Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

UWS Q9 > GU Survey Exam 3 > Flashcards

GU Survey Exam 3 Flashcards

1
Q

What are the 2 functions of the testes?

A
  1. produce sperm

2. secrete hormones (testosterone)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is in the scrotum?

A

testicles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the function of the scrotum?

A
  • contains the testi at a lower temperature to allow for optimal sperm production
  • prone to injuries
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q 
Testicular or Scrotal mass?
firm solid and 
1. painless
2. do not transilluminate
3. usually malignant
A

testicular mass

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Testicular or Scrotal mass?

  1. painful
  2. transilluminate
  3. usually benign
A

scrotal mass

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Are testicular masses usuaslly painful?

A

no, painless

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Will testicular masses transilluminate?

A

no, do not transilluminate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

are testicular masses usually benign or malignant?

A

usually malignant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

are scrotal masses and those in the epididymiss or spermatic cord usually painful?

A

yes painful

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Will scrotal masses and those in the epididymiss or spermatic cord transilluminate?

A

yes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

are scrotal masses and those in the epididymiss or spermatic cord usually malignant or benign?

A

benign

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what tissue/part of the penis is the erectile tissue?

A

corpora cavernosa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What tissue/part of the penis contains the urethra?

A

corpus spongiosum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what layer of tissue surrounds the erectile tissue?

A

tunica albuginea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

define circumcision

A

surgical removal of the foreskin of the penis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

is the american academy of pediatrics in support of circumcision?

A

Yes, as a result of emerging evidence that found links between circumcision and decreased risk of urinary tract infection, rare penile cancer, HPV, HIV and other STIs, the AAP is in more support of the procedure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Does the AAP recommend routine circumcision for all newborn males?

A

no, “What remains unchanged is that the AAP still holds that the
health benefits are not great enough to recommend routine
circumcision for all newborn males,”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what are 3 non medical reasons PRO circumcision?

A
  1. religious/faith
  2. aesthetics
  3. hygiene
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what are 2 possible medical advantage of circumcision?

A
  1. less UTI, STI/HIV

2. less risk of penile cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are 5 cons/surgical risks to infant of circumcision?

A
  1. hemorrhage
  2. infection
  3. pain/trauma
  4. diminshed sensation
  5. > mother/child bonding
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

where are the seminal vesicles located?

A

out-pocketing of vas deferens: extend from base of bladder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

what does the seminal vesicles and vas deferens form?

A

ejaculatory duct

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

what is the order of sequency from the seminal vesicles?

A
  1. extend from base of bladder, out pocketing of vas deferens –> forms ejaculatory duct –> thru prostate –> to urethra
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

what is secreted from the seminal vesicles?

A

70% of fluid components of semen = energy/fluidity for sperm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

secretions from where supply 70% of fluid for semen and provide the energy for sperm?

A

seminal vesicles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

HPO axis for tesis?

A

hypothalamus > GnRH > pituitary > LH and FSH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

what does LH in the testis stimulate?

A

leydig cells to produce testosterone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

what cells produce testosterone?

A

leydig cells/interstitial cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

testosterone + FSH =>

A

spermatogenesis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

how many sperm does a male produce each day?

A

70-100 million each day!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

length of time for production of spermatogenesis in the testes?

A

approx 70 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

length of time for maturation of sperm in the epididymis?

A

= 2 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

what 3 components occurs as part of the maturation of sperm in the epididymis?

A

acquisition of

  1. motility
  2. capacity to bind to an ovum
  3. capacity to penetrate the zona pellucida
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

after what age should FOBT x3 be used as lab work up for preventative health?

A

after age 50

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

what is the peak age for tumors for penile conditions?

A

60 YO

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

what parts to the penis are tumors likely to involve (2)?

A

prepuce or glans

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

dx?

painless, enlarging wart-like growth

A

HPV, conyloma acuminata

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

dx?

hyperkeratotic, scaly, white patches of penile epithelium, yes for biopsy?

A

leukoplakia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

is a biopsy necessary if you suspect leukoplakia?

