Men's health Flashcards
s/s of BPH
decreased in force of urine stream, hesitancy, post void dribbling, frequency
prostate in BPH
firm, smooth, symmetrically enlarged
factors that can increase PSA levels
ejaculation, cycling, prostate infection, massage
factors that can decrease PSA levels
bed rest, 5alpha-reductase inhibitors
PSA levels after a DRE
increase but clinically insignificant. Okay to have labs drawn after DRE
disease that can cause an elevated PSA
BPH, prostate cancer, prostate infection
decrease bladder outlet obstruction
alpha-adrenergic antagonists
reduce the size of the prostate
5-alpha-reductase inhibitors
ex of alpha-adrenergic antagonists
terazosin (Hytrin), tamsulosin (Flomax), doxazosin (Cardura)
education to give when rx alpha-adrenergic antagonists
take at bedtime, may cause 1st dose orthostatic hypotension
education to give about 5-alpha reductase inhibitors
may take 6-12 months to see benefit
ex of 5-alpha reductase inhibitors
duasteride, finasteride (Proscar)
uro specific alpha blocker
tamsulosin (Flomax)
precaution with tamsulosin (Flomax)
sulfa allergy
Causes of acute prostatitis
E. coli (most common), Proteus, chlamydia, trich
s/s of acute prostatitis
fever, chills, malaise, lower abd/pelvic pain, dysuria, pain with defecation, hematuria
prostate in acute prostatitis
enlarged, boggy, and tender
medication for acute prostatitis
TMPS or cipro x 6 weeks; if no improvement in 2-6 days, REFER
defer PSA after acute prostatitis for
1 month after treatment
prostate in chronic prostatitis
normal
risk factors for prostate cancer
older age, African American, family hx
prostate in prostate cancer
asymmetry, induration, nodules
New onset erectile dysfunction
indicate a DRE to r/o prostate cx
Normal PSA is
less than 4.0
causes of noninfectious epididymitis
prolonged sitting (car/plane trip, desk job)
causes of infectious epididymitis
chlamydia or gonorrhea
s/s of epididymitis
gradual development of scrotal pain, dysuria, discharge, tender/enlarged/indurated epididymis
diagnostic for epididymitis
UA: will be normal in noninfectious, pyuria in infectious;
Ultrasound
trx for noninfectious epididymitis
scrotal support, ice, NSAIDs
trx for infectious epididymitis
ceftriaxone 250 mg IM and doxycycline 100 mg bid x 10 days
f/u with epididymitis
if no improvement in 3 days then refer
s/s of inguinal hernia
scrotal mass with active bowel sounds in scrotum
s/s of testicular torsion
sudden onset of tesituclar pain, N/V, absent cremasteric reflex
trx for testicular torsion
must be referred and trx within 4-6 hours
risk factors for testicular cx
men 15-30 years old, hx of cryptorchidism, family hx
trx for testicular cx
radical orchiectomy
management with 5alpha reductase inhibitors
check baseline PSA
avoiding given alpha adrenergic blockers with
PDE5 meds for ED
renal carcinoma risk factors
black men, smokers, family hx
bladder cancer risk factors
white older men, smokers
refer if testicle has not descended by age
6 months
