Male GU Flashcards
Hernia
-Protrusion of a peritoneal – lion sack through some defect in the abdominal wall
Patho:
Subjective: Soft swelling or a bulge in inguinal area. May have pain on the straining.
Objective: indirect: soft swelling in area of internal ring. Hernia comes down Canal and touch his fingertips on examination. Large hernia may be present in scrotum. Direct: Bulgin area of Hesselbach triangle. Easily reduced. Hernia bulges and hear your Lee, pushes against side of finger on examination. Femoral: inguinal canal empty on examination. Strangulated: hernia is nonreducible. This condition requires prompt surgery
Paraphymosis
-The inability to replace the foreskin to its usual position after it has been attracted behind the glans
Patho:
Subjective: The traction of the foreskin during penile examination, cleaning, urethral catheter I Seshan, or cystoscopy. Penile pain and swelling.
Objective: Glands penis is congested and enlarged. Foreskin a demitasse. Constructing band of tissue directly behind the head of the penis. If untreated, necrosis and gangrene of the glans penis maybe present
Syphilitic canchre
Subjective: painless lesion of penis. History of sexual contact.
Objective: solitary lesion. From around small commonly located on the glands but can be located on the foreskin. Lesion has indurated borders with a clear base. Scrapings show spirochetes
Genital herpes
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Patho: Most commonly caused by HSV-2 virus
Subjective: Painful lesions on penis, general area, pier name. History of sexual contact. May have burning with urination.
Objective: Superficial vesicles on the glands, penile shaft, or at the base of the penis. Often associated with inguinal lymphadenopathy and systemic symptoms, including fevers. Men who have sex with men also get blisters in or around the anus.
Condyloma acuminata
-Genital warts caused by HPV
Patho:
Subjective: Soft painless wart like lesions on penis. History of sexual contact.
Objective: Single or multiple papular lesions. Maybe pearly filiform cauliflower or plaque like. Can be smooth or lobulated. Maybe the same color as the skin or maybe reddish or hyperpigmentation. Lesions are commonly present on the prepuce, glance penis, and penile shaft.
Lymphogranuloma venereum
-STI the lymphatics
Patho: Caused by chlamydia. Initial lesion of hers that side of entry. Travels be a lymph attic still regional lymph nodes. Local lymph nodes become involved. DrainingSinus tracts may form
Subjective: Painless lesions on penis. Symptoms may be systemic. History of system to contact
Objective: initial lesion is a painless erosion at or near the coronal sulcus. Enlarged regional lymph nodes. If lymphatic drainage is blocked, penile and Squirtle lymphedema man see you. Draining sinus tract in untreated infection.
Molluscum contagiosum
-Viral infection of the skin and mucous membranes. Considered an STI and adults.
Patho: Caused by a pox virus that infects the skin. Spread by contact with skin or object. Growth of here after incubation period
Subjective: Palos lesions on the penis. Contact with an infected person.
Objective: lesions are pearly gray, often umbilicated, smooth, dome – shaped, and with discrete margins. Lesions most common on the glans penis.
Peyrione disease
-Characterized by a fibrous band in the corpus cavernosum
Patho: Dance, fibrous scar tissue/Plaque forms in the wall of the corpus cavernosum. Interferes with expansion during erection. Unclear ideology. Generally unilateral. Mid top of penis most commonly involved.
Subjective: bending and indentation of the erection. Lots of penile length. May have pain with erection. Family history of the condition. History of dupuytren contracture.
Objective: One or more palpable hardened areas. Reduce elasticity of the flaccid penis. Radiography or alter sound can show plaque calcification.
Penile cancer
-Almost all cases are squamous cell carcinoma usually originating in the glands or foreskin
Patho: Associated with HPV types 16 and 18. Lower risk with circumcision.
Subjective: Painless ulceration that fails to heal. Uncircumcised. Poor penile hygiene.
Objective: Lesion, usually are glands, may present as a red area. Papular or pustular. Warty growth. Shallow erosion, or deep ulceration with rolled edges. May have a fibrosis that of scares the lesion.
Hydrocele
-Fluid accumulation in the scrotum
Patho: Fluid accumulates in the scrotum as a result of a defect. Common in infancy. Generally disappears in the first six months of life.
Subjective: Painless enlargement or swelling of the scrotum
Objective: Nontender, smooth, firm mass superior and anterior to the testes. Transilluminate. Confined to the scrotum and does not enter the inguinal canal, unless it has been present for a long time it is very large and talked.
Spermatocele
-Benign cystic accumulation of sperm occurring in epididymis
Patho: Unknown
Subjective: Asymptomatic. Incidental finding on physical examination or self examination
Objective: Smooth, spiracle, nontender mass at epididymis superior and posterior to the testes. Usually smaller than 1 cm.
Varicocele
-Abnormal tortuosity and dilation of the pampiniform plexus within the spermatic cord.
Patho: More common in the left testicle than the right. Maybe associated with reduced to a fertility.
Subjective: Usually asymptomatic and found in course of valuation with infertility. May report pain or happiness in scrotum
Objective: Often visible only when the patient to standing. Is classically described as a bag of worms.
Graded as
small: palpated only during Valsalva maneuver. Moderate: easily palpated without Valsalva maneuver.
Large: visible bulging of the scrotum.
Orchitis
-Acute inflammation of the testes secondary to infection
Patho: Mumps, or prostate infection in older adults
Subjective: Acute onset of testicular pain and swelling. Pain ranges from mild discomfort to severe pain. Associated systemic symptoms: fatigue, malaise, myalgias, fever. Months orchitis follow the development of para Titus by 4 to 7 days.
Objective: and large, tender testees. Erythematous and a demitasse squirrel skin. In large the epididymis associated with epididymoorchitis
Epididymitis
-Inflammation of the epididymis, a major consideration in the differential diagnosis is testicular torsion, a surgical emergency.
Patho: Associated with UTI and STI. Sometimes a consequence of TB
Subjective: Painful scrotum, urethral discharge, fever, pyuria, recent sexual activity.
Objective: epididymis skills firm and lumpy, tender. Vasa differentia maybe beaded. Overlying scrotum maybe markedly erythematous.
How to distinguish from torsion: older age, gradual onset of pain, vomiting and anorexia uncommon, fever and dysuria common, urethral discharge and recent history of sexual activity.
Testicular torsion
-Twisting of the testes on spermatic cord. Just a killer torsion a surgical emergency
Patho: Twisting of the spermatic cord cut off blood supply to the testicle. Most common in adolescence
Subjective: Acute onset of scrotal pain, often accompanied by nausea and vomiting. Absence of systemic symptoms such as fever and myalgia. Risk factors of trauma and strenuous physical activity.
Objective: testicle is exquisitely tender. Squirtle discoloration is often present. Absence of cream steric reflects on the side of a cute swelling.
How to distinguish from epididymitis: younger age, acute onset of pain, vomiting and x-ray anorexia common, fever and dysuria uncommon, absence of cream a steric reflects on the side of a cute swelling and Squirtle discoloration on exam.
