Mens Health Flashcards
BPH >4.0 do what?
BPH > 10?
> 4.0 refer
10 need biopsy
What is Phren’s Sign? When is it positive?
Pain relief with lifting of the testicle
Positive in Epididymitis
What is cremasteric reflex?
Absent in what?
Stroke/pinch inner thigh and testicle elevated (normal)
Absent in testicular torsion
You want the testicle to elevate normally (positive cremasteric)
Most common pathogen in prostatitis?
E. Coli
Chronic Prostatitis
Symptoms? Is the prostate tender?
Treatment?
Urinary symptoms, pain with ejaculation, lower back pain/perineal pain
NO
Cipro
Risk factors for Prostate CA (4)
Age > 66
AA
Family hx
BRCA1/2
What does testicular mass feel like in testicular CA?
Like a little BB that doesn’t transilluminate
How to diagnose testicular CA?
Scrotal US to identify mass, then refer the patient for tumor markers
Biopsy before removal not recommended d/t risk of mets
Where there are no results for chlamydia or gonorrhea, what do you do?
Treat both
How to diagnose varicocele? Do these affect fertility?
US or physical exam
Yes d/t decreased sperm count
Symptoms in balanitis
Curd-like discharge
Itching
Redness
Shallow ulcers
Pain, especially with foreskin retraction
How to treat balanitis?
Topical anti-fungals, be sure to assess DM management
Common meds that cause ED
SSRI
Antipsychotics
Beta blockers
Thiazides
ETOH and smoking
What do you need before starting PDE-5 inhibitors?
(2 main things)
EKG, fasting total testosterone
(if testosterone is low, viagra won’t work)
CBC, CMP, LFTs, A1C
PDE-5 inhibitors (Cialis) contraindicated with what?
Nitrates, multiple myeloma, pigmentary retinopathy
What is priapism? tx?
Painful erection > 4 hours
Refer to ED to prevent ischemia
Risk factors for priapism? (2)
Sickle cell
ED meds
Most common cause of epididymitis < 35? >35?
- < 35: Chlamydia and Trachomatis
- > 35: E. Coli
Symptoms of mumps orchitis?
Fever
Testicle/scrotal pain
Redness
Edema
Risk factors for mumps orchitis?
Tx?
- Living in crowded environments, not vaccinated
- Tx: NSAIDs, ice packs
Classic presentation of epididymitis? (4)
Key distinguishing factor?
Posterior scrotal pain
Swelling
Dysuria
Urinary frequency
Positive Phren’s test
Epididymitis diagnostics?
UA
What diagnostic test is used for chlamydia? LT affects M/F?
- Nucleic acid amplification test
- PID females, sterility in males
Treatment of Chlamydia dosing? 1st and 2nd
- Doxy 100mg BID x 7 days
- Azithromycin 1g PO once
Paraphimosis
What it is?
Tx?
Swollen glans -> can’t return foreskin
Refer to ED d/t ischemia
Crytorchidism
Testicle doesn’t descend by 4mo
Usually corrected in infancy
