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Review > Men's Health > Flashcards

Men's Health Flashcards

1
Q

Priapism

A

Long, painful erection

>2-3 hours

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2
Q

People at highest risk for priapism

A

sickle cell anemia

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3
Q

Risks for priapism

A
  • high doses of ED medication
  • cocaine
  • quadripelgia
  • etc
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4
Q

Which form of priapism is a medical emergency

A

ischemic

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5
Q

People at risk for testicular cancer

A
  • teenage to young adult (15-30)

- White males

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6
Q

Testicular cancer presentation

A
  • nodule
  • sensation of heaviness or aching
  • one larger testicle
  • tenderness
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7
Q

Prostate cancer presentation

A
  • low back pain
  • rectal area/perineal pain
  • obstructive voiding symptoms
  • may be asymptomatic
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8
Q

Highest risk for prostate cancer

A
  • > 50
  • obese
  • Black
  • family history
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9
Q

Blue dot sign indicates

A

torsion of appendix testes

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10
Q

Torsion of appendix testes occurs in..

A

school age

-infarction

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11
Q

Testicular torsion presentation

A
  • acute onset
  • affected testicle higher and closer to body
  • negative cremasteric reflex
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12
Q

where is sperm produced

A

seminiferous tubules of testes

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13
Q

cryptochordism increases risk for what

A

testicular CA

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14
Q

Spermatogenesis is stimulated by

A

testosterone

FSH

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15
Q

Which testicle usually hangs lower

A

left hangs lower than right

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16
Q

Function of prostate fluid

A
  • alkaline pH

- helps sperm survive in vagina

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17
Q

Where is immature sperm stored

A

epididymis

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18
Q

What transports sperm from epididymis to urethra

A

vas deferens

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19
Q

What structure is clipped during a vasectomy

A

vas deferens

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20
Q

Where is cremasteric reflex illicted

A

-stroke ipsilateral inner thigh

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21
Q

What condition with testes will transluminate

A

-hydrocele

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22
Q

Gold standard for testicular CA

A

biopsy

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23
Q

Testicular CA treatment plan

A
  • US

- Urology referral for biopsy

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24
Q

When will permanent testicular damage occur with testicular tosion

A

<6 hours

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25
Q

Is digital rectal exam with PSA (Screening) recommended?

A

no

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26
Q

Diagnostic test for prostate cancer

A

biopsy

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27
Q

PSA level for prostate CA

A

> 4

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28
Q

Prostate CA plan

A
  • Refer to urology if PSA >4

- individualize screening

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29
Q

BPH presentation

A
  • elevated PSA
  • prostate is rubbery and enlarged
  • gradual urinary obstructive symptoms
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30
Q

Alpha-adrenergic antagonist

A

Terazosin (Hytrin)

Tamsulosin (Flomax)

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31
Q

5-alpha reductase inhibitors

A

Finasteride (Proscar)

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32
Q

What herbal remedy may be used for BPH

A
  • saw palmetto
  • mild benefit
  • not effective for everyone
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33
Q

adverse effect of alpha blockers

A

orthostatic hypotension

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34
Q

Male with BPH and HTN

A
  • start with alpha-adrenergic antagonist (Flomax)

- relaxes smooth muscles on prostate gland and bladder neck

35
Q

Mechanism of Finasteride

A

blocks androgen receptor

  • temporarily shrinks prostate
  • will return to original size if medication stopped
36
Q

Chronic bacterial prostatis duration

A

> 6 months

37
Q

Organisms that cause chronic bacterial prostatitis

A
  • E.coli

- proteus

38
Q

Chronic bacterial prostatitis presentation

A
  • elderly
  • several weeks of suprapubic or perineal discomfort
  • dysuria
  • nocturia
  • frequency
  • no systemic symptoms
39
Q

Chronic bacterial prostatitis treatment

A

-Bactrim 4-6 weeks

40
Q

Screening tool for BPH severity

A

American Urologic Assessment Prostate Symptom Score

41
Q

Duration of treatment needed to see 5alpha reductase effects

A

6-12 months

42
Q

Which BPH medication works the fastest

A

-alpha adrenergic antagonists

43
Q

PDE-5 inhibitor for BPH

A

Tadalafil (Cialis)

44
Q

Patient education for alpha-adrenergic antagonists

A
  • take at bedtime
  • orthostatic hypotension
  • may feel lightheaded in am
45
Q

Acute prostatitis presentation

A

-fever
-chills
pain at tip of penis
-enlarged, boggy, tender prostate
-urinary symptoms
-pain with BM
-elevated PSA

