Mens Health

Question 1

BPH >4.0 do what?
BPH > 10?

Answer 1

> 4.0 refer
10 need biopsy

Question 2

What is Phren’s Sign? When is it positive?

Answer 2

Pain relief with lifting of the testicle
Positive in Epididymitis

Question 3

What is cremasteric reflex?

Absent in what?

Answer 3

Stroke/pinch inner thigh and testicle elevated (normal)

Absent in testicular torsion

You want the testicle to elevate normally (positive cremasteric)

Question 4

Most common pathogen in prostatitis?

Answer 4

E. Coli

Question 5

Chronic Prostatitis
Symptoms? Is the prostate tender?
Treatment?

Answer 5

Urinary symptoms, pain with ejaculation, lower back pain/perineal pain
NO
Cipro

Question 6

Risk factors for Prostate CA (4)

Answer 6

Age > 66
AA
Family hx
BRCA1/2

Question 7

What does testicular mass feel like in testicular CA?

Answer 7

Like a little BB that doesn’t transilluminate

Question 8

How to diagnose testicular CA?

Answer 8

Scrotal US to identify mass, then refer the patient for tumor markers

Biopsy before removal not recommended d/t risk of mets

Question 9

Where there are no results for chlamydia or gonorrhea, what do you do?

Answer 9

Treat both

Question 10

How to diagnose varicocele? Do these affect fertility?

Answer 10

US or physical exam
Yes d/t decreased sperm count

Question 11

Symptoms in balanitis

Answer 11

Curd-like discharge
Itching
Redness
Shallow ulcers
Pain, especially with foreskin retraction

Question 12

How to treat balanitis?

Answer 12

Topical anti-fungals, be sure to assess DM management

Question 13

Common meds that cause ED

Answer 13

SSRI
Antipsychotics
Beta blockers
Thiazides

ETOH and smoking

Question 14

What do you need before starting PDE-5 inhibitors?
(2 main things)

Answer 14

EKG, fasting total testosterone
(if testosterone is low, viagra won’t work)

CBC, CMP, LFTs, A1C

Question 15

PDE-5 inhibitors (Cialis) contraindicated with what?

Answer 15

Nitrates, multiple myeloma, pigmentary retinopathy

Question 16

What is priapism? tx?

Answer 16

Painful erection > 4 hours
Refer to ED to prevent ischemia

Question 17

Risk factors for priapism? (2)

Answer 17

Sickle cell
ED meds

Question 18

Most common cause of epididymitis < 35? >35?

Answer 18

• < 35: Chlamydia and Trachomatis
• > 35: E. Coli

Question 19

Symptoms of mumps orchitis?

Answer 19

Fever
Testicle/scrotal pain
Redness
Edema

Question 20

Risk factors for mumps orchitis?
Tx?

Answer 20

• Living in crowded environments, not vaccinated
• Tx: NSAIDs, ice packs

Question 21

Classic presentation of epididymitis? (4)

Key distinguishing factor?

Answer 21

Posterior scrotal pain
Swelling
Dysuria
Urinary frequency

Positive Phren’s test

Question 22

Epididymitis diagnostics?

Answer 22

UA

Question 23

What diagnostic test is used for chlamydia? LT affects M/F?

Answer 23

• Nucleic acid amplification test
• PID females, sterility in males

Question 24

Treatment of Chlamydia dosing? 1st and 2nd

Answer 24

• 1. Doxy 100mg BID x 7 days
• 2. Azithromycin 1g PO once

Question 25

Paraphimosis
What it is?
Tx?

Answer 25

Swollen glans -> can’t return foreskin
Refer to ED d/t ischemia

Question 26

Crytorchidism

Answer 26

Testicle doesn’t descend by 4mo
Usually corrected in infancy