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Physical Dx Final > Male Genital and Rectal > Flashcards

Male Genital and Rectal Flashcards

1
Q

Irregular lymph nodes

A

hard or immobile; suggest cancer

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2
Q

What to palpate in the scrotum

A

Testes,
epididymis
spermatic cord (vas deferens)

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3
Q

Testicles should feel like

A

an eraser or a hard-boiled egg

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4
Q

Highest incidence of testicular cancer

A

15-35

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5
Q

Where is the epididymis located? What does it feel like?

A

Superiorly and posterolaterally on the testicle; feels like a bag of worms

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6
Q

Spermatic cord

A

bilateral firm cords that feel like “the inside of a bic pen”; palpate from the epididymis to the inguinal ring using thumn and index finger

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7
Q

Hernia exam

A

Use scrotum skin and stick finger in inguinal canal; ask patient to turn their head and cough

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8
Q

Prostate size

A

about the size of a walnut

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9
Q

Shape of prostate

A

almond w/ 2 lobes

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10
Q

Consistency of the prostate

A

firm, like tip of nose or thenar area of palm

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11
Q

Condyloma acuminata

A

caused by HPV (most common); multiple lesions, grow together and spread to perineum and anal area; variably sized soft papules and plagues in anogenital regions

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12
Q

Genital Herpes

A

HSV2; begins with PAINFUL vesicles on erythematous base; vesicles can ulcerate; incurable w/ recurrent outbreaks

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13
Q

What causes syphilitic chancre

A

treponema pallidum

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14
Q

Syphilis

A

painless papule that erodes into a painless ulcer; may become secondarily infected; heals w/o treatment in 4-8 weeks

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15
Q

Urethritis

A

infection or inflammation of urethra; gonococcal (caused by N. gonorrhoeae) or non-gonococcal (cause by chlamydia trach); male with c/o dysuria and urethral d/c; may see inflamed meatus

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16
Q

Peyronie’s Disease

A

idiopathic condition resulting in fibrosis in the tunica albuginea; firm plague in penile shaft are palpable; may develope penile curvature, painful erections, and occasionally erectile dysfunction

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17
Q

Carcinoma of the penis

A

begins as firm nodule or ulcer that DOES NOT HEAL; average age is 50; usually nontender; more common in uncircumsized males, inguinal adenopathy often present

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18
Q

Sx with carcinoma of penis

A

inguinal LAD

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19
Q

Indirect inguinal hernia

A

most common in all ages, both sexes; above inguinal ligament, near internal inguinal ring; often extends into scrotum; palpable as impulse down canal

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20
Q

Direct Inguinal Hernia

A

less common; usually in men over age 40; above inguinal ligament, RARELY IN SCROTUM; bulges anteriorly

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21
Q

Femoral hernia

A

least common; more common in WOMEN; below inguinal ligament; more lateral than inguinal hernias; may mimic lymph node; never into scrotum

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22
Q

Varicocele

A

Varicose veins of scrotal vessels; develops slowly; feels like a soft “bag of worms,” may slowly collapse if scrotum elevatd while patient supine; associated w/ infertility

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23
Q

Hydrocle

A

soft non-tender hemi-scrotal swelling that TRANSILLUMINATES; size of swelling may wax and wane; check for concurrent indirect hernia or testicular masses

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24
Q

Spermatocele/epididymal cyst

A

painless, mobile mass just above the testis; smaller than hydrocele usually; may transilluminate

25
Q

Acute epididymitis

A

infection of epididymis via the vas deferens; fever/chills; acute and unilateral, dull to severe scrotal pain radiating to ipsilateral flank; hemi-scortal swelling and tenderness which may progress to erythematous, fluctuant mass; PREHN’S SIGN (elevation of the scrotum providing relief)

26
Q

Acute orchitis

A

inflammation or infection of the testis; testicular swelling and tenderness; similar in appearance to epididymitis; complication of epididymitis and mumps