46
Q

Acute prostatitis management

A

-urine dip with C&S

47
Q

Acute prostatitis treatment

A
  • Bactrim, cipro, levofloxacin for 6 weeks
  • if <35, consider STD’s
  • stool softeners
  • fluids
  • if symptoms do not improve in 2-3 days, refer to urologist
48
Q

When should prostate cancer screening conversations begin

A

age 40-45

-screen if at least 10 year life expectancy with PSA alone

49
Q

PSA value that rules out prostate CA

A

none

50
Q

Which medication can alter PSA levels

A

5-alpha reductase inhibitors

51
Q

When to consider urology referral with BPH

A
  • PSA >4
  • rise in PSA while on 5-alpha reductase inhibitor
  • abnormal DRE
52
Q

Acute prostatitis labs

A
  • leukocytosis with left shift (bandemia)

- UA: pyuria, hematuria

53
Q

SSRI with highest risk of ED

A

paroxetine (Paxil)

54
Q

Acute bacterial epididymitis affects which groups

A
  • <35 more likely to be infected with STI

- >35: usually E.coli

55
Q

Acute bacterial epididymitis presentation

A
  • swollen red scrotum
  • tenderness
  • urethral discharge
  • induration of posterior epididymitis
  • UTI symptoms
  • possible fever
  • positive Prehn’s sign
56
Q

Positive Phren sign

A
  • relief of pain with scrotal elevation

- indicates epididymitis vs. testicular torsion

57
Q

Acute bacterial epididymitis treatment

A
  • <35: doxycycline PO x 10 days plus ceftriaxone IM
  • > 35: ofloxacin (Floxin) or levofloxacin x 7-10 days
  • scrotal elevation and ice packs
  • stool softeners if constipated
  • ED if septic or severe pain
58
Q

Erectile dysfunction causes

A
  • vascular insufficiency
  • neuropathy
  • medications
  • smoking
  • alcohol
  • hypogonadism
59
Q

First line treatment for ED

A
  • PDE-5 inhibitors
  • Take Viagra on empty stomach for optimal effectiveness
  • 30-60 minutes before sex
  • Tadalafil can be take for combined BPH and ED
60
Q

PDE-5 inhibitor contraindications

A
  • concomitant nitrates
  • alpha blockers
  • recent MI
  • post-cerebrovascular accident
  • major surgery
  • any condition in which exertion is contraindicated
61
Q

Can a hydrocele be present with testicular CA

A

yes

62
Q

Conditions with acute scrotum

A
  • epididymitits

- testicular torsion

63
Q

Acute onset of testicular pain with negative cremasteric reflex

A

-testicular torsion

64
Q

Acute or chronic testicular pain with positive cremasteric reflex

A

-epididymitis

65
Q

Etiology of noninfectious epididymitis

A
  • relfux of urine
  • prolonged sitting
  • underlying congenital defect
66
Q

Management of noninfectious testicular pain

A
  • conservative treatment
  • scrotal support
  • NSAIDs/tylenol
67
Q

Gradual onset of ED indicates what

A

organic disease

68
Q

Hydrocele is common in..

A
  • newborns, usually disappears by age 1

- older boys and adults due to inflam or injury

69
Q

Nonpainful hydrocele diff dx

A
  • spermatocele
  • varicocele
  • hematocele
  • inguinal hernia
  • testicular tumor
70
Q

Painful hydrocele diff dx

A
  • infection
  • epididymo–orchitis
  • hematoma
  • testicular torsion
  • trauma
  • thrombosis
71
Q

Varicocele

A

-enlargement of veins within scrotum

72
Q

Varicocele risks

A
  • low sperm production
  • decreased sperm quality
  • infertility
73
Q

Varicocele treatment

A
  • pain killers

- surgery

74
Q

Peyronie’s disease

A
  • inflammatory disorder of penis
  • fibrotic plaques on tunica albuginea
  • penile pain primarily during erection
  • palpable nodules and penile deformity (crooked erections)
  • may resolve spontaneously
  • surgical correction if needed
75
Q

Balanitis

A

-candidal infection of glans

76
Q

Balanitis is more common in

A

-uncircumcised
-diabetic
-IC
use of SGLT2 inhibitors

77
Q

Balanitis treatment

A
  • topical OTC azoles

- treat partner if they also have symptoms

78
Q

Phimosis

A

foreskin unretractable due to edema

79
Q

Varicocele also called

A

bag of worms

80
Q

New onset varicocele can indicate what

A

testicular tumor

mass that is impeding venous drainage

81
Q

Where does fluid collect in hydrocele

A

-tunica vaginalis

82
Q

Treatment for adult with enlargin or new onest hydrocele

A

US and urology referral

83
Q

PSA level when patient is on Finasteride

A

multiple PSA by 2

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