Men’s Health Flashcards
1
Q
BPH Investigations
A
IPSS Urine dipstick, UFEME, MC&S Blood: FBC, UEC, PSA Imaging: Ultrasound KUB + prostate Special tests: flow study (with urodynamic if irritative symptoms present), cystoscopy
2
Q
Treatment of BPH
A
Lifestyle modification: avoid alcohol, caffeine, smoking, adequate fluid intake except night, high fiber diet Medical - alpha-adrenergic blockers for symptomatic relief - prazosin/tamsulosin - 5-alpha-reductase inhibitors - finasteride to shrink prostate Surgery - transurethral resection of prostate
3
Q
Erectile dysfunction tests
A
Morning testosterone, TSH, prolactin, LH
FBG, LFT, UEC, lipids
if unclear, penile duplex doppler ultrasound
4
Q
Erectile dysfunction management
A
Modifiable RF: Meds, psychosocial issues, lifestyle Patient education Psychotherapy and sex behavioural modification Oral meds - PDE-5 inhibitor - most effective for neurogenic - enhances erection, needs stimulation - 50mg 1 hr before sex Intrapenile injection - alprosatadil, self-administered - low dose - spontaneous erection in 5-20 mins - if prolonged erection >2 hours take 120 mg pseudoephedrine and have hot shower, repeat 4hrs later if needed Vacuum constriction Surgery
5
Q
Sildenafil CI and SE
A
Unstable angina, stroke, MI, nitrates
Headache, nasal congestion, facial flushing, dyspepsia, blue vision, diarrhoea
6
Q
Prostate cancer investigations
A
Urine dipstick, UFEME, C&S FBC UEC PSA Ultrasound KUB + prostate Cystoscope Flow study with urodynamic if irritative symptoms CT scan for staging Bone scan for mets Prostate biopsy
7
Q
Treatment of prostate cancer
A
Low risk
- watchful waiting for those unsuitable for surgery
- active surveillance
Moderate risk
- Radical prostatectomy
- Androgen deprivation: bilateral orchidectomy, LNRH agonist
High risk:
- radical prostatectomy + pelvic LN resection
- androgen deprivation
Mets
- chemo
- palliative care
8
Q
Testicular cancer investigation and management
A
If testicular lump - Ultrasound screening - alpha fetoprotein and b-hcg If cancer - need staging via CXR, CT , lactate dehydrogenase - orchidectomy - chemo
