MEN's HEALTH Flashcards

1
Q

presentation of BPH

A

hx of gradual onset obstructive voiding symptoms, weaker stream, dribbling, incomplete emptying, nocturia

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2
Q

DRE signs with a person with BPH

A

prostate = firm/rubbery diffusely loarge non tender

prostate feels firm and uniformly enlarged

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3
Q

1 st line tx for BPH

A

Alpha blockers
Terazosin ( hytrin) at bedtime, Watch hypotension when moving

use with pt with HTN

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4
Q

Other alpha blockers (Tamsulosin/Flomax) considerations

A

dont give prior to eye sugery

watch for dizziness, hypotension, blurred vision

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5
Q

5-alpha-reductase inhibitors Proscar

A

dont give to pt who are trying to get pregnant

this med will redice prostate by 50 % so when checking PSA you have to double it

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6
Q

Herbal tx for BPH

A

saw palmetto

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7
Q

Prostate cancer screening

A

against regular screening

high risk: AA, + fm hx

PE: indurated/hard areas or nodule on the surface w/ DRE

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8
Q

Acute Bacterial Prostatitis ( P/key/labs)

A

Acute onset of fevers, suprapubic / perineal pain w/ urinary symptoms. Perineal pain may radiate to the back/rectum/penis

Key: do not vigorously massage prostate could cause urosepsis

Labs: CBC, UA. UC, fractional urine x 3

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9
Q

ABP ( tx and organisms)

A

Organism : e.coli
For sexual active men : STD’s - Chlamydia, Gonorhhea

TX for uncomplicated m< 35 with increased prob of STD
- Ceftriazone 250 mg X once + Doxy for 10 days

Uncomplicated w/ lower risk for STD
- Cipro BID or Levofloxacin

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10
Q

Chronic Bacterial Prostatis (age, organism, PE,

A

common in older men
caused by e.coli
usually asympotmatic
DRE: may be normal

labs: UA, UC after light massage

TX: Cipro or Levoflocin for 4 weeks

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11
Q

Testicular Torsion

A

Peak age : 12 -18

acute onset scrotal pain , red swollen scrotum. N/V, afebrile

PE: very tender , warm tetes “ that high riding”
missing cremasteric reflex

UA: negative

TX; ED

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12
Q

Blue dot sign

A

may be seen in torsion of tesicular appendage (which is benign condition in children)

will see a blue nodule on spuerior aspect of testicle. non tender testicle

refer to ED to r/o testicular torsion

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13
Q

Hydrocele

A

Painless, enlarged scrotum due to serous fluid trapped in tunica vaginalis

will have + transilluniation is affected scrotum

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14
Q

Testicular Cancer

A

young male discovers painless nodule or swelling on one testicle. May see evelated LDH, HCG, AFP

PE: nodules found on lower half of testicular

Risk factors: family hx and crytorchism ( undescended testicles)

next step: order scrotal US and refer

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15
Q

Acute Bacterial Epidimyitisis

A

sexually active males < 40. acute onset of fever w/ red swollen scrotum that is tender w/ urinary symptoms

PE: indurated and very tender epididmyitis w/ swollen red scrotum. + phrens sign, may have green discharge

Phrens sign: pain releived w/ elevation of scrotum

Labs: CBC , UA ( with wbc and blood)

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16
Q

ABE organism and tx

A

if suspected STD - ceftriazone + doxy
lower risk - e.coli - levofloxacin for 10 days

pain releif : scrotal elevation and scrotal ice packs

17
Q

Erectile Dysfunction organic verse non organic

A

no time time erections- r/o organic cause
which means inability to have erection under any circumstances

may be caused by vascular insuffiency, neuropathy, smoking

meds : SSRI, beta blockers, alcohol

18
Q

ED treatment

A

Viagra take one dose 1 hour prior to sex

contraindiacted : when taking - nitrates, unstable agina, some aphla blockers

19
Q

Peyronie’s dx

A

pain crooked erections

20
Q

Balanits

A

infection of glans ( DM)

21
Q

Phimosis

A

foreskin can not be pushed back from the penis

22
Q

Priapism

A

abnormal, painful prolonged erection > 4 hours

23
Q

Varicocele

A

varicose / veins , may cause infertility, bag of worms

24
Q

Indirect hernia

A

intestines slip through the internal inguinal ring, can drop down into the scrotum ( through the tunica vaginalis)

25
Q

Direct Hernia

A

intestines protrude through a weak area in the fascia of anterior abdominal wall ( middle age and older men)

26
Q

PE for hernias

A

when you gently slip finer throught scrotum into inguinal ring tell pt to cough if + pain = indirect if - pain = direct

order a US

27
Q

most common type of hernia in female?

A

femoral hernia and it is at higher risk for strangulation

28
Q

What are sliding hernias?

A

hiatal or diaphragmatic hernia

29
Q

Strangulated Hernia

A

Emergency

gradual onset of abdominal pain that worsens into severe colicky pain. vomits bile, incarcerated hernia feels warm and tender

hyperactive and high pitched bowels sound that eventually become hypoactive, distended abdomen

percussion : tympany

complication is a obstructed bowel