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PCM II: Test 1 > Male Genitourinary and Prostrate exam > Flashcards

Male Genitourinary and Prostrate exam Flashcards

1
Q

vascular erectile tissue

A

Corpus spongiosum – containing the urethra.

Corpora cavernosa – two.

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2
Q

glans

A

cone shaped end of the penis.

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3
Q

prepuce/foreskin

A

present on uncircumcised males, covers the glans

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4
Q

urethral meatus

A

vertical slit like opening at the tip of the glans.

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5
Q

scrotum

A

pouch that contains the testes

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6
Q

tunica vaginalis

A

serous membrane covering the testes

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7
Q

epididymis

A

tightly coiled spermatic ducts on the posterior-lateral surface of each testicle. Storage of sperm.

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8
Q

Vas deferens

A

cordlike tube, transports sperm from epididymis to urethra

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9
Q

Spermatic cord

A

contains vas deferens, blood vessles, nerves and cremaster muscle fibers (pulls testicle outwards, helps to maintain testicle position in order to regulate temperature)

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10
Q

Prostate gland: where is cancer most common?

A
  • sits along backside of bladder, divided into five lobes.
  • posterior lobe is most common for cancer: prostate is like hole of doughnut, as prostrate grows larger, hole of doughnut gets smaller, difficulty with urination
  • posterior lobe is what can be felt on examination
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11
Q

Indirect hernia

A
  • most common for both sexes
  • occurs above inguinal ligament
  • often occurs into the scrotum
  • comes through internal ring and slides through the canal
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12
Q

Direct hernia

A
  • less common, usually seen in men
  • occurs above the inguinal ligament
  • rarely moves into the scrotum
  • comes through external ring
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13
Q

femoral hernia

A
  • least common, more common in women than men
  • occurs below the inguinal ligament
  • never moves into the scrotum
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14
Q

dysuria

A

painful urination

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15
Q

hematuria

A

red urine

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16
Q

components of male GU examination

A 
penis
scrotum and its contents
hernias
prostate exam
special techniques
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17
Q

Inspection of penis

A
  • look at skin (lesions and rashes)
  • hair (distribution, lesions, infections)
  • prepuce/foreskin (retract if present)
  • glans (ulcers, scars, rashes, inflamm.)
  • meatus (lesions or inflammation,discharge), milk or strip the penis and put the sample on a glass slide
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18
Q

STD’s

A

Chlamydia - WBC
Gonorrhea - WBC with Gm(-) intracellular diplococcic
Trichomonas - WBC with moving organisms
GEN Probe – Chlamydia & GC

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19
Q

Palpation of penis

A
  • Palpate from the glans to the base.
  • Note any tenderness, nodules, masses,
    inflammation.
  • Palpate the inguinal areas for lymph
    nodes, masses, hernias or tenderness. (will see enlarged lymph nodes with gonorrhea and syphilis)
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20
Q

scrotum examination

A
  • inspection of the skin and scrotal contours
  • palpation of the testes and epididymis (should be smooth)
  • palpation of the spermatic cord (feels like rope, roll gently between fingers)
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21
Q

hernia palpation:

A
  • finger slides up into the inguinal canal

- have patient bend down and cough, will feel hernia bounce

22
Q

prostate gland

A 
bi-lobed, heart shaped, consistency of a rubber ball.  The inferior aspect of the posterior lobe is best palpated on DRE.
Note size (walnut), tenderness, consistency, nodules, etc.
23
Q

Testicular self-exam

A 
- Best performed during or after a bath
or shower.
- Examine each testicle with both hands.
Gently roll the testicle between the 
thumbs and fingers.
- Locate the epididymis on the posterior
surface of the testicle.
- Follow up with a physician if you find any
lumps or tenderness.
- Educate your patients.
24
Q

Prostate Cancer

A
  • most common non-skin cancer
  • 2nd cause of death in males
  • screening tests: DRE and PSA
  • PSA can detect some cases of prostate cancer, but can also result in false positives (prostatitis, prostatic hypertrophy)
  • US government recommends against screening in patients older than 75 (should be looking at it in patients at 50 years old)
  • if pain, then send them for an ultrasound
25
Q

hypospadias

A
  • congenital displacement of the urethral meatus on inferior surface of penis along the urethral groove.
  • important in a newborn exam, associated with congenital renal abnormalities
  • epispadias = urethral opening on dorsal shaft
26
Q

