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Men's Health Issues > Gyn Concerns/Issues in Men's Health > Flashcards

Gyn Concerns/Issues in Men's Health Flashcards

1
Q

What is the leading cause of secondary amenorrhea?

A

pregnancy

secondary: absence of menarche after the establishment of normal menstrual cycling

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2
Q

What is primary amenorrhea?

A

Absence of menarche by age 16

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3
Q

Considering the Bethesda Classification, when would you refer a woman based on their cervical intraepithelial neoplasia finidngs?

A

CIN 2 (moderate dysplasia), CIN3 (severe dysplasia), or CIS (carcinoma in situ).

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4
Q

What is the third most common GYN cancer?

A

Cervical

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5
Q

Which is the most common GYN cancer killer?

A

Ovarian

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6
Q

Which is the most common cancer in women?

A

Lung

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7
Q

Which cancer has the highest incidence in women?

A

Breast

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8
Q

Which is the second most common cancer among both men and women?

A

Colorectal

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9
Q

What is the second leading cause of cancer in men?

A

Prostate

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10
Q

All of the following you would expect to find in a woman with PID except:

a. afebrile
b. positive CMT
c. abdominal tenderness
d. adnexa tenderness

A

a. afebrile.

You would expect to find a temp >38 along with N/V, dyspareunia, dysuria, vaginal discharge, and possibly infertility.

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11
Q

What diagnostics would you run on a woman with a woman presenting with signs/symptoms of PID?

A

STD testing. ESR or CRP. US to look for ovarian cysts.

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12
Q

How do you treat PID?

A

Ofloxacin x 14 days or Levofloxacin x 14 days w/wo Flagyl x 14 days.
OR
ceftriaxone IM + Doxycycline x 14 days w/wo Flagyl OR cefoxitin IM + Probenecid + Doxy w/wo Flagyl

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13
Q

Your patient comes in c/o breast tenderness, feeling bloated, HA, irritable, anxiety, and weird food cravings. She says she is supposed to start her period in 5 days. You diagnose her with Premenstrual Syndrome/Premenstrual Dysphoric Disorder (PDD). What do you advise?

A

Stop drinking caffeine as it can increase irritability, anxiety, tension, and depression.

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14
Q

What are key characteristics that differentiate fibrocystic breast disease and breast cancer?

A

tender, mobile cysts/masses palpable, may be round or nodular soft or firm vs nontender with poorly defined borders, fixed, and firm. May have dimpling, nipple retractions, bloody discharge, and lymphadenopathy.

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15
Q

What is the primary chief complaint in menopause?

A

hot flashes

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16
Q

If a menopausal women asks for hormone replacement and she is s/p hysterectomy, what will you NOT give her?

A

Progesterone.

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17
Q

In addition to HRT in menopausal women, what else would you prescribe?

A

Calcium and exercise

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18
Q

When starting a woman on HRT, what are your considerations?

A

History of breast cancer, myocardial infarction/CAD, and uterine cancer

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19
Q

In a younger woman, what presentation would alert you to screen for osteoporosis?

A

eating disorders/excessive exercise–> amenorrhea–> lack of estrogen resulting in bone loss

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20
Q

What does a DEXA scan score of -2.1 indicate?

A

Osteopenia/ Low bone mass

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21
Q

What does a DEXA scan score of - 2.8 indicate?

A

Osteoporosis

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22
Q

What are the dietary recommendations for calcium and Vitamin D in women ages 50-64?

A 
1500mg Calcium (if not taking HRT) vs 1000mg if on HRT
800-1000 iU/day of Vitamin D
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23
Q

What is the black box warning associated with biphosphanates (“dronate meds”)?

A

can cause osteonecrosis of the jaw, esp in women with cancer

24
Q

How do you instruct a women to take her bisphosphonate?

A

With a full glass of water. Remain NPO for 30mins-1hour. Sit upright for 30mins-1hr after taking.

25
Q

What is the population typically affected by SLE?

A

women of childbearing age

26
Q

How does SLE manifest itself?

A

Flu-like symptoms plus butterfly rash on face, alopecia, photosensitivity, weight loss, anorexia.

27
Q

If you are suspicious of SLE, what is the workup?

A

antinuclear antibodies (ANA), antiphospholipid antibodies, CBC revealing anemia, leukopenia, and thrombocytopenia.

28
Q

If you suspect SLE, before treating with NSAIDs, hydroxychloroquine or glucocorticoids, what would you do?

