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Men's Health Module > Hernias and Male GU Dermatology > Flashcards

Hernias and Male GU Dermatology Flashcards

1
Q

What is a groin hernia? What are 2 types?

A

a protrusion of abdominal-cavity contents through the inguinal canal

inguinal or femoral

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2
Q

What body landmark divides inguinal and femoral hernia?

A

inguinal ligament

inguinal above
femoral below

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3
Q

Location of ventral hernia

A

above umbilicus

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4
Q

Which type of groin hernia is more rare? Which is more common in men?

A

femoral (rare, more in women)

inguinal (common, more in men)

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5
Q

Ages that are most affected by groin hernias

A

< 1 yo and > 50 yo

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6
Q

Most common abdominal wall hernias

A

inguinal

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7
Q

Risk factors for groin hernias

A 
Older age 
Male 
Caucasian 
Smoking 
Chronic cough
Chronic constipation
Abd wall injury
H/O Cryptorchidism
H/O or FHX hernia
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8
Q

Location of indirect vs direct inguinal hernias

A

indirect: through natural weakness of deep inguinal ring; LATERAL to inferior epigastric artery
direct: directly through abdominal wall - posterior/floor of inguinal canal; MEDIAL to inferior epigastric artery

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9
Q

congenital and acquired etiologies of groin hernias

A

due to failure of the processus vaginalis to obliterate and internal ring to close

due to a weakening or disruption of the fibromuscular tissues of the abdominal wall

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10
Q

Risks with cryptorchidism

A

groin hernias, testicular torsion, sterility

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11
Q

Hesselbach’s triangle

A

inferior epigastric artery, inguinal ligament, rectus abdominis muscle

contains inguinal canal

where direct inguinal hernias protrude

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12
Q

Most common: indirect or direct?

A

indirect

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13
Q

Which type of inguinal hernia is found more in children?

A

indirect

*direct more in adults

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14
Q

Which groin hernias are congenital?

A

indirect and direct inguinal hernias

*femoral is acquired

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15
Q

How is hernia best seen on exam?

A

patient standing and Valsalva maneuver

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16
Q

Differences of indirect and direct inguinal hernia on PE

A

bulge shape: direct more rounded; indirect more oval

location: direct medial; indirect lateral
palpation: indirect more pointy

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17
Q

Complications of inguinal hernia if painful on palpation

A

incarceration - trapping of hernia contents (localized pain)

strangulation - ischemia, decreased blood flow, and necrosis of hernia contents (erythema, greater pain)

bowel obstruction - blocked passage of stool/gas through hernia (N/V and diffuse abd pain)

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18
Q

Findings on palpation of uncomplicated hernia

A
  • usually non-tender

- may not be visible externally

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19
Q

When should you get U/S for hernia?

A

occult (hidden) hernia

differentiating inguinal from femoral

20
Q

When should you get CT for hernia?

A

complicated

differentiating hernia from other causes of pain

21
Q

incarcerated vs unincarcerated hernia

A

incarcerated is painful and unincarcerated is not

22
Q

4-6 hrs of strangulation. next step?

A

refer

23
Q

Treatment of uncomplicated hernias with minimal symptoms

A

watchful waiting

24
Q

When is elective repair an option for patient with hernia?

A

uncomplicated hernias with significant symptoms or femoral hernia

25
Q

Treatment for acutely incarcerated hernias who do not have sx of strangulation

A

Manual reduction

26
Q

Treatment for unreducible incarcerated hernias and/or strangulated hernias

A

Emergent repair

27
Q

Benign dome-shaped subcutaneous papules on scrotum

A

Follicular or sebaceous cysts

28
Q

Follicular or sebaceous cysts treatment

A

Reassurance
Surgical removal
if unsightly, painful, infected

29
Q

Man comes in thinking he has STI because small dome-shaped flesh-colored papules on coronal margin or sulcus of glans penis

A

Pearly penile papules

30
Q

Pearly penile papules treatment

A

Reassurance

Laser ablation for cosmetic reasons if desired

31
Q

Well-demarcated scaly erythematous plaques

Frequently accompanied by perianal & intergluteal cleft plaques

A

psoriasis

32
Q

Psoriasis treatment

A

Hydrocortisone during symptomatic periods
Calcipotriene (vit D3 analog) cream for prevention
Recurrences are normal

33
Q

black, blue, or dark red, dome-shaped papules ranging from 1-6 mm in diameter on the scrotum
May bleed if scratched
May be present elsewhere on the body

A

Angiokeratomas of Fordyce

34
Q

Angiokeratomas of Fordyce treatment

A

Reassurance (benign)

Laser ablation, electrocautery, or cryotherapy for cosmetic reason if desired

35
Q

When do Angiokeratomas of Fordyce usually occur?

A

after puberty

36
Q

Violet, flat-topped lesions usually seen on glans & shaft

May develop pruritic or painful erosive lesions

A

Lichen planus

37
Q

Lichen planus

A

Reassurance – usually resolves spontaneously after several years (possibly decades)

Papular Lesions - tx with topical corticosteroids

Erosive Lesions - tx with intralesional steroid injection

38
Q

Progression of Lichen sclerosis symptoms

A

Early: Atrophic Pruritic white plaques/papules
Progressing: dysuria, painful erection
Later: phymosis, meatal stenosis

39
Q

How is Lichen sclerosis dx’d?

A

biopsy

40
Q

Lichen sclerosis also called ________.

A

Balanitis xerotica obliterans (BXO)

41
Q

Treatment of Lichen sclerosis

A

Early stages = High potency topical
Later stages = High potency intralesional corticosteroids
Long term use may cause epidermal atrophy
Circumcision may be necessary if foreskin affected

42
Q

Uncircumsized boy under 5 yo with small red erosions and swelling of glans and foreskin. Started to have discharge.

A

balanitis

43
Q

Balanitis treatment

A

Antibiotics, Antifungal, or Steroid depending on suspected underlying cause

44
Q

Collection of thick whitish discharge under the foreskin

A

smegma

45
Q

Smegma treatment

A

Retract foreskin and clean regularly

Men's Health Module (10 decks)

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