskin, offensive, yellow non-urethral discharge

Answer 13

anaerobic bacterial balanitis

Question 14

itchy foreskin with wickhams striae and violaceous plaques

Answer 14

lichens planus

Question 15

mx for dermatitis related balanitis

Answer 15

mild potency corticosteroids (hydrocortisone)

Question 16

mx for eczema/psoriasis related balanitis

Answer 16

mild potency corticosteroids (hydrocortisone)

Question 17

mx for anaerobic bacterial balanitis

Answer 17

tropical/oral metronidazole

Question 18

chronic white plaques, itchy foreskin, significant scarring

Answer 18

lichens sclerosis

Question 19

mx for lichen sclerosis balanitis

Answer 19

high potent topical steroids (clobetasol)

sometimes circumcision can help

Question 20

not itchy foreskin, painless erosions, no discharge

linked to reactive arthritis

Answer 20

circinate balanitis

Question 21

mx for circinate balanitis

Answer 21

mild potency corticosteroids (hydrocortisone)

Question 22

chronic clearly circumscribed areas of inflmmation on foreskin
not itchy

Answer 22

plasma cell balanitis

Question 23

what is the most likely diagnosis? 
lower abdo/suprapubic pain
dysuria /frequency/urgency/nocturia 
cloudy/offensive smell to urine 
low grade fever/malaise 

elderly - acute confusion

Answer 23

Cystitis/UTI

Question 24

mx for non-pregnant women for UTI?

Answer 24

trimethoprim/nitrofurantoin for 3/7days

Question 25

mx for pregnancy women with UTI?

Answer 25

7/7 day abx
send urine MCS

first trimester -> nitrofurantoin
closer to term -> trimethoprim

Question 26

mx for UTI in men?

Answer 26

7/7 nitrofurantoin or trimethoprim

same for catheterised pts

Question 27

mx of UTI in children

Answer 27

<3months = immediate paeds referral

> 3months and UUTI = consider admission and oral cephalosporin/co-amox

> 3months and LUTI = oral abx - local guideline