27
Q

PREHN’s sign

A

Epididymytis

28
Q

Testicular torsion

A

ACUTE onset of scrotal pain, UNILATERAL with hemiscrotal swelling; often hours after vigorous physical activity/minor trauma; pain on palpation without relief w/ elevation; ABSENT CREMASTERIC REFLEX; most common in neonates and adolescents

29
Q

Cause of testicular torsion

A

Twisting of the testes and spermatic cord causes ischemia

30
Q

test for testicular torsion

A

(-) Cremasteric reflex

Dopplar U/S shows decreased blood flow

31
Q

Tx for testicular torsion

A

SURGICAL EMERGENCY

32
Q

Bell-clapper deformity

A

Testical in horizontal plate

33
Q

Testicular tumor

A

painless, SOLID testicular swelling or nodule; inguinal LAD or para-aortic LAD; +/- abdominal pain or with pulmonary symptoms or neuro deficits

34
Q

Inguinal LAD associated with

A

penile carcinoma

Testicular tumor

35
Q

(-) Cremasteric reflex

A

Testicular torsion

36
Q

Cause of acute orchitis

A

complication of epididymitis and mumps

37
Q

Associated w/ infertility

A

Varicocele

38
Q

Internal hemorrhoid

A

enlargements of normal vascular cushions above pectinate line; can cause BRIGHT RED BLEEDING WITH DEFECATION; can prolapse and appear as red moist mass

39
Q

External hemorrhoid

A

Dilated veins covered covered with skin; tender, swollen, BLUISH mass at anal margin; asymptomatic unless thrombosed

40
Q

Anal fissure

A

tear in the inside lining of the wall of the anus; caused by stretching of anal mucosa; SEVERE PAIN W/ PASSAGE OF STOOL AND SCANT BLEEDING; pain causes spasm, worsens fissure;

41
Q

Dx of anal fissure

A

hx and anoscopy

42
Q

Anorectal abscess

A

from an infected anal crypt gland; severe pain in the anal or rectal area; fevere and malaise; perianal erythema and a palpalble, often fluctuant mass; PURULENT RECTAL DRAINAGE MAY BE NOTED IF THE ABSCESS HAS BEGUN TO DRAIN SPONTANEOUSLY

43
Q

What can an anorectal abscess lead to

A

anorectal fistula

44
Q

Rectal polyps

A

Protuberance into the lumen above the surrounding colonic mucosa; may be pedunculated or sessile; soft, difficult to feel w/ finger

45
Q

Tx for rectal polyps

A

Bx to r/o malignancy

46
Q

Pedunculated

A

stalk

47
Q

Sessile

A

attached at base

48
Q

Rectal carcinoma

A

firm, nodular, rolled edge; often have blood per rectum; not typically dx’d by physical exam

49
Q

Prostatitis types

A

Acute vs. chronic

50
Q

Prostatitis acute

A

enlarged, tender prostate gland; UTI symptoms, often w/ fever and chills; perineal or abd pain; examine gently

51
Q

Tx for prostatitis acute

A

antibiotics

52
Q

Prostatitis- Chronic

A

presents with RECURRENT UTI’s; prostate exam may be normal

53
Q

Tx for prostatitis chronic

A

abx for a lot longer than acute

54
Q

Benign prostatic hypertrophy prevalence

A

more common w/ increasing age

55
Q

BPH

A

symmetrical enlargement . of gland; SLOWING OF URINE STREAM WITH DIFFICULTY STARTING STREAM

56
Q

Carcinoma of prostate

A

enlarged, firm nodule or area of hardness; IRREGULAR CONTOUR and median sulcus is obscured; usually a slow-growing tumor; metastasizes locally and to bone

57
Q

Complaint with carcinoma of prostate

A

obstructive voiding symptoms

58
Q

Trouble peeing

A

BPH; carcinoma of prostate

Physical Dx Final (4 decks)

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