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#Clinical Assesment > Male GU > Flashcards

Male GU Flashcards

1
Q

within the shaft ___________ is paired and __________ is singular

A

cavernosum is paired

spongeosum is singular

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2
Q

___________ cells within seminiferous tubules make sperm

A

sertoli

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3
Q

testosterone is synthesis in the ______ cells

A

leydig

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4
Q

____________ is the serous membrane covering the testis (except the post aspect)

A

tunica vaginalis

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5
Q

_________ provides a reservoir for sperm storage

A

epididymis

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6
Q

_______ transports the sperm from the epididymis to the urethra

A

vas defrens (merges with seminal vesicles to make the ejaculatory duct)

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7
Q

4 things in spermatic corrd

A

vas, nerves, blood vessels, and muscle fibers

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8
Q

3 things that contribute to seminal fluid

A

vas, seminal vesicles, and prostate

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9
Q

hypothalamus secretes LH and FSH… LH works on _____cells,,, FSH works on________ cells

A

LH- leydig testosterone

FSH- sertoli sperm

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10
Q

1ry vs 2ry hypogonadism

A

1- d/t dysfxn of leydig or LH production -dec testosterone and inc gonadotropin releasing hormone
2 - d/t pituitary or hypothalamus lesions/dz - dec testosterone, dec gonadotropin releasing hormone

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11
Q

___________ innervates the skin/pubis

A

illiohypogastric

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12
Q

________innervates scrotum and medial thigh

A

genitofemoral

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13
Q

prostate has 3 lobes; ___lateral and ___medial (#)

A

2 lat; 1 medial

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14
Q

there is ________innervation proximal to the dentate line and _____innervation distal.

A

visceral

somatic

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15
Q

male sexual maturity rating of ____ means they have vellus hair and are prepubertal

A

1

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16
Q

male sexual maturity rating of 2 means…

A

sparse long hair slightly pigmented, enlargement of testes and scrotal skin pinks

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17
Q

hair with a horizontal upper border would indicate a male sexual maturity rating of ___

A

5; they are an adult

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18
Q

darker coarser hair spread sparsely with with an enlargement of length indicates a male sexual maturity rating of

A

3

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19
Q

male sexual maturity rating of 4 means….

A

adult hair but in a smaller area, not spread to medial thighs, development of glands, testes larger and scrotal skin darkens.

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20
Q

what are the 5 things you want to know for sexual hx (response section)

A 
satisfaction
libido
ED
orgams acheived with ease?
premature ejaculation
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21
Q

make sure you ask about scrotal….

A

heaviness, aching, buldging, pain

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22
Q

6 things that can cause dysuria(painful urination)

A

cystitis(bladder infxn), UTI, urethritis, bladder stone, bladder tumor, prostatitis

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23
Q

what are the 4 urinary obstructive sx

A

hesitancy/straining, weak stream, intermittancy, post void dribble

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24
Q

incarcerated vs strangulated hernia

A

incarcerated- irreducible, @risk reduced blood

strangulated - irreducible, nd compromised blood supply (freq n/v/f, pain and redness at site, EMERGENT)

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25
Q

hematochezia vs melana

A

hematoch- dt lower gi bleed - streaks

melana - dt upper gi bleed

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26
Q

what are the 3 reportable STI’s and their importance ranking

A

chlamydia>gonnorrhea>syphillis

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27
Q

_______ is the most prevalent STI and can cause genital warts, anal CA, penile cancer, and oropharangeal ca

A

HPV

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28
Q

HPV vaccine reccomended for boys age ___ or ___ up until ___yo

A

11 or 12 until 21

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29
Q

increased risk of testicular ca(which is rare but highly treatable with) int those with _________

A

cryptorchidism (under dev testes)

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30
Q

_______ is the 2nd leading cause of CA death in men

A

prostate CA

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31
Q

______ is not a very effective way to detect prostate cancer

A

PSA (prostate specific antigen)

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32
Q

colonoscopy sb be done starting at age ____ if no sx present; then repeated every ____ yrs if clear and every ___ yrs if polyps found

A

50yo
10yrs with neg
3-5yrs with polyps

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33
Q

what 2 tests are alternatives to colonoscopy but must be done annually?

A

gFOBT- test for blood in stool

FIT- tests for abnormal DNA in stool

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34
Q

as mena age there is a gradual decline in testosterone leading to ___ry hypogonadism

A

primary

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35
Q

what are the physical effect of testosterone decline (8)

A

osteoporosis, testicular atrophy and dec in penis size, ED, loss of libido, depression, fatigue, forgetfulness

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36
Q

what are the risks of HRT? (6)

A

growth of breast/prostate, liver toxic, tumors, infertility, polycythemia, and abnormal lipids

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37
Q

hypospadias?

A

condition where urethral opening is on bottom of penis

38
Q

epispadius?

A

condition where urethral opening is on the bottom of the penis

39
Q

what is peyronie’s dz

A

curvature in penis dt fiberous plaque developing

40
Q

what is balanitis

A

inflamation of the glans and foreskin

41
Q

Erythroplasia of Queyrat is..

A

cancer of glans, carcinoma in situ

42
Q

phimosis is…

A

tight foreskin that cannot be pulled back over head fo the penis

43
Q

paraphimosis is

A

foreskin is retracted or rolled and cannot be rolled back, can lead to gangrene

44
Q

profuse yellow penile discharge suggests

A

gonnococcal urethritis

45
Q

scant white/clear penile discharge suggests

A

nongonnoccal, likely chlamydia (need a gram stain)

46
Q

a painless 2cm penile errosion with clean raised borders suggests

A

1ry syphillis (chanker)

47
Q

what’s the incubation period for syphilis?

