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repo med tes 2 > PENIS!!!!! > Flashcards

PENIS!!!!! Flashcards

1
Q

Balanitis/Posthitis Etiology –

A

typically monilial (yeast; usually in poorly controlled DM)

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2
Q

Balanitis/Posthitis Work-up –

A

visual inspection;
HgbA1c,
STI testing

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3
Q

Balanitis/Posthitis Treatment –

A

lotrimin +/- limited course of mild topical steroid; control DM; hygiene

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4
Q

inability to retract foreskin

A

Phimosis

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5
Q

Phimosis etiology

A

Physiologic: normal to age 4

Pathologic: usually feature of poor DM control in adult with monilial (yeast) posthitis; rarely traumatic

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6
Q

Phimosis presentation

A

penile pain; fissuring of foreskin; deflection with erection; associated UTI; associated urinary retention

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7
Q

Phimosis work up

A

good exam; urine C&S;
urinary residual;
HgbA1c

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8
Q

Phimosis treatment

A

Child: expectant until age 4, then topical steroid
If refractory, refer for consideration of circumcision
Adult: Nystatin +/- topical steroid ( Mycolog)

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9
Q

foreskin is stuck in retracted position, cannot be reduced

A

Paraphimosis

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10
Q

Paraphimosis etiology

A

Iatrogenic – frequent feature of poor catheter care

Tight phimosis with retraction of prepuce

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11
Q

Paraphimosis presentation

A

Edema, redness, pain
Glans can potentially be compromised
Need to ask patient, family, caregiver: “Circumcised?”

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12
Q

Paraphimosis tx

A 
Manual compression/reduction of edematous tissue
Dorsal slit (incise the foreskin in the OR)
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13
Q

inflammation of the urethra

A

Urethritis

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14
Q

Urethritis Etiology

A

STI (usually gonococcal, chlamydial)

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15
Q

Urethritis Presentation

A

diffuse purulent d/c with dysuria

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16
Q

Urethritis Work-up

A

urine probes, swabs

17
Q

Urethritis Treatment

A

treat as if for both G&C

Ceftriaxone/Cipro + Azithro/Doxy

18
Q

inability to obtain/maintain erection

A

Erectile Dysfunction (ED)

19
Q

Erectile Dysfunction (ED) etiology

A

Vasculogenic (poor arterial inflow; veno-occlusive etiologies), neurogenic, medication adverse effect (psychotropics, antihypertensives), hormonal, psychogenic

20
Q

Erectile Dysfunction (ED) risk factors

A

Up to 20% of patients with undiagnosed vascular disease will present with ED
DM, HTN, CAD, hyperlipidemia, smoking; surgery (radical prostatectomy); pelvic XRT

21
Q

Erectile Dysfunction (ED) made worse by

A

hormonal milieu (low testosterone)

22
Q

Erectile Dysfunction (ED) work up

A

Careful history (?maintain/attain; ?ejaculate; penile pain/curvature; ?partner satisfaction; ?