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Physical Exam Midterm & Final > GU (the fun stuff) > Flashcards

GU (the fun stuff) Flashcards

1
Q

When should you start routine rectal exams to screen for prostatic disease

A

Age 40

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2
Q

Is a rectal screening sensitive of specific

A

Very (94%) specific but not very sensitive

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3
Q

Where are the seminal vessels located

A

Just lateral to the prostate

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4
Q

What are the dimensions of a normal prostate

A

4cm wide x 3cm long x 2cm deep

Size of a walnut

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5
Q

What is the prostate made up of

A

Capsule made of CT & fascia with smooth muscle interior

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6
Q

What receptors are in the prostate

A

Alpha 2 receptors

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7
Q

How many sphincters does the prostate have? Which one is important in prostate CA

A

2 (internal and external) and the exterior one is important in prostate CA

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8
Q

What is a danger of BPH

A

Constriction of urethra backing up urine to the kidney and causing renal failure

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9
Q

Is a digital rectal exam (DRE) good at ruling prostate CA in or out?

A

Good at ruling out

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10
Q

What are the purposes of a DRE

A 
Evaluation of symptoms
Prostate CA screening
Colorectal CA screening
Evaluation of a retroverted uterus
Rectal complaints (like bleeding)
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11
Q

What is the difference between hematachezia and melena

A 
Melena = dark bloody stool, bleeding higher in GI tract
Hematachezia = bright red bloody stool, bleeding in the distal GI tract
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12
Q

What is the MC male CA

A

Prostate CA

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13
Q

Prostate CA is most common over what age

A

50 y/o

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14
Q

How is prostate CA staged

A

Gleeson score (based on histology)

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15
Q

For prostate CA screening what is the biopsy cut point in terms of PSA level

A

PSA > 4mg/dL

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16
Q

What are the ACS prostate CA screening recommendations

A

Age 50 for baseline risk
45 for high risk (1st degree relative)
40 with multiple affected relatives
DRE & PSA q 2 years if PSA < 2.5mg/dL

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17
Q

What is the importance of Finasteride in prostate CA screening

A

It reduces the PSA levels by > 50%

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18
Q

What are the findings in BPH

A

Rubbery, nontender, symmetrically enlarged prostate w/o nodules

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19
Q

Does BPH increase the risk of prostate CA

A

No, not by itself

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20
Q

What are the obstructive SxS of BPH

A

Nocturia, hesitency, dribbling, weak stream

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21
Q

What is acute prostatitis

A

Inflammation of prostate; febrile condition caused by bacterial infection

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22
Q

In acute prostatitis in pt < 35 y/o what might be the cause

A

GC/chlamydia

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23
Q

In acute prostatitis in pt > 40 y/o what might be the cause

A

GNR - Enterobacteraciae

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24
Q

What are the SxS of acute prostatitis

A

Dysuria, pelvic & rectal pain, fever

25
Q

What are the prostate findings in acute prostatitis

A

Prostate is swollen, firm, warm, & VERY TTP

26
Q

Why should you not massage the prostate in suspected prostatitis

A

Will precipitate bacteremia

27
Q

Where do internal hemorrhoids originate and what do the arise from

A

Originate above the pectinate line

Arise from the internal rectal veins

28
Q

What might internal hemorrhoids indicate

A

Liver disease

29
Q

These hemorrhoids will not be painful or bleed…internal or external

A

Internal

30
Q

Where do external hemorrhoids originate and what do they look like

A

Originate below the pectinate line

Appearance = small, blue, olive-shaped mass at anal margin

31
Q

What is the danger of an external hemorrhoid

A

It can thrombose

32
Q

What might external hemorrhoids indicate

A

Portal hypertension

33
Q

What are 2 things you always need to use for a DRE

A

Lube & gloves

34
Q

What do you need to note regarding the prostate upon DRE

A

Size, symmetry, nodularity, & median sulcus

35
Q

What position is most comfortable for the pt during a DRE

A

Pt in left lateral decubitus

AKA Simm’s position

36
Q

When should testicular screening be started

A

Recommend to your pts to start doing them monthly at age 15

37
Q

When is it best to do a testicular exam

A

After a hot shower

38
Q

When should mammogram be done

A

Ages 40-75 then based on pt

39
Q

When should clinical breast exams be done and how often

A

Start at age 20 then q 3 years till 40 then annually

40
Q

When should self breast exams be done

A

Promoted starting in pt’s 20’s and monthly 5-7 days after menses

41
Q

Dimpling of breast tissue is consistent with…

A

Underlying malignancy

42
Q

Where is most breast CA found

A

In the tail of the breast (where it goes over to the axilla)

43
Q

What HPV causes 90% of genital warts

A

HPV 6 & 11

44
Q

What HPV causes most cervical CAs

A

HPV 16 & 18

45
Q

Guardasil vaccine covers what HPV strands

A

HPV 16 & 18

46
Q

In women 40+ y/o with new IBS/GI SxS what do you have to be suspicious of and test for? Why?

A

Ovarian CA

B/c it is HIGHLY deadly

47
Q

Varicosities of the spermaticord; scrotum doesn’t elevate as much as it normally does –> poor temp control, sperm distruction, may lead to infertility; can be corrected with Sx

A

Varicocele

48
Q

Fluid accumulation around the testes

A

Hydrocele

49
Q

Infectious inflammation of epididymis, may be due to STD, pt reports pain and tenderness in the posterior of the testicle

A

Epididymitis

50
Q

Relief of pain with elevation of the testicles

A

Phren’s sign

51
Q

Development of feminine characteristics due to hormonal causes; may cause enhancement of breast tissue, production of breast secretions

A

Gynecomastia

52
Q

Cryptochidism leads to higher risk of ______ later in life

A

Testicular CA

53
Q

Strawberry cervix is associated with…

A

Trichomonas

Tx with Flagyll

54
Q

Chandelier sign (extreme TTP of the cervex) is associated with…

A

Cervicitis/PID

55
Q

Pelvic/thigh heaviness, menorrhagia

A

Fibroids

56
Q

What do you need to r/o with mastitis in a non-lactating woman or with persistent dermatitis of the nipple

A

Inflammatory breast carcinoma

57
Q

Nipple retraction, dimpling, edema (orange peel sign), unilateral bloody nippledischarge suggests…

A

Ductal breast CA

58
Q

Acanthosis nigricans

A

Internal malignancy

59
Q

Post-menopausal vaginal bleeding = ________ until proven otherwise

A

Endometrial CA

Physical Exam Midterm & Final (11 decks)

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