A

yes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q 
dx?
an intraepidermal (pre)cancerous indurated erythematous plaque, ulcerated center, development of pinkish or brownish papules covered with a thickened horny layer
A

Bowen’s dz

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

is a biopsy necessary for bowen’s dz?

A

yes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

what are 2 skin cancers of the penis?

A

squamous cell carcinoma, SCC
and
melanoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

what is balanitis

A

inflammation of glans

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Causes of balanitis? (8)

A 
1. Uncircumcised w/ poor hygiene
or over hygiene
2. Diabetes
3. Chemical irritants
4. CHF, cirrhosis, nephrosis
5. Drug allergies
6. Obesity
7. Infections: candida, HPV,
anaerobes, treponema,
gardnerella, tichomonas
8. Penile cancer
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

what is phimosis?

A

In ability to retract the distal foreskin.
-at birth the foreskin is adherent to the glans penis. These adhesions usually spontaneously separate and allow the foreskin to become retractible.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

what is paraphimosis?

A

Paraphimosis is the entrapment of a retracted foreskin behind the coronal sulcus. Paraphimosis is a disease of uncircumcised or partially circumcised males.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

where is the urethral opening with hypospadius

A

urethral opening on the ventral surface

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

which side is the ventral surface of the penis?

A

under

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

which is more common hypospadius or epispadius?

A

hypospadius

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

what is it called when the urethral opening is on the dorsal surface of the penis?

A

epispadius

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

which side is the dorsal surface of the penis?

A

upper

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

What are 3 causes of hypospadius and epispadius?

A
  1. exposure to PG hormone, finesteride
  2. lack of T in utero
  3. inherited
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

what is hypo and epispadius often associated with? (2)

A
  1. inguinal hernias

2. cryptorchidism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

what is priapism?

A

non-erotic sustained painful erection with acute onset

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

why does the glans remain soft with priapism?

A

glans remains soft because involves the corpora cavernosa but not the spongiosum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

Etiology of priapism?

A
  • unknown in most cases
  • possible associated w/ leukemia, metastatic carcinoma, local trauma, sickle cell dz, spinal cord trauma, circulatory distrubances, medications like viagra
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

tx for priapism? (5)

A
  1. spontaneously resolve in few hours
  2. ice water
  3. enema
  4. pharmaceutical intervention
  5. drainage is rare cases
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

dx?

plaques/strands of dense fibrous tissue surrounding the corpus cavernosum –> deformity and painful erection, impotence

A

peyronie’s dz

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

what are the s/sx of peyronie’s dz?

A
  1. hardened tissue
  2. pain during erection
  3. curvature with erection
  4. distortion (indentation, shortening)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

most common age for peyronie’s dz?

A

45-60 YO

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

etiology/risk factors for peyronie’s dz? (5)

A
  1. unknown
  2. trauma (surgery, injury)
  3. HLA-B7 (SLE. Scleroderma)
  4. 30% of ppl will develop fibrotic tissue in other areas like dupuytrens contracture
  5. diabetics
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

how do you dx peyronie’s dz?

A

exam and vasoactive injection to cause erection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

tx for peyronie’s dz? (3)

A
  1. watch and wait 1-2 years, often resolves
  2. non surgical tx within 6 mnths of dx: ca+ channel blockers, collagenase, cortisone
  3. surgery
    - severe/persistent
    - can cause partial loss of erectile function, penis length, urethral damage, infection, sensation loss
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

penile cancer incidence?

A

1/100k USA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

what percentage of malignancies in men is d/t penile cancer?

A

0.2%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

how much higher is cervical cancer incidence than penile cancer?

A

10x higher

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

how much higher is prostate cancer incidence than penile cancer?

A

100x

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

how much higher is fatal heart attack incidence than penile cancer?

A

200x

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

what are 3 sx of penile cancer?

A
  1. penile growths or sores
  2. abnormal penile d/c
  3. bleeding
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

what area is the most common site for penile cancer?

A

glans and foreskin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

Risk factors for penile cancer? 4)

A
  1. intact/non-circumcised male (high risk factor, low incidence)
  2. HPV infection (only certain strains, low risk factor)
  3. smoking
  4. age: majority >50 YO (40% <40 YO)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

chance for penile cancer in uncircumcised vs circumcise?

