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Surgery > Male Reproductive > Flashcards

Male Reproductive Flashcards

1
Q

Dick Necrotizing Fasciitis

Dx/Tx =

A

Fournier’s

Debridement in OR

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2
Q

Testicular Torsion tx:

A

Bilateral Orchiopexy

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3
Q

Risk factors for Priapism include:
excess Testosterone
Trazodone
(3)

A

Cocaine
Etoh
Sickle Cell Anemia

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4
Q

2 treatments for Priapism:

A
  1. Aspirate blood from Corpus Cavernous

2. Intracavernous Phenyleprine injection
alpha 1 agonist

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5
Q

BPH can increase risk of what infection?

A

UTI

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6
Q

BPH most likely to arise in what 2 zones?

A

Central and Transition

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7
Q

Prostate cancer most likely to arise in what zone?

A

Peripheral

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8
Q

PSA levels in BPH versus Prostate Cancer:

A

BPH: wnl/elev PSA

Prostate cancer: elevated PSA

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9
Q

Nodular and firm prostate concerning for:

A

Prostate cancer

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10
Q

Risk factors for Prostate cancer:

A

Age > African American > FMH

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11
Q

Recurrent UTIs with intermittent relief and
painful ejaculation is consistent with ____.

Treatment:

A

Chronic Bacteria Prostatitis

Fluoroquinolone (Ciprofloxacin)

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12
Q

Painful prostate on palpation consistent with

A

Acute Bacterial Prostatitis

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13
Q

Painful, unilateral testicular mass
(↑ AFP/hCG/LDH)

what do next? what is likely dx & tx?

A

Scrotal u/s
Testicular Cancer
Orchiectomy

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14
Q

Ropey bag of worms
worse with standing
better with laying
NO translumination

A

Varicocele

dilation of pampiniform plexus → retrograde flow

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15
Q

Treatment of varicocele in young/fertile patients

A

Gonadal vein ligation to prevent infertility

*old men get NSAIDs & scrotal sac surgery

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16
Q

Finasteride is a _____ used for treatment of ____

A

5 alpha inhibitor

BPH

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17
Q

Leuprolide is a _____ which can be used as an adjuvant for treatment of ____

A

GnRH agonist

BPH s/p TURP

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18
Q

What is a surgery that can be used to treat BPH?

A

Transurethral Resection of Prostate (TURP)

can recur so give finasteride + leuprolide

19
Q

In a penile fracture you repair the ___

A

Tunica alba

20
Q

s/p penile fracture patient has urinary retention, dysuria, or blood at the urethral meatus.
What do next?

A

Urethrogram

21
Q

Unilateral varicocele that does not improve when supine what is the likely diagnosis and what is the next best step in management?

A

Tumor blocking L Renal vein or IVC

Get a CT scan

22
Q

A painless enlargement may be present
Dull, aching pain of the hemiscrotum (typically left-sided)
Soft bands/strands are palpable in the upper pole of the affected scrotum (“bag of worms”)
Symptoms worsen when standing or when performing the Valsalva maneuver.
Negative transillumination

A

Varicocele
(abnormal dilation/tortuosity of the pampiniform plexus s/t proximal obstruction of the spermatic vein)

MCC of scrotal enlargement

23
Q

Initial imaging and follow up imaging for varicocele :

A

Ultrasound
Dilated (> 2 mm) hypoechoic pampiniform vessels

Doppler ultrasonography

*Grade based on the extent of vein dilation/reflux during Valsalva

24
Q

A unilateral right-sided varicocele is uncommon and should raise suspicion of a mass in the ____ blocking the spermatic vein.

A

Retroperitoneal space

lymphoma, RCC, Ormond disease

25
Q

Fluctuant, painless swelling of affected scrotum

Positive transillumination

A

Hydrocele

fluid in tunica vaginalis

26
Q

A hydrocele must be differentiated from an

A

inguinal hernia

27
Q

Congenital hydrocele usually resolves spontaneously within ____ of birth.

A

6 months

28
Q

Indications for hydrocele surgery:
If spontaneous resolution does not occur by __ of age
If ____ is a concern

A

1 year

infertility

29
Q

Cryptorchidism typically resolves without treatment via spontaneous descent of testicles by ____ of age.

A

6 months

if not do surgery ASAP

30
Q

Cryptorchidism complications include:

Infertility
Inguinal hernia
_____
_____

A

Testicular cancer (germ cell tumors)

Testicular torsion

31
Q

Pt presents with unilateral scrotal pain and swelling which radiates to the flank. Pain is alleviated when the scrotum is elevated or sitting

On physical exam
There is tenderness along the posterior testis. Scrotal skin overlying the epididymis appears red, shiny, and edematous

Pt has Low-grade fever and urinary sxs.

Diagnosis?

A

Acute epididymitis

32
Q

Acute epididymitis treatment if:

suspected UTI source: ___

suspected STI source (chlamydia/gonorrhea): ___

A

UTI → levofloxacin

STI → ceftriaxone + doxycycline

33
Q

Pt presents with painless or dull, achy L scrotum.
Aching worsen when standing or when performing the Valsalva maneuver.

Physical exam reveals soft bands/strands palpable in the upper pole of the affected scrotum (“bag of worms”)
Negative transillumination.

Diagnosis?

A

Varicocele

34
Q

Most common cause of scrotal enlargement in men

A

Varicocele

35
Q

Abnormal enlargement and tortuosity of the pampiniform plexus in the scrotum due to proximal obstruction of the spermatic vein.

A

Varicocele

36
Q

Suspected varicocele on physical exam.

Next best step in management?

A

U/S (dilated, hypoechoic pampiniform)

*Doppler U/S (assess grade and reflux during Valsalva)

37
Q

Invasive treatment for Varicocele indications:

  • Pain
  • Infertility

Laparoscopic ______

A

Varicocelectomy

affected dilated pampiniform veins are ligated by
percutaneous embolization.

38
Q

Cryptorchidism complications include:

Testicular cancer (germ cell tumors)
Testicular torsion
_____
_____

A

Infertility

Inguinal hernia

39
Q

The testicle is located between the external and internal inguinal ring, preventing adequate mobilization: ___ testis

A

Inguinal

40
Q 
What testicular tumors present with elevated Tumor markers: 
alpha fetoprotein (AFP)
human chorionic gonadotropin (HCG)
A

Germ cell tumors

seminoma, dysgerminoma, teratoma, & yolk sac

41
Q

1st diagnostic step for suspected testicular tumor?

A

Testicular ultrasound

Then tumor markers & biopsy

42
Q

If a testicular tumor is suspected, the testis should be ____ and sent to pathology .

____ is contraindicated because of the risk of tumor seeding!

A

excised

transscrotal biopsy

43
Q

Presents with Palpable painless lump or ulcerative lesion of the penis.
Swollen inguinal lymph nodes. Diagnosis?

A

Carcinoma of the penis

tx: surgery

44
Q

What is the diagnostic (gold standard) for carcinoma of the penis?

A

Excision biopsy

Surgery (36 decks)

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