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Step 2CK > Male Reproductive System > Flashcards

Male Reproductive System Flashcards

1
Q

What are the PSA screening recommendations?

A

USPSTF: No screening
American Cancer Society: Screen
American Urological Association: Screen

Due to the controversy, PSA screening should be determined on a case-by-case basis.

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2
Q

What drugs most commonly leads to priapism?

A
  1. Prazosin
  2. Trazodone

For the boards also remember TRAZODONE.

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3
Q

What class of drugs are commonly used to treat premature ejaculation?

A

SSRI (eg, fluoxetine)

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4
Q

What effect do anti-hypertensive medications have on the male reproductive system?

A
  1. impotence
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5
Q

What are the most common causes of priapism?

A
  1. Sickle cell disease
  2. Leukemia
  3. Perineal or genital trauma (eg laceration of the cavernous artery)
  4. Neurogenic lesions (eg spinal cord injury, cauda equina compression)
  5. Medications (eg, prazosin & trazodone)
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6
Q

Causes of microscopic hematuria:

A
  1. Renal cell cancer
  2. IgA nephropathy
  3. Ureteral stricture
  4. Ureteral stone
  5. Bladder cancer
  6. Cystitis
  7. BPH
  8. Prostate cancer
  9. Urethritis
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7
Q

What is the most important risk factor for bladder cancer?

A

Cigarette smoking

Smoking cessation decreases the risk, but past smokers still have a higher risk for developing bladder cancer even up to 20 years after smoking cessation.

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8
Q

When is cystoscopy indicated?

A
  1. Unexplained gross hematuria
  2. Microscopic hematuria
    Bladder cancer risk factors:
  3. Cigarette smoking
  4. Occupational exposure (eg, painters, metal workers)
  5. Chronic cystitis
  6. Cyclophosphamide use
  7. Pelvic radiation exposure
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9
Q

Treatment:

BPH

A
  1. Alpha adrenergic antagonists (eg, terazosin, tamsulosin)
    with or without
  2. 5-alpha reductase inhibitors (eg, finasteride, dutasteride)

Alpha-1 blockers provide rapid relief.

5-alpha reductase inhibitors take 6-12 months before they become effective.

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10
Q

When might you consider prostate biopsy to evaluate for cancer?

A

If PSA is abnormal and digital rectal exam reveals an asymmetrically enlarged prostate.

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11
Q

What is the most common cause of urinary retention in an elderly male?

A

enlarged prostate

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12
Q

Diagnosis:

Patient with infertility who’s lab indicate:

  1. Erythocytosis
  2. Cholestasis
  3. Hepatic failure
  4. Dyslipidemia
  5. Slightly elevated creatinine
A

Anabolic steroid use

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13
Q

How do you differentiate psychogenic from organic causes of male erectile dysfunction?

A

If the patient continues to have nocturnal and early-morning penile erect vascular and nerve function is intact in the penis.

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14
Q

When is urinalysis indicated and what are you evaluating for?

A

UA is indicated when patients present with lower urinary tract symptoms:

  1. Urinary frequency
  2. Nocturia
  3. Hesitancy

You want to evaluate for hematuria or infection.

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15
Q

Mechanism of Action:

Terazosin

A

Alpha-1 adrenergic antagonist (also, tamsulosin)

Relaxation of smooth muscle in bladder neck, prostate capsule and prostatic urethra.

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16
Q

Mechanism of Action:

Finasteride

A

5-alpha reductase inhibitor (also, dutasteride)

Inhibits the conversion of testosterone to dihydrotestosterone effectively reducing prostate gland size. Effects may take 6-12 months!

17
Q

Side effects:

Tamsulosin

A

Alpha-1 adrenergic antagonist (also, terazosin)

  1. Orthostatic hypotension
  2. Dizziness
18
Q

Side effects:

Dutasteride

A

5-alpha reductase inhibitor (also, finasteride)

  1. Decreased libido
  2. Erectile dysfunction
19
Q

Treatment:

Overactive bladder in a patient with urinary frequency, urgency, incontinence

A

Tolterodine (antimuscarinic)

*This is symptomatic treatment, but you should still work to diagnose the primary cause (i.e. BPH, urethritis, etc.)

20
Q

How can you differentiate acute bacterial prostatitis from other UTIs?

A 
1. Perineal pain
Pronounced systemic symptoms:
2. Fever
3. Chills
4. Acute illness
5. Tender, boggy prostate
21
Q

Which diagnostic test should ALWAYS be ordered to workup acute bacterial prostatitis?

A
  1. Urine Culture

* You need to direct antibiotic treatment.*

22
Q

What is the most common manifestation of a testicular germ cell tumor in a young male?

A

Painless testicular mass

23
Q

What are the more rare manifestations of a testicular germ cell tumors in a young male?

A
  1. Dyspnea/cough –> pulmonary nodules on imaging
  2. Dull back pain –> retroperitoneal lymphadenopathy on imaging

These are signs of metastatic disease.

Step 2CK (10 decks)

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