A

un- 1/600

circumcised- 1/1500

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

what are the 3 main tx for penile cancer?

A
  1. surgery: excision, laser, circumcision, partial to complete penectomy, nodal dissection
  2. radiation
  3. chemotherapy: topical, oral/IV
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

What are some examples of surgical procedures for treatment of penile cancer?

A
  1. excision
  2. laser
  3. circumcision
  4. partial to complete penectomy
  5. nodal dissection
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

what is the most common reason for visit to a urologist?

A

scotal masses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

define a scrotal mass?

A

painless or painful lump or swelling

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

can scrotal masses be solid or cystic?

A

yes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

can you develop a scrotal mass at any age?

A

yes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
79
Q

how are scrotal masses evaluated?

A

via US

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
80
Q

how do most men discover scrotal masses?

A

most men discover scrotal masses themselves

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
81
Q

Describe a testicular exam

A
  1. stand in front of mirror
  2. examine each testicle with both hands
  3. gently roll the testicle between the thumbs and fingers
  4. if palpable lump, refer for US and/or a urologist
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
82
Q

what are 5 causes of scrotal masses?

A
  1. cysts
  2. infection
  3. inflammation
  4. hernia
  5. tumors
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
83
Q

what is cryptorchidism?

A

undescended testicles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
84
Q

what is a 30% risk with preterm infants?

A

undescended testicles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
85
Q

what are 3 risks associated with crytorchidism ?

A
  1. testicular cancer
  2. infertility
  3. torsion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
86
Q

what are the two location for the testicle for cryptorchidism?

A
  1. abdominal testicle

2. pubo-scrotal testicle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
87
Q

what are the two location for ectopia undescended testicle?

A
  1. femoral

2. perineal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
88
Q

ddx?

worse with lifting the testicle

A

testicular torsion

ddx epididmyitis- pain lessens

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
89
Q

describe the sx of testicular torsion?

A
  1. sudden severe pain, swelling, erythema

2. lower ab pain, N/V

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
90
Q 
dx?
 1. sudden severe pain,
swelling, erythema
2. lower abdominal pain,
N/V
3. worse with lifting the
testicle
A

testicular torsion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
91
Q

Is testicular torsion considered a medical emergency?

A

yes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
92
Q

within how many hours should surgery for testicular torsion occur?

A

6-8 hrs to prevent atrophy, 80% good prognosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
93
Q

after how many hours is preservation of the testicle doubtful in relationship to testicular torsion?

A

24 hrs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
94
Q

what type of surgery is advised if delayed beyond 48 hr?

A

orchiectomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
95
Q

does pain get worse or better with lifting of testicle with epididymitis?

A

pain lessens

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
96
Q

what is a hydrocele?

A

collection of fluid in the sheath (tunica) that holds the testicle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
97
Q

Cause of hydrocele?

A

excess fluid production or decreased fluid absorption

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
98
Q

is a hydrocele painful?

A

often painless

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
99
Q

will hydrocele be transilluminated?

A

yes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
100
Q

describe a hydrocele?

A

often painless, swollen, soft, unilateral or bilateral, that will transilluminate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
101
Q

what is the ddx for hydrocele?

A

varicocele

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
102
Q

younger or older men more likely to have hydrocele?

A

older

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
103
Q

can hydrocele develop rapidly?

A

yes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
104
Q

causes of hydrocele?

A
  1. trauma
  2. radiation therapy
  3. inflammation
  4. congenital
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
105
Q

“bag of worms”

A

varicocele

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
106
Q

what causes a varicocele?

A

blood backs up in the veins leading from the testicles d/t valve dysfunction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
107
Q

varicocele painful or painless?

A

painless

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
108
Q

which side is more likely to have a varicocele?

A

more common on the left side

109
Q

which vein does left spermatic vein empty into?

A

left renal vein

110
Q

Which vein does the right spermatic vein empty into?

A

inferior vena cava

111
Q

sx/s of varicocele?

A

may feel heavy, better with lying down, achy, testicular atrophy, infertility, visibly enlarged vein, will not transilluminate

112
Q

will a varicocele be transilluminated?

