Made Ridiculously Simple Flashcards
Inflammation of the prostate, can be acute or chronic
*Bacterial causes include E coli, Gonorrhea and Chlamydia
- Sxs= fever, chills, dysuria, frequency, urgency, etc.
- Signs= prostate is tender and soft (“boggy”) on exam
Prostatitis
Prostate enlarges with age leading to compression of the urethra
*symptoms such as incomplete bladder emptying, poor urinary stream strength, urinary frequency, urgency
BPH
Obstruction in BPH can weaken the bladder over time, leading to retention of urine which can predispose to….
UTIs
Tx for BPH can be pharmacologic or surgical. What is the surgical procedure?
Transurethral resection of the prostate (TURP)
Screening via digital rectal exam (DRE) and serum PSA is important for men over 50 to help dx…..
Prostate cancer
Which location is common for prostate cancer mets?
Spine! often get back pain in late disease
- Orchiectomy (removing the testicles)
- Anti-androgen therapy (blocks testosterone)
- LH releasing hormone antagonists
All treatments for prostate cancer
hormonal therapy..seeks to remove hormonal, mainly testosterone, stimulation
Testicular inflammation
MC cause= mumps
*also caused by gonorrhea and chlamydia
Orchitits
Testicular pain, swelling and constitutional symptoms
- if viral, will resolve spontaneously
- if bacterial, give abx
tx testicular pain with ice, bed rest and analgesic therapy
Orchitis
Can be asymptomatic or can present as a testicular mass, infertility, pain and/or sensation of testicular fullness
*more common in young men (under 40)
Testicular cancer
Cryptorchidism (failure of testicular descent at birth) increases the risk of…..
Testicular cancer
Can be caused by trauma, exercise or predisposition secondary to undescended tests or a congenital “bell clapper” deformity
- most common in men under 30
- severe scrotal pain, swelling and erythema of scrotum, abdominal pain and/or N/V
Testicular torsion
Menstrual cycle is mediated by…. (4 things)
LH
FSH
Estrogen
Progesterone
Day 1 of the menstrual cycle corresponds to menstruation, at which time a new ovum-containing follicle beings to grow under the influence of….
FSH (follicle stimulating hormone)
..which comes from the pituitary
FSH stimulates the follicle to secrete _______, which causes the proliferation of the endometrial lining
estrogen!
Estrogen secretion from the follicle stimulates an increase in LH and FSH section from the pituitary, which leads to an LH surge around what day of the cycle?
(*this is a positive feedback loop!)
day 14
the LH surge on day 14 causes the ovum to be released..ovulation!!
LH surges on day 14, which causes the ovum to be released (ovulation) and the follicle to become the….
corpus luteum
What does the corpus luteum secrete?
Estrogen and progesterone, which stimulate development of secretory glands in the endometrium
Corpus luteum secretes estrogen and progesterone which stimulate development of ______ glands in the endometrium
secretory
If the ovum is not fertilized, the continued estrogen and progesterone secretion will inhibit….
FSH and LH
**the fall in FSH and LH will lead to the degeneration of the corpus luteum
Estrogen can function both to increase LH/FSH secretion (leading to ovulation) and to inhibit it, at the end of the _____ phase
luteal
Combination OCPs serve to suppress….
LH/FSH, which prevent ovulation
The hypothalamus stimulates the pituitary gland via…
GnRH
The pituitary gland releases which 2 things, which stimulate the uterus
FSH/LH
If a woman has primary amenorrhea and her FSH levels are HIGH..this suggests what may be the cause?
Ovarian failure!
*if the ovaries fail, the level of estrogen they secrete decreases, reducing the negative feedback on FSH secretion from the pituitary
Discharge= yellow, frothy
Wet mount= protozoans
KOH/whiff test= negative (no rxn)
Trichomonas
*tx= Metronidazole (oral)
Discharge=white, thick, “curds”
Wet mount= branching yeast
KOH/whiff test= negative (no rxn)
Candida
Discharge= gray, thin
Wet mount= clue cells (cells with many small bacteria attached to the surface)
KOH/whiff= gives fishy odor
Gardnerella
bacterial vaginosis
Inflammation of the cervix caused by trauma, radiation, malignancy or infection (chlamydia, gonorrhea, HSV, HPV)
- generally coexists with vaginitis
Cervicitis
Acute abdominal pain, sometimes N/V
- abdominal exam reveals tenderness and can also show signs of peritonitis (rebound, guarding)
- vaginal exam: purulent cervical discharge and cervical motion tenderness
PID
Fitz-Hugh-Curtis syndrome (inflammation/fibrosis surrounding the liver from intra-abdominal spread)
complication of PID
Occurs when a sperm fertilizes an “empty” ovum (i.e. an ovum with no maternal chromosomes in it)
*this empty ovum can be fertilized by one sperm, which then duplicates and forms a…
COMPLETE MOLE
this is a type of Gestational trophoblastic disease (GTD)
An ovum with one set of maternal chromosomes can be fertilized by 2 sperm causing the formation of a…
partial mole
this is a type of Gestational trophoblastic disease (GTD)
Can present as pregnancy: enlarged uterus, N/V, positive pregnancy test
- early bleeding, uterus may be too big/too small for presumed stage of pregnancy
- patients may notice vesicle like material in vaginal bleeding
Gestational trophoblastic disease (GTD)
Diagnosis is confirmed by extreme elevation of beta-hCG and a “snow storm” appearance on ultrasound
Molar pregnancy (GTD)
What does it mean if you remove a mole but beta-hCG does not decrease?
Either an incomplete removal of the mole or possible malignant transformation (choriocarcinoma)
If a mole becomes malignant (choriocarcinoma), what is the tx?
Chemo! (usually involving methotrexate)
larger tumor-like growths seen in endometriosis (aka chocolate cysts) because of the appearance of the thick, dark liquid they contain
Endometriomas
How do you confirm a endometriosis dx?
Laparoscopic exam with biopsy
OCPs
Danzol (inhibitor or FH/LSH)
GnRH agonist
Can be used in tx of endometriosis
Bleeding, pain, urinary symptoms, infertility, palpable mass
Diagnosis made with scan and biopsy
Uterine fibroids
Post menopausal bleeding
(usually adenocarcinoma, MC)
Diagnosis made with sampling/bx
Endometrial cancer
Asymptomatic or abdominal/pelvic/bloating/pain
Torsion possible
Acute mass, may be palpable
Dx made with ultrasound/laparoscopy
Ovarian cyst
Often asymptomatic leading to diagnosis at advanced stage and poor prognosis
*when symptoms are present:
vague abdominal/pelvic bloating/pain
Dx with CA-125, LDH, aFP, b-hCG can be elevated
*ultrasound, CT scan
Ovarian cancer
Cyclic diffuse breast pain (usually right before period)
Lumpiness of breasts on exam
Fibrocystic changes
Mass: firm, well circumscribed
Painless, moveable
very common in younger women
Fibroadenoma
