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Yr 2.0 Sem 4 > Integrative > Flashcards

Integrative Flashcards

1
Q

5 List 3 markers of testicular tumours

A

aFP
hCG
LDH

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2
Q

5 What 2 types of drugs would you use to manage male lower urinary tract symptoms ?

A 
Alpha blockers (rapid relief)
5α-Reductase Inhibitors (slower symptom relief but slows progressio reduces risk of retention)
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3
Q

5 What examination/s would you do for a male patient with LUTS (lower urinary tract symptoms)?

A

Examine penis

DRE

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4
Q

5 What is the incidence of phimosis?

A

1% in adult non-circumcised population

More so in childhood & adolescence (physiological)

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5
Q

5 List 8 sequelae of phimosis

A 
Hygiene issues incl inc risk STIs
Pain on intercourse, splitting / bleeding 
Balanitis 
Posthitis (inflamed foreskin / prepuce)
Balanitis Xerotica Obliterans
Paraphimosis
Urinary retention
Penile cancer
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6
Q

5 What are the 3 commonest causes of paraphimosis?

A

Phimosis
Catheterisation
Penile cancer

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7
Q

5 What are the 2 main risk factors for squamous cell carcinoma of the penis?

A

Phimosis (due to poor hygiene and smegma build up)

HPV 16 and 18

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8
Q

5 Besides religious choice what are the main indications for pediatric circumcision ?

A

Recurrent balanitis and UTIs

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9
Q

5 List 5 key indications for circumcision in adults

A 
– Recurrent balanitis
– Phimosis
– Recurrent paraphimosis
– Balanitis xerotica obliterans
– Penile Cancer
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10
Q

5 What cause should you always consider in acute scrotal pain?

A

Testicular torsion

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11
Q

5 What is the typical history in testicular torsion?

A

Young man, under 30

Sudden onset of unilateral scrotal pain with nausea but no associated lower urinary tract symptoms.

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12
Q

5 How would you manage a patient with suspected testicular torsion?

A

Examination and refer to urology for emergency scrotal exploration

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13
Q

5 What findings on examination would help confirm a diagnosis of testicular torsion?

A

Very tender testis, lying high in scrotum with horizontal lie

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14
Q

5 What’s the most common cause of epididymo-orchitis in middle aged men?

A

UTI (esp E.coli)

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15
Q

5 Why is it important to examine the skin of the whole scrotal and perineal area in cases of epididymo-orchitis?

A

In case of Fournier’s Gangrene - necrotic area of scrotal skin.
Although rare has a high mortality rate

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16
Q

5 Why is it more worrying if a palpable scrotal lump is within the body of the testis?

A

May be a testicular tumour

17
Q

5 What is the differential diagnosis for a painful and tender scrotal lump?

A

Epididymitis
Epididymo-orchitis
Strangulated inguino-scrotal hernia (this is an emergency)

18
Q

5 In what age range are germ cell testicular tumours most common?

A

<45 year olds (in older men tumour may be lymphoma)

19
Q

5 How does a hydrocele form?

A

imbalance of fluid production and

resorption between tunica albuginea and tunica vaginalis

20
Q

5 What would be the typical history of a varicocele?

A

History of dull ache in scrotal area in evenings. On examination L sided non-tender scrotal swelling with “bag of worms” texture above testis.

21
Q

5 What is the treatment for a testicular tumour?

A

Inguinal orchidectomy

22
Q

5 When would a radiological embolisation be indicated for a varicocele?

A

If pt symptomatic, infertile, or if adolescent and growth of testis affected
(otherwise reassurance)

23
Q

5 What range of residual volume of urine would suggest that a case of urinary retention has an acute cause?

A

<1000ml

acute on chronic >1000ml

24
Q

5 What are the 2 main treatments for acute-on-chronic urinary retention

A

Long term catheter
Surgery
(NB trial w/o catheter usually unsuccessful and no point if associated kidney damage)

25
Q

5 What is the main cause of nocturnal enuresis in older men?

A

Chronic retention w/ overflow incontinence

26
Q

5 What are the main type of receptors that mediate sympathetic smooth muscle tone of the bladder?

A

Alpha 1 adrenoreceptors

27
Q

5 What are the 3 main lifestyle interventions for managment of BPH?

A
  • Reduce caffeine intake
  • Avoid fizzy drinks
  • Avoid drinking more than 2.5L day
28
Q

5 How do 5α-Reductase Inhibitors work?

A

Shrink prostate by depriving it of androgens

29
Q

5 What is the standard surgical treatment for BPH?

A

Transurethral resection of prostate (TURP)

30
Q

5 If there is a scrotal lump in the body of the testis, what cause is it vital to investigate for?

A

Testicular cancer

31
Q

5 What are the 6 main physical causes of erectile dysfunction?

A 
Diabetes
Atherosclerosis incl smoking
Regular heavy drinking
Side effects of prescribed drugs (esp those for high blood pressure, heart disease, depression, peptic ulcers and cancer)
Prostate gland surgery
Spinal cord injury

Yr 2.0 Sem 4 (4 decks)

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