A

nope

113
Q

typical age for varicocele?

A

15-25 YO

114
Q

why is varicocele associated with 40% infertile men?

A

increased testicular temperature

115
Q

what are 4 big risk factors for varicocele?

A
  1. pelvic floor stress (constipation, heavy lifting)
  2. vascular damage
  3. hereditary
  4. tumor
116
Q

2 dx evaluation procedures for varicocele?

A

US and venogram (dye/xray)

117
Q

tx for varicocele?

A
  1. scrotal support (atheletic supporter, tighter underwear)
  2. surgical ligation “varicocelectomy”
  3. embolization
  4. laparscopy
118
Q

what is a varicocelectomy

A

surgical ligation for a varicocele

119
Q

what % of varicocele reoccur?

A

5-20% reoccur

120
Q

what % of those with varicocele develop a hydrocele?

A

2-5%

121
Q

what is an inguinal hernia?

A

protrusion of abdominal contents, usually the small bowel, thru a weak point of the abdominal wall, where the vas deferens passes

122
Q

sx/s of inguinal hernia?

A
  1. bulge in the groin area that may extend into the scrotum

2. painful or uncomfortable

123
Q

tx for inguinal hernia

A

surgical repair

124
Q

define epididymitis

A

infection in the tubular coil, epididymis

125
Q

what is the function of the epididymis?

A

collects sperm from the testes

126
Q

where is pain with epididymitis?

A

produces pain in the top and rear of the scrotum

127
Q

what organisms are often associated with epididymitis?

A

often a complication of gonorrhea/chlamydia

- may be enterobacteriacae or pseudomonas (w/prostatitis)

128
Q

s/sx of epididymitis?

A
  • pain is generally severe and insidious

- fever and swelling are common

129
Q

tx (2) for epididymitis?

A
  1. antibiotics

2. STI screen

130
Q

what is inflammation of the testes called?

A

orchitis

131
Q

what is the causative agent of orchitis?

A

often d/t bacterial infection or mumps virus

132
Q

can spermatogenisis be affected by mumps?

A

spermatogensis is irreversible damaged in 30% of mumps cases

133
Q

if the patient has orchitis, what might they are have or be experiencing?

A

prostatitis or epididymitis

134
Q

s/sx of orchitis?

A
  1. pain and swelling

2. heaviness

135
Q

can orchitis cause permanent damage to testicles?

A

yes

136
Q

orchitis can cause permanent damage to testicles resulting in what 3 things?

A
  1. diminished size
  2. inadequate hormone production
  3. infertility
137
Q

what are 6 scrotal mass ddx?

A
  1. epididymitis
  2. hydrocele
  3. varicocele
  4. hernia
  5. orchitis
  6. cancer
138
Q

is testicular cancer highly treatable when detected and treated early?

A

YES, 95%

139
Q

what is the most common cancer in men 15-34 YO?

A

testicular cancer

140
Q

what is the common age for testicular cancer?

A

15-34 YO

141
Q

what are 5 main testicular cancer risk factors?

A
  1. cryptorchidism
  2. genetic (klinefelter’s and chromosome 12 abnormality)
  3. caucasion (4-5x)
  4. family hx
  5. HIV
142
Q

how much higher risk of testicular cancer does a male have if his crytorchidism is untreated?

A

3-17x higher risk

143
Q

what are two genetic abnormality that are risk factors for testicular cancer?

A

klinefelters and chromosome 12 abnormality

144
Q

is there an increased risk of testicular cancer with injury or vasectomy

A

no increased risk

145
Q

sx/s of testicular cancer?

A
  1. unilateral enlargement or change in the way it feels
  2. painless lump or swelling or collection of fluid (recommend monthly self-screening)
  3. dull ache in back, groin or lower abdomen
  4. gynecomastia &/or mastalgia
  5. discomfort/pain or feeling in heaviness
146
Q

can a male experience gynecomastic or mastalgia with testicular cancer?

A

yes

147
Q

might there be no symptoms with testicular cancer?

A

yes

148
Q

what is secondary testicular cancer?