A

Look at meds patient is taking as several drugs can mimic SLE symptoms such as atenolol, gemfribrozil, simvastatin, oral contraceptives, amiodarone, diltiazem

29
Q

What is the most likely organism to cause UTI in women and men?

A

Women: E. Coli
Men: Proteus

30
Q

What are the three outpatient antibiotics safe to use for the treatment of UTI in pregnancy?

A

Amoxicillin, Nitrofurantoin, and cephalexin x 7-10 days

31
Q

What are the top for reasons why geriatric patients may have a change in their LOC?

A

UTI. TIA. Drugs/Polypharmacy. Pneumonia.

32
Q

What would you expect to find a patient with a UTI?

A

A UA with >10 WBCs/mL and nitrates.

33
Q

How would you treat an uncomplicated UTI?

A

Bactrim or Cipro for 3 days

34
Q

Which of the following would be indicate of an upper UTI vs a lower UTI?

a. urinary frequency
b. nocturia
c. dysuria
d. fever and chills

A

d. fever and chills

35
Q

What is the treatment for pyelonephritis?

A

Bactrim or Cipro x 14 days vs 6 weeks (depending on severity)

36
Q

What are the two types of urinary incontinence? Differentiate between the two.

A

Stress and Urge.
Stress: immediate urine leakage from activities that put increased pressure on bladder. “squeeze before you sneeze.”
Urge: detrusor muscle overactivity= “overactive bladder.” S/Sx urgency, nocturia, frequency, involuntary urinary loss. “freeze and squeeze.”

37
Q

What is the management for urge incontinence?

A

Kegel exercises, distraction, muscarinic receptor antagonists such as oxybutinin (ditropan) or tolterodine (detrol).

38
Q

What is the management for stress incontinence?

A

Bladder training- timed voids to prevent full bladder, pessary, and surgery.

39
Q

At what Tanner stage do the scrotum and tested enlarge?

A

Stage 2

40
Q

In what Tanner stage does the scrotal rugae appear?

A

Stage 4

41
Q

In what stage does masterbation happen?

A

Stage 3 along with elongation of the penis.

42
Q

What would you expect to see in a male with epididymitis?

A

Scrotal edema and positive Prehn’s sign (when you elevate the scrotum there is a relief from pain).

43
Q

What would you expect to find in a male with acute bacterial prostatitis?

A

UTI-like symptoms and a tender/boggy prostate that is painful with palpation.

44
Q

How does your management of epididymitis differ in a male who is 35 yrs.

A

Ceftriaxone IM + Doxycycline OR 1 gm Azithromycin for males 35: Bactrim or Cipro x 10 days

45
Q

What is the management of acute bacterial prostatitis?

A

Bactrim, Levo/Norfloxacin/Ofloxacin… like UTI

+ Sitz bath TID and no sex until acute phase resolves.

46
Q

What would you expect the prostate to feel like in BPH? What about prostate cancer?

A

Smooth and rubbery in BPH. Hard with obscure borders and possibly with nodules in prostate CA.

47
Q

Although you might suspect BPH, what is the first diagnostic test you perform?

A

A UA to rule out UTI

48
Q

At what level is a PSA considered to be abnormal?

A

> 4ng/ml

49
Q

How do you manage BPH?

A

Alpha-blockers: terasozin, tamsulosin- relax muscles of the bladder and prostate.
5-alpha-reductase inhibitors (finasteride and dutasteride) are second line therapy- used to shrink the prostate.
Saw palmetto may be effective in some males.

50
Q

What are some medications implicated in erectile dysfunction?

A

diuretics, antihypertensives, H2 blockers, NSAIDs, antihistamines, Parkinson’s disease meds.

51
Q

When using phosphodiasterase inhibitors (sildenafil, vardenafil, tadalafil) what medication should you ensure your patient is not taking?

A

Nitrates (isosorbide) due the risk for syncope.

52
Q

Which phosphodiasterase inhibitor works within 15 minutes, lasts up to 36 hours, and can be taken with or without food?

A

Tadalafil (Cialis)

53
Q

Besides medications, what are other causes of erectile dysfunction?

A

Stress, atherosclerosis, diabetes, druges (alcohol, cocaine, opiates, weed).

54
Q

What are normal creatinine clearance values?

A

Males

55
Q

What would be some atypical findings in a gero patient with a UTI?

A

incontinence, confusion, lethargy, decreased appetite, dehydration.

Men's Health Issues (2 decks)

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