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History and Physical Exam Final > Male Exam > Flashcards

Male Exam Flashcards

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1
Q

What are some Genitourinary questions?

A

Urinary frequency?

How often & what amount?

Do you have to wake at night to urinate? (Nocturia)

Any urinary incontinence?
With sneezing, when you have the urge to go?

Any pain with urination? (Dysuria)

Any blood in the urine? (Hematuria)

Any history of urinary tract infections?

Any history of kidney stones? (Renal calculi)

Any history of sexually transmitted infections?

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2
Q

What are some male Genitourinary questions?

A

Any testicular swelling?

Any testicular pain?

Any penile discharge?

Are you having any sexual difficulties? (Erectile dysfunction)

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3
Q

During an Inguinal Palpation, what should you check for?

A
  • Groin lymph nodes
  • Hard or immobile nodes in the inguinal ligament (suggest cancer)
  • Pubic hair (lice or scabies)
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4
Q

During a penile exam, what should you check for?

A
  • Palpate both sides of the penis & inspect the urethral meatus (checking for erythema or discharge)
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5
Q

During a scrotal exam, what should you check for?

A
  • Inspect scrotal skin for moles, rash, etc.
  • Move scrotum to side and lift to check perineal area
  • Palpate testes, epididymis, & spermatic cord (vas deferens)
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6
Q

What should you consider during a testicular exam?

A
  • highest incidence of testicular cancer in 15-35 year old age group
  • consistency of testicle should be like a “hard-boiled egg”
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7
Q

How do you perform a hernia exam?

A

Move s..l..o..w..l..y

Invaginate some scrotal skin when inserting index or little finger into inguinal ring

Use “cross-handed” method:

Right hand for patients right side & vice versa

Insert index finger into inguinal canal

Use little finger for child or smaller adult

Ask patient to, “turn your head and cough” or Valsalva

Feel for sudden pressure at side or tip of finger

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8
Q

When palpating the prostate, what should you check for?

A

Size: about size of a walnut

Shape: “almond” (with 2 lobes)

Consistency: firm, like tip of nose or thenar area of palm

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9
Q

Genital Herpes

A

Caused by Herpes Simplex virus
- Usually HSV 2

Begins with painful vesicles that become ulcerated

Often recurrent

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10
Q

Molluscum contagiosum

A

Umbilicated vesicular-like lesions
- Contagious, usually painless

Benign viral condition; self-limited (6-12 mos.)

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11
Q

Primary Syphilitic Chancre

A

A small red macule enlarges and develops through a papular stage

Typical round, painless ulcer.

If untreated, the ulcer usually heals after 4-8 weeks

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12
Q

Urethritis

A

Test for both!

Gonococcal - caused by Neisseria gonorrheoeae (purulent urethral discharge)

Non-gonococcal - Chlamydia tracho-matis is most common (micropurulent discharge)

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13
Q

Peyronie’s Disease

A

Idiopathic condition resulting in fibrosis in the corpora cavernosa

Palpable, nontender plaques just beneath skin, usu. along the dorsum of the shaft of the penis

May result in penile curvature, painful erections; occasionally erectile dysfunction

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14
Q

Carcinoma of Penis

A

Begins as a firm nodule or ulcer that does not heal

Usually nontender

More common in uncircum-sized males

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15
Q

Indirect Inguinal Hernia

A

Most common type in all ages, both sexes

Above inguinal ligament, near the internal inguinal ring

Often extends into scrotum

Palpable as impulse down inguinal canal

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16
Q

Direct Inguinal Hernia

A

Less common

Usually in men over age 40

Above the inguinal ligament

Rarely into the scrotum

Bulges anteriorly

17
Q

Femoral Hernia

A

Least common

More common in women

Below the inguinal ligament

More lateral than an inguinal hernia

May mimic lymph node

Never into scrotum

18
Q

Varicocele

A

Varicose veins of scrotal vessels

Usually on the left

Feels like a soft “bag of worms”

May slowly collapse if scrotum elevated while patient supine

May be assoc. with infertility

19
Q

Hydrocele

A

Benign, nontender, fluid-filled mass within the tunica vaginalis

Transilluminates - red glow

20
Q

Spermatocele

A

Painless, mobile mass just above the testis

Usu. smaller than a hydrocele

Contains sperm

May transilluminate

21
Q

Acute Epididymitis

A

Infection of the epididymis

Local pain & swelling

Primarily in adults

Often assoc. with UTI or prostate infection

22
Q

Acute Orchitis

A

Inflammation or infection of the testis

Testicular swelling & tenderness

Similar in appearance to epididymitis

Complication of mumps & other viral infections

23
Q

Testicular Torsion

A

Due to twisting of the spermatic cord

Intense pain

Red, swollen, tender scrotum

Testis may be pulled upwards

Surgical emergency!

24
Q

Testicular Tumors

A

Firm, painless testicular nodule

Does not transillum-inate

25
Q

Difference between Internal and External Hemorrhoids

A

Internal hemorrhoid prolapse – protrudes from anus

External hemorrhoid thrombosis – develops blood clot, painful

26
Q

Anal Fissure

A

Anal fissure is a tear in the inside lining of the wall of the anus

May be caused by the passage of very hard stools

Symptoms – severe pain as stool passes

Also, itching, burning, bleeding & wet discharge

Diagnosed by history & anoscopy

27
Q

Perianal Condylomata

A

HPV – human papillomavirus infection

Usually sexually transmitted

28
Q

Prostatitis - Acute & Chronic

A

Enlarged, tender prostate gland

Much more tender during acute infection, often with fever & chills

Examine carefully

Avoid spread of infection

Treat with antibiotics

29
Q

Benign Prostatic Hypertrophy (hyperplasia)

A

BPH more common with increasing age

Symmetrical enlargement of gland

Slowing of urine stream with difficulty starting stream

30
Q

Carcinoma of Prostate

A

Enlarged, firm nodule or area of hardness

Irregular contour, median sulcus obscured

Usually a slow-growing tumor

Metastasizes locally and to bone

History and Physical Exam Final (3 decks)

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