A

cancer metastasizes from primary (i.e. hodgkins)

149
Q

T/F: testicular lymphoma is more common than testicular cancer in men over 50

A

T

150
Q

what are 4 cancers that can metastasize to testicles

A
  1. hodgkins
  2. prostate
  3. lung
  4. skin
151
Q

Where is stage 1 testicular cancer?

A

confined to testicles

152
Q

where is stage II testicular cancer?

A

mets to nodes

153
Q

where is stage III testicular cancer?

A

mets above diaphragm or to visceral organs

154
Q

5 yr survival rate for stage I testicular cancer?

A

98%

155
Q

5 yr survival rate for stage II testicular cancer?

A

97%

156
Q

5 yr survival rate for stage III testicular cancer?

A

72%

157
Q

what are some sx that may be noted especially during a testicular self exam?

A
  1. lump on testicle
  2. slight enlargement of one of the testes
  3. heavy sensation in testicles or groin
  4. dull ache in lower abdomen or groin
158
Q

what are 3 PE findings to dx testicular cancer?

A
  1. firm, non-tender testicular mass that does not transilluminate”
  2. fluid collection
  3. regional lymphadenopathy
159
Q

will testicular cancer transilluminate?

A

nope

160
Q

what is the first imaging step in Dxing testicular cancer?

A
  1. US
  2. CXR
  3. abd CT
161
Q

are there any blood screening tests for testicular cancer?

A

nope

162
Q

what are some blood tests to monitor the response to treatment?

A
  1. AFP: alpha-fetoprotein
  2. beta HCG
  3. LHD: lactic dehydrogenase
163
Q

what test might a MD perform in diagnosing testicular cancer if other tests are inconclusive?

A

biopsy

164
Q

what are 5 main testicular cancer tx?

A
  1. radical inguinal orchiectomy
  2. retroperitoneal lymph node dissection with metastatic dz
  3. testicular prosthesis available
  4. radiation- adjunct tx to orchiectomy
  5. chemotherapy
165
Q

what might a man do prior to testicular cancer treatment in terms of family planning?

A

sperm banking before tx

166
Q

what is the 2nd leading cause of urinary tract problems in males?

A

prostate related

167
Q

sxs of prostate related complaints?

A
  1. pain
  2. discomfort
  3. sexual problems
168
Q

define prostatitis?

A

inflammation of the prostate

169
Q

what % of all visits regarding GU concern in young to middle aged men is related to prostatitis?

A

25%

170
Q

is prostatitis contagious?

A

not contagious, not STI unless d/t NG/CT

171
Q

what are 6 main sx of prostatitis?

A
  1. tender/swollen prostate
  2. fever/chills (in acute)
  3. dysurina, nocturia, urgency, hesitancy, frequency, hematuria
  4. pelvic/abdominal pain
  5. LBP, joint/mm pain
  6. painful ejaculation
172
Q

7 risk factors for prostatitis?

A
  1. medical procedure- catheterization
  2. unprotected vaginal &/or rectal intercourse
  3. abnormal urinarytract
  4. enlarged prostate (BPH)
  5. diabetes
  6. immunocompromised
173
Q

dx?

  • sudden onset
  • chills
  • fever
  • LBP
  • body aches
  • dysuria/freq/urgency/nocturia
  • perineal pain
A

acute bacterial prostatitis

174
Q

cause of acute bacterial prostatitis?

A

overgrowth of bacteria normally found in prostatic fluid (E. coli) or STI

175
Q

tx for acute bacterial prostatitis?

A

ER referral, tx with antibiotics

176
Q

PE findings of acute bacterial prostatitis?

A

tender, swollen, indurated prostate*

  • purulent prostatic secretions if obtained
  • often accompanied by bacteriuria
177
Q

what is the pathogenesis of chronic prostatitis?

A

variable causes

  • CT
  • ureaplasma urealyticum
178
Q

what are the sx of chronic prostatitis?

A
  1. suprapubic pain
  2. LBP
  3. dysuria
  4. nocturia
  5. intermittent
  6. waxing/waning
  7. bacterial chronic- often assoc w/ recurrent UTIs
179
Q

what might longstanding prostatitis be associated with?