A

9-90 days

48
Q

a deep painful nonindurated ragged margin penile errosion suggest

A

chancroid of haemophilis ducryi

49
Q

haemophilis ducryi has an incubation period of

A

3-7 days

50
Q

what would be small scattered vesicles that turn into erosions?

A

genital herpes simplex

51
Q

what’s the incubation period for herpes?

A

2-7 days

52
Q

_____ is caused by mites that burrow under the skin and make little red bumps

A

scabies

53
Q

pearly papules with central umbilication is likely

A

molluscum contagiosum

54
Q

pearly penile papules on the head of the penis should make you think….

A

it’s a benign natural variant

55
Q

condylomata acuminata is

A

genital warts ( look kind of like coral)

56
Q

what is peyronie’s disease

A

development of a fiberous plaque on the corpus cavernosum that leads to curvature (no treatment, only 15% resolve)

57
Q

what is cryptorchidism

A

undesc testicle (in risk of CA)

58
Q

scrotal edema can be caused by ____ and ____

A

CHF and dec albumin

59
Q

what is tinea cruris?

A

jock itch; fungal infection, irregular border rash

60
Q

what is pediculosis pubis

A

crabs

61
Q

what is a spermatocele

A

epididymal cyst (off of the spermatic cord)

62
Q

what is a hydrocele? how test?

A

tunica vaginalis is filled with fluid, test for hernia by doing transillumination with a flashlight

63
Q

what is a vericocele?

A

vericose veins in scrotum, “bag of worms”, inc risk of infert

64
Q

what are the 5 risk factors for acute epidiymitis

A

sex, bladder obst, urogenital malformation, prolonged bike/motorcycle riding, running sports

65
Q

what are the sx of acute epididymitis (6)

A 
progressive UL scrotal pain
erethema/swelling
pos fever
dysuraia
freq
urgency
66
Q

what is prehn’s sign?

A

lifting the scrotum relieves pain (epididymitis)

67
Q

4 tx for acute epididymitis

A

ABx, scrotal elevation, ice pack, minimize activity

68
Q

what is acute orchitis

A

swelling/pain in one or both tesiticles (entire testicle)

69
Q

what is testicular torison? how long do you have to tx?

A

rotation of testis around spermatic cord and constriction of testicular artery; you have 6 hours to detorse

70
Q

the ____ deformity inc risk for testicular torsion

A

bell clapper (tunica vaginalis wraps around entire testicle and epididymis)

71
Q

with testicular torsion the _____ reflex is absent, and prehn’s sign is _____.

A

cremater reflex absent (stroke inner thigh and testicles DON’T retract(abnnormal)
prehn’s sign is absent (elevation does not alleviate)

72
Q

*what is the significance of prehn’s sign in testicular torsion vs epididymitis?

A

prehn’s sign= lifting testicles relieves pain
pos in epididymitis (no pain)
neg in torsion (pain still felt with lifting)

73
Q

Inguinal nodes typically lie…

A

at the inguinal ligament (ASIS-pubic tubercle) or just below

74
Q

a(n) ____ hernia can be felt sliding down to meet your finger at the external ring during a cough

A

indirect

75
Q

what is a pilonidal cyst

A

congenital abnormality in which a draining fistula tract forms near the anus

76
Q

Sensation is/is not felt:
above the dentate line?
below the dentate line?

A 
above= no feeling
below= feeling
77
Q

external hemerhoids are ____ the dentate line

internal are _____ the dentate line

A

ext=below

int=above

78
Q

external hemorhoids…

A

are painful but rarely bleed

79
Q

internal hemorrhoids…

A

seldom painful (unless prolapsed), bleed with deification

80
Q

3 risk factors for hemorrhoids

A

pregnancy, obesity, and straining with defication

81
Q

3 Tx for hemorrhoids

A

stool softner, sitz bath, and avoid steroids

82
Q

what are anal fissures? 3 causes?

A

small split/tear in mucosal lining (irritation during defication but no sx b/w bms); crohn’s, dry hard stool,and intumentation/anal sex

83
Q

*____ classification is used to locate anal fistula tract

A

Park’s

84
Q

rectal prolapse happens d/t _____ weakening

A

pelvic floor

85
Q

what 6 signs in the Hx might suggest prostatitis

A

epididymitis, UTI, urethritis, BPH, phimosis(can’t retract), urinary instrumentation (boggy LNs may be present acutely)

86
Q

what are the 6 sx of BPH?

A

hesitancy/straining, weak flow, post pee dribble, feeling bladder still full, urge to urinate freq, dysuria(pain during urination)

87
Q

4 signs of BPH seen on DRE

A

smooth, soft, mobile, boggy, and symmetrically enlarged

88
Q

when considering BPH dx, must run ____, ____, and _____ tests because…..

A

BUN & creatinine - r/o obstructive uropathy or nephropathy
and run a PSA to R/o prostate CA (can be elevated in BPH)

89
Q

what are the 3 risk factors for prostate CA

A

80+, af amer descent, Fam Hx

90
Q

____ pain can be a sing of prostate cancer b/c mets

A

back pain

91
Q

what are 4 things found on DRE of prostate CA

A

induration(fiberous hardening), nodule, asymmetry, rock hard

92
Q

thick yellow d/c with tender LNs is likely

A

gonorrhea

#Clinical Assesment (5 decks)

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