Male Exam Flashcards
What is classic presentation of a testicular torsion?
Young male with acute onset of unilateral scrotal pain.
What does PE show for testicular torsion and what is usually not present?
Scrotal edema and redness. Testicle is firm, tender and usually retracted. Abdominal pain.
Cremaster reflex is absent
What is the treatment for testicular torsion and what 2 things usually diagnose it?
Bilateral orchiplexy (if done within 6 hours blood flow can be restored and usually can save the testicle).
What is balanitis?
Inflammation of the penis head under the foreskin
3 presenting signs of epididymitis?
Gradual onset of posterior scrotal pain with fever
Urethral discharge
Urinary symptoms
3 presenting signs of acute orchitis?
Sudden onset of testicular pain and high fever
N
V
Scrotal abscesses can involve what 3 things?
Exam typically shows what 3 things and rarely is associated with what?
Epi, testicle, or urethra.
Edema, induration and redness.
NV
What is the most common cause of epididymitis in boys less than 14? What is the most common cause of epi in sexually active males 14-35? What is the treatment of choice for epi in this group of patients?
Reflux of urine into the ejaculatory ducts
Gonorrhea and chlamydia
Single IM dose of ceftriaxone with 10 days of oral doxycycline
What pathogen is also likely to cause epi in gay men and what is the treatment of choice for them?
E. coli
Ceftriaxone with 10 days of oral Levofloxacin or ofloxacin
3 presenting signs of urethritis and what two pathogens most commonly cause it? What is the most common of all STIs?
Urethral discharge, penile itching and burning when peeing
Chlamydia and gonorrhea
HPV
When a male presents with urethral symptoms, what should be examined? What is advised to be examined? What is considered?
Inguinal LAD, ulcers and urethral discharge
Check for epididymitis or orchitis
Digital rectal examination of the prostate
How do we diagnose urethritis, what 3 things?
Presence of urethral discharge, positive leukocyte esterase test in the first void, or at least two white blood cells per high power field in urine.
Check for 2 pathogens with this.
What is the level B screening recommendation for sexually active teens and adults?
Intensive behavioral counseling who are at increased risk for STI
What are the two level A screening recommendations for syphilis?
Persons at increased risk
All pregnant women
What is the level B recommendation for Gonorrhea/chlamydia screening?
Screen sexually active women 24 years and younger and old women at risk
Explain what Fournier gangrene is and what causes it? What is it secondary to sometimes or associated with?
Necrotizing fasciitis of the perineum and genital region due to synergistic poly microbial infection.
Epididymitis
2 common presenting signs of prostatitis and and what 3 others can also be present?
Acute onset of irritation or obstructive voiding symptoms
Painful ejaculation, hematospermia, and painful defecation
4 symptoms of cystitis?
Voiding symptoms, cloudy and strong smelling urine, hematuria, pelvic pain/pressure
Top 3 causes of genital ulcers in the US?
HSV 1 and 2, syphilis, and chancroid
Ulcer presentation to remember for the following conditions?
HSV, Syphilis, Chancroid, LGV?
Multiple vesicular lesions and rupture and become painful, shallow
Single, painless well demarcated
Nonindurated painful
Small, shallow, painless genital or rectal papule or ulcer.
What to remember about LGV?
Rare and men who have sex with men get it
What is the level A screening recommendation for HIV?
Screen for HIV in teens and adults 15-65
What type or organism is gonorrhea? Chlamydia? Syphilis?
Gram negative diplococci
Gram negative
Spirochete
What test to use for syphilis?
Dark field microscopy