A

underlying prostate defect= harbors persistent bacteria (BPH, anatomical variant)

180
Q

what type of chronic prostatitis is more common?

A

non bacterial

181
Q

sx of chronic non bacterial prostatitis?

A

similar to CBP w/o fever

182
Q

what are some theories of pathogenesis of chronic non-bacterial prostatitis?

A
  1. infectious agents undetected by standard lab tests
  2. heavy lifting causing urine retention
  3. physical acitivity may irritate/inflame prostate
  4. pelvic mm spasm may lead to increased prostate pressure
  5. structural abnormalities; urethral narrowing = pressure
183
Q

how is the dx for chronic non bacterial prostatitis made?

A

made by excluding other causes

184
Q

4 diagnostic prostatitis lab procedures

A
  1. prostatic stripping and culture discharge (expressed prostatic secretion- EPS)
  2. WBCs in EPS, (assoc w/ non bacterial prostatitis, urethritis, prostatic stones, recent ejaculation)
  3. pH of prostatic fluids rises when infection is present 6.5 to > 8.0
  4. PSA levels often elevated (collect pre-DRE)
185
Q

is WBCs in expressed prostatic secretions associated with bacterial prostatitis?

A

nope

186
Q

when should PSA level be collected?

A

collect pre-DRE, repeated testing 6 weeks after resolution of prostatitis

187
Q

when performing a DRE in prostatits what are you checking for?

A
  1. size
  2. symmetry
  3. consistency
  4. lumps/nodules
  5. discomfort/pain
188
Q

what is the classic presentation (3) for DRE in prostatitis?

A
  1. sx patient
  2. enlarged, soft/boggy gland
  3. mod-severe tender on palpation
189
Q

what may you palpate during a DRE in prostatitis?

A

prostatic stones

190
Q

can prostatic stones cause recurrent infections?

A

YES

191
Q

ddx acute prostatitis with lab work?

A

WBCs and bacteria in urine/prostate fluid w/ acute onset and systemic sxs

192
Q

ddx chronic bacterial prostatitis with lab work?

A

WBCs and bacteria in urine/prostate fluid w/ insidious onset

193
Q

ddx chronic non-bacterial prostatitis with lab work?

A

may see WBC in urine or prostate fluid

- no evidence of infection

194
Q

tx of acute prostatitis?

A

Antibiotics 7-10d, repeat if symptoms do not resolve

195
Q

tx of chronic prostatitis?

A
  • Antibiotics 4-12 wks 60% will clear up
  • NSAIDs to palliate symptoms
  • Sitz baths may provide symptomatic improvement
196
Q

tx for non infectious prostatitis?

A
  • reduce inflammation: NSAIDs, natural COX2 inhibitors

- relax tissue, decrease congestion

197
Q

what % of american men have sx of prostadynia?

A

11%

198
Q

what % of men dx’d as chronic prostatitis have no evidence of bacterial infection or inflammatory cells in the prostatic fluid

A

95%

199
Q

another name for prostadynia?

A

chronic pelvic pain syndrome (CPPS)

200
Q

sx of prostadynia?

A

 Pain in pelvis or perineum, can extend to penis, testes, rectum
 May cause voiding or sexual dysfunction

201
Q

define prostadynia

A

prostatitis sx w/o inflammation or bacterial infection

202
Q

what is the cause of prostadynia?

A

Cause = unknown; pain may be due to muscle spasms or

musculoskeletal conditions, like nerve entrapment

203
Q

what might be helpful in decreasing sx and is routing rx’d for prostadynia?

A

Finesteride

204
Q

3 causes for pudendal nerve entrapment?

A
  1. impact trauma
  2. surgery
  3. congenital malformation
205
Q

sx of pudendal nerve entrapment?

A
  1. pain in penis, scrotum, or anorectal area
  2. prostatitis-like pain and voiding/sexual dysfunction are the hallmark of PNE
  3. aggravated by sitting, relieved by standing, lying
206
Q

what is the hallmark of pudendal nerve entrapment

A

prostatitis-like pain &
voiding/sexual
dysfunction

207
Q

where is the pudendal nerve predisposed to entrapment?

