MEN's HEALTH Flashcards
presentation of BPH
hx of gradual onset obstructive voiding symptoms, weaker stream, dribbling, incomplete emptying, nocturia
DRE signs with a person with BPH
prostate = firm/rubbery diffusely loarge non tender
prostate feels firm and uniformly enlarged
1 st line tx for BPH
Alpha blockers
Terazosin ( hytrin) at bedtime, Watch hypotension when moving
use with pt with HTN
Other alpha blockers (Tamsulosin/Flomax) considerations
dont give prior to eye sugery
watch for dizziness, hypotension, blurred vision
5-alpha-reductase inhibitors Proscar
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
Herbal tx for BPH
saw palmetto
Prostate cancer screening
against regular screening
high risk: AA, + fm hx
PE: indurated/hard areas or nodule on the surface w/ DRE
Acute Bacterial Prostatitis ( P/key/labs)
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
ABP ( tx and organisms)
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
Chronic Bacterial Prostatis (age, organism, PE,
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
Testicular Torsion
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
Blue dot sign
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
Hydrocele
Painless, enlarged scrotum due to serous fluid trapped in tunica vaginalis
will have + transilluniation is affected scrotum
Testicular Cancer
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
Acute Bacterial Epidimyitisis
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)