GU (the fun stuff) Flashcards by Eric Rozman

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

Age 40

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Is a rectal screening sensitive of specific

Very (94%) specific but not very sensitive

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Where are the seminal vessels located

Just lateral to the prostate

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What are the dimensions of a normal prostate

4cm wide x 3cm long x 2cm deep

Size of a walnut

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What is the prostate made up of

Capsule made of CT & fascia with smooth muscle interior

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What receptors are in the prostate

Alpha 2 receptors

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

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

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What is a danger of BPH

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

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

Good at ruling out

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What are the purposes of a DRE

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

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What is the difference between hematachezia and melena

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

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What is the MC male CA

Prostate CA

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Prostate CA is most common over what age

50 y/o

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How is prostate CA staged

Gleeson score (based on histology)

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

PSA > 4mg/dL

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What are the ACS prostate CA screening recommendations

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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What is the importance of Finasteride in prostate CA screening

It reduces the PSA levels by > 50%

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What are the findings in BPH

Rubbery, nontender, symmetrically enlarged prostate w/o nodules

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Does BPH increase the risk of prostate CA

No, not by itself

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What are the obstructive SxS of BPH

Nocturia, hesitency, dribbling, weak stream

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What is acute prostatitis

Inflammation of prostate; febrile condition caused by bacterial infection

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

GC/chlamydia

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

GNR - Enterobacteraciae

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What are the SxS of acute prostatitis

Dysuria, pelvic & rectal pain, fever

What are the prostate findings in acute prostatitis

Prostate is swollen, firm, warm, & VERY TTP

Why should you not massage the prostate in suspected prostatitis

Will precipitate bacteremia

Where do internal hemorrhoids originate and what do the arise from

Originate above the pectinate line | Arise from the internal rectal veins

What might internal hemorrhoids indicate

Liver disease

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

Internal

Where do external hemorrhoids originate and what do they look like

Originate below the pectinate line | Appearance = small, blue, olive-shaped mass at anal margin

What is the danger of an external hemorrhoid

It can thrombose

What might external hemorrhoids indicate

Portal hypertension

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

Lube & gloves

What do you need to note regarding the prostate upon DRE

Size, symmetry, nodularity, & median sulcus

What position is most comfortable for the pt during a DRE

Pt in left lateral decubitus | AKA Simm's position

When should testicular screening be started

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

When is it best to do a testicular exam

After a hot shower

When should mammogram be done

Ages 40-75 then based on pt

When should clinical breast exams be done and how often

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

When should self breast exams be done

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

Dimpling of breast tissue is consistent with...

Underlying malignancy

Where is most breast CA found

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

What HPV causes 90% of genital warts

HPV 6 & 11

What HPV causes most cervical CAs

HPV 16 & 18

Guardasil vaccine covers what HPV strands

HPV 16 & 18

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

Ovarian CA | B/c it is HIGHLY deadly

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

Varicocele

Fluid accumulation around the testes

Hydrocele

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

Epididymitis

Relief of pain with elevation of the testicles

Phren’s sign

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

Gynecomastia

Cryptochidism leads to higher risk of ______ later in life

Testicular CA

Strawberry cervix is associated with...

Trichomonas | Tx with Flagyll

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

Cervicitis/PID

Pelvic/thigh heaviness, menorrhagia

Fibroids

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

Inflammatory breast carcinoma

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

Ductal breast CA

Acanthosis nigricans

Internal malignancy

Post-menopausal vaginal bleeding = ________ until proven otherwise

Endometrial CA