A

at level of ischial

spine and within pudendal canal:

208
Q

what are some mechanisms of injury for pudendal nerve (4)?

A
  1. At ischial spine, nerve can be compressed between
    sacrotuberous and sacrospinous ligaments.
  2. Nerve may be ensheathed by ligamentous expansions
    that form a perineural compartment.
  3. At pudendal canal, nerve can be compressed by falciform
    process of the sacrotuberous ligament
  4. If thickened, duplication of obturator fascia may act as an
    entrapment site
209
Q

is imaging helpful in Pudendal NE?

A

not necessarily

210
Q

what should you r/o with pudendal NE?

A

R/O causes of prostatitis (urology referral)

211
Q

what type of surgery may help with pudendal NE?

A

decompression surgery

212
Q

which ethnicity has increased incidence of BPH?

A

african americans

213
Q

is BPH precancerous?

A

nope!

214
Q

what percentage of men over 80 have BPH?

A

90%

215
Q

Etiology of BPH?

A

uknown, condition of aging

216
Q

What is the hormonal influence of BPH?

A
  1. combo of decreased testosterone and increased estrogen

2. increased sensitivity to DHT in the prostate

217
Q

Where does hyperplasia in BPH typically occur?

A

Hyperplasia nearly always occurs in transitional zone beginning around prostatic urethra & extending peripherally

218
Q

what % of males with BPH have sx?

A

20%

219
Q

what are sx of BPH? (5)

A
  1. difficulty initiating urine stream (hesitancy)
  2. interruption of steam
  3. frequency
  4. urgency
  5. nocturia
220
Q

what are the rectal exam findings of of BPH?

A

non-tender, soft, boggy

221
Q

what are the rectal exam findings of cancer?

A

rock-hard

222
Q

what are the rectal exam findings of prostatitis?

A

painful

223
Q

What are 3 complications of BPH?

A
  1. decreased QOL, ADLs
  2. increased risk of UTI and acute urinary rentention, but ER referral (d/t residual urine)
  3. complete obstructuion requires surgery
224
Q

does complete obstruction d/t prostate require surgery?

A

YES

225
Q

does BPH increase the risk of developing prostate carcinoma?

A

NOPE

226
Q

what are two Hx/PE procedures for BPH?

A
  1. DRE

2. AUA sx index questionnaire

227
Q

4 things PSA is elevated in?

A
  1. BPH
  2. prostate cancer
  3. recent ejaculation/DRE (~2 days)
  4. prostatitis
228
Q

is PSA elevated in BPH?

A

yes

229
Q

what are DRE screening for?

A

colorectal cancer and prostate cancer

230
Q

what is the normal consistency of the prostate?

A

normal= rubbery, walnut size, 4 cm, symmetrical and absent of any nodules or polyps

231
Q

what is the recommended starting age for DRE?

A

50 YO, earlier with sx or risk factors

232
Q

what should the rectal wall feel like in a DRE?

A

smooth without abnormalities or unusual lumps, swelling or tenderness

233
Q

where are PSA produced?

A

by cells of prostate capsule and periurethral gland

234
Q

what is a normal PSA level?

A

0-4.0 ng/mL

235
Q

does PSA normally increase with age?

A

YES

236
Q

when should you refer in regards to PSA and DRE?

A
  1. PSA 4-10 ng/mL w/ abnormal DRE
  2. PSA >10
    regardless of DRE
  3. palpable nodule on DRE, regardless of PSA
  4. pts w/ UTI, prostatitis or recent biopsy should have PSA test deferred to avoid a potential unnecessary biopsy
237
Q

should patients with recent UTI, prostatitis, or recent biopsy have a PSA test?

A

no, PSA test deferred to avoid a

potentially unnecessary biopsy.

238
Q

what is the typical conventional tx for BPH?

A

watchful waiting and regular follow up

239
Q

what are 2 medications used to tx BPH?

A
  1. 5-alpha-reductase inhibitors: finasteride (proscar)

2. alpha blockers

240
Q

how does 5 alpha reductase inhibitors work for BPH?

