Male/Female Reproductive and Pregnancy Flashcards
Baseline […] function should be assessed prior to initiating trastuzumab in patients with HER-2 positive breast cancer.
Baseline cardiac function should be assessed prior to initiating trastuzumab in patients with HER-2 positive breast cancer.
e.g. with echocardiography; due to associated cardiotoxicity (cardiac function should also be assessed in regular intervals during treatment)
Do patients with cryptorchidism repaired before 1 year of age (e.g. orchiopexy) have an increased risk of testicular cancer?
Yes
risk of testicular cancer is decreased post-orchiopexy, but still elevated compared to the general population
Empiric antibiotic therapy for acute bacterial prostatitis consists of […] or a […] for a duration of 4 - 6 weeks.
Empiric antibiotic therapy for acute bacterial prostatitis consists of TMP-SMX or a fluoroquinolone for a duration of 4 - 6 weeks.
Empiric antibiotic therapy for acute bacterial prostatitis consists of TMP-SMX or a fluoroquinolone for a duration of […].
Empiric antibiotic therapy for acute bacterial prostatitis consists of TMP-SMX or a fluoroquinolone for a duration of 4 - 6 weeks.
Patients with testicular cancer may present with low back pain due to […] lymphadenopathy.
Patients with testicular cancer may present with low back pain due to para-aortic (retroperitoneal) lymphadenopathy.
diagnosis is confirmed with scrotal ultrasound and tumor markers
PDE-5 inhibitors (e.g. sildenafil) can cause significant hypotension, especially in patients taking […] or […].
PDE-5 inhibitors (e.g. sildenafil) can cause significant hypotension, especially in patients taking alpha blockers or nitrates.
other common side effects include headaches and disturbances in vision and hearing
Pregnant women with antiphospholipid syndrome should receive low-dose aspirin and […] to avoid pregnancy loss related to arterial and venous thrombosis.
Pregnant women with antiphospholipid syndrome should receive low-dose aspirin and LMWH to avoid pregnancy loss related to arterial and venous thrombosis.
What are the current recommendations regarding PSA screening in asymptomatic patients?
Conroversial; should be determined on a case-by-case basis by the physician and patient
What are the recommended screening guidelines for mammogram in patients with average risk of breast cancer?
mammogram every 2 years in women age 50-75
What are the recommended screening guidelines for pap smear in patients with average risk of cervical cancer?
pap smear every 3 years in women age 21-65
alternatively, women age 30-65 may do pap smear with HPV testing every 5 years
What is the first-line treatment for most patients with erectile dysfunction?
PDE-5 inhibitors (e.g. sildenafil)
What is the likely diagnosis in a 50-year-old male that presents with fever, chills, dysuria, and perineal pain? Rectal examination shows a boggy, tender prostate. Urinalysis is positive for leukocyte esterase.
Acute bacterial prostatitis
urine cultures should be obtained to direct antibiotic therapy
What is the likely diagnosis in a middle-aged man that presents with progressive urinary urgency and hesitancy for the past several months with perineal pain during ejaculation? Physical exam, including rectal exam, is unremarkable. Urine culture is negative.
chronic non-bacterial prostatitis/chronic pelvic pain syndrome
non-infectious (culture negative) chronic prostate inflammation of unknown etiology; treatment includes antibiotics, alpha-blockers, and/or 5-alpha-reductase inhibitors
What is the likely diagnosis in a young woman that presents with bilateral, non-focal breast tenderness and diffuse, cord-like thickening of the breasts with no discharge? Her last menstrual period was three weeks ago.
Fibrocystic change
classically causes diffusely nodular breasts with non-focal tenderness that fluctuates with menstruation
What is the likely diagnosis in a young woman with a history of two miscarriages and the laboratory values below?
VDRL: positive
FTA-ABS: negative
PT: 12s (normal)
PTT: 46s (high)
Antiphospholipid antibody syndrome
characterized by a false positive VDRL, prolonged PTT, thrombocytopenia, and recurrent abortions
What is the likely etiology of erectile dysfunction in a middle-age man that complains of difficulty attaining/maintaining an erection during sexual activity for 6 months? He continues to have normal early-morning penile erections.
Psychogenic
persistence of nocturnal and early-morning erections indicates intact vascular and nerve function in the penis
What is the next step in management for a male that presents with a painless, hard mass in his testicle and ultrasound imaging consistent with a testicular tumor?
Radical orchiectomy
What is the next step in management for an elderly man with a significant smoking history that presents with urinary frequency and episodic gross hematuria for the past two months? Physical exam, including rectal exam, is unremarkable.
Cystoscopy
recommended for patients with gross or microscopic hematuria and other risk factors for bladder cancer (e.g. smoking)
What is the next step in management for an elderly women that presents with urinary incontinence for the past week? The patient is delirious. History and physical exam are unremarkable.
Urinalysis and culture
UTI should be excluded even with no fever or dysuria (elderly patients may have atypical presentations)
What is the preferred initial treatment for uncomplicated benign prostatic hyperplasia (BPH)?
Alpha-1 blockers (e.g. terazosin, tamsulosin)
5-alpha-reductase inhibitors can be used as an alternative or in addition to alpha blockers but have a slower onset of action