Phimosis

A
  • the foreskin cannot be retracted over the penis
  • painful with erection
  • can be due to lack of poor hygiene
  • treatment = circumcision
27
Q

paraphimosis

A
  • foreskin cannot be retracted back over the glans, stuck behind the corona
  • treatment = circumcision
28
Q

hydrocele

A

fluid filled mass within tunica vaginalis

- transilluminates with a light

29
Q

cryptorchidism

A
  • undescended testicle
  • usually atrophied
  • increased risk for cancer
30
Q

syphilis

A
  • syphilitic chancre: painless round or oval erosion or ulcer, non-tender enlarged inguinal lymph nodes are common.
  • RPR and VDRL are positive, screening test, many false positives.
  • FTA- ABS is positive or Dark Field Microscopy, confirmatory test.
31
Q

secondary syhpilis

A
  • unexplained rash on palms of hands, back, soles of feet
32
Q

non-treponemal tests for syphilis

A
  • common false positives
    RPR (Rapid Plasma Regain)
    VDRL (Venereal Disease Research Lab)
33
Q

confirmatory test for syphilis

A
  • FTA-ABS (fluorescent treponemal antibody absorbed)
  • TP-PA (T. pallidum particle agglutination)
  • Dark field microscopy
34
Q

Genital herpes

A
  • cluster of small vesicles.
  • Burning and painful.
  • Progress to ulcers on a erthymic base.
  • Dx – viral culture of the fluid in the vesicle.
    Herpes simplex virus 1 and 2
  • Virus: Herpes simplex 1 and Herpes simplex 2.
  • Primary infection – painful lesions, lymphadenopathy, fever, malaise.
  • Recurrent infections – localized lesions and less symptoms.
  • Viral shedding is usually asymptomatic.
  • Pregnant women can vertically transmit HSV to the infant during birth.
  • Viral culture of vesicle fluid can confirm active infection.
  • Treatment – acute and suppressive therapy. (not curative)
35
Q

venereal warts

A
  • Venereal warts (Condyloma acuminatum) - caused by HPV (human papillomavirus. Grow in cauliflower like clusters.

Difficult to treat – cryosurgery, laser surgery, electrosurgery, podophyllin, Aldara(imiquimod), surgery.

36
Q

genital scabies

A
  • Contagious disease caused by a mite (Sarcoptes scabiei)
  • Direct skin contact.
  • Nocturnal pruritus is very characteristic progressing to intense pruritus.
  • Linear, curved or s-shaped burrows.
  • Diagnosis: clinical suspicion, slide mount preparation.
  • Treatment: Permethrin cream (Elimite), Lindane; oral steroids or antihistamines for pruritus.
37
Q

gonococcal vs nongonococcal urethritis

A
  • purulent discharge of gonorrhea

nongonoccoal = chlamydia

38
Q

sample on slide for chlamydia?

A

WBC

39
Q

sample on slide for gonorrhea

A

WBC and Gm- intracellular diplococcic

40
Q

Trichomonas on slides?

A

WBC with moving organisms

41
Q

What are three positions to examine prostate?

A
  1. Sim’s position/left lateral decubitus: laying on left side
  2. modified lithotomy: similar to female GU
  3. standing position and leaning forward (gives best access to posterior lobe anteriorly.)
42
Q

testicular cancer

A

USPSTF recommends against routine screening for testicular cancer and against testicular self-exam

  • it has low incidence and favorable outcome - most cancers are found by patients and their partners
  • seen often in young men: most common cancer of young men between the ages of 15 and 35
43
Q

treponema pallidum

A

organism causing syphilis

44
Q

Herpes simplex virus 1 and 2

A

causes genital herpes

45
Q

condyloma acuminatum

A

HPV virus causing venereal warts

46
Q

sarcoptes scabiei

A

scabies mite

47
Q

niesseria gonorrheoea

A

gram- bacteria causing gonorrhea

causes gonococcal urethritis

48
Q

nongonococcal urethritis?

A

caused by chlamydia. Chlamydia trachomatis bacteria.

49
Q

What does prostatic cancer feel like?

A

hard, irregular nodules and asymmetric gland

50
Q

what does BPH feel like?

A

benign prostatic hyperplasia

- symmetrical, enlarged, soft gland that may bulge into the rectal lumen

51
Q

prostatitis palpation?

A

feels tender, boggy and fluctuant gland

see chapman’s reflex in lateral thigh

PCM II: Test 1 (5 decks)

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