A

finasteride inhibits peripheral conversion of testosterone to DHT, block growth effect of DHT

  • clinical trials show its effective in reducing size and sx
  • assoc w/ lower risk of acute urinary retention and need for sx common with placebo 4y trial in 3040 men with mod-severe BPH sx and enlarged prostate
241
Q

do alpha blockers change prostate size?

A

no, relaxes smooth mm, do not decrease prostate size

242
Q

what are 3 surgical tx for BPH?

A
  1. TURP- transurethral resection of the prostate (core out middle part of prostate to open lumen
  2. laser/thermoablation
  3. prostatectomy
243
Q

what are 2 goals of complementary care for BPH?

A
  1. reduce hyperplasia by inhibiting conversation of T to DHT

2. prevent estrogen from binding to estrogen r/c

244
Q

what is saw palmetto used to tx

A

BPH

245
Q

according to research is saw palmetto good for tx of BPH?

A

research is mixed “may be beneficial”

246
Q

side effects of saw palmetto?

A

HA, nausea, dizziness

247
Q

how might saw palmetto tx BPH?

A

may improve urine flow and decrease sx while avoiding negative SE of conventional tx

248
Q

Will saw palmetto effect PSA?

A

nope, does not affect PSA like medications

249
Q

what are 6 supplements for tx of BPH?

A
  1. amino acids
  2. beta-sitosterol
  3. zinc picolinate
  4. pygeum
  5. nettles (urtica diocia)
  6. saw palmetto
250
Q

what % of men over age of 40 have sexual dysfunction?

A

> 50%

251
Q

what are 3 common ways male sexual dysfunction presents?

A
  1. decreased libido
  2. ejaculatory disturbances
  3. erectile dysfunction
252
Q

what is the most common presentation of sexual dysfunction?

A

erectile dysfunction

253
Q

4 physical causes of male sexual dysfunciton?

A
  1. drugs
  2. blood flow abnormalities
  3. nerve abnormalities
  4. hormonal abnormalities
254
Q

how might hormonal abnormalities contribute to male sexual dysfunction?

A

andropause

  1. tesosterone levels decline
    - about 2-3%/y b/w 40-70, SHBG increases as well
255
Q

what are 4 psychological causes of male sexual dyfunction?

A
  1. depression
  2. stress
  3. performance anxiety
  4. misinformation about sexuality
256
Q

What is ADAM?

A

androgen decline in aging men

257
Q

sx of ADAM (5)

A
  1. mood dysfunction
  2. sexual dysfunction (libido loss, erectile dysfunction)
  3. osteoporosis
  4. mm atrophy
  5. cognitive changes
258
Q

What are some lab tests to run with ADAM?

A

free and total testosterone (diurinal variation)

and LH, PRL

259
Q

5 factors that may compound testosterone?

A
  1. stres: physical and psychologica;
  2. obesity
  3. diabetes
  4. pituitary tumor
  5. drugs: cimetidine, digoxin, spironolactone
260
Q

What should you R/O for ADAM?

A
  1. hypothyroid
  2. depression
  3. anemia
  4. prolactinoma
261
Q

what is the most common type of cancer in MEN in the US?

A

prostate cancer

262
Q

what is the second leading cause of cancer death in men?

A

prostate cancer

263
Q

incidence of prostate cancer?

A

1/6 will get prostate cancer

264
Q

cause of prostate cancer?

A

cause is uknown, genetic, hormonal and environmental factors may play a role

265
Q

what can prostate cancer growth be inhibited by?

A
  1. orchiectomy or use of estrogen therapy

2. decrease/eliminate testosterone which feeds prostate cancer cell growth

266
Q

6 major risk factors for prostatic cancer?

A
  1. age > 50
  2. race or ethnicity, African american
  3. family hx, testing should begin at age 40 if so
  4. diet: high fat,, sedentary lifestyle & obesity
  5. vasectomy
  6. smoking
267
Q

annual DRE and PSA screening guideline?

A

baseline screening at 50 for those w/o risk factors

268
Q

annual DRE and PSA screening guideline for AA and men w/ 1st degree relative?

A

at 40 YO for baseline screening

UWS Q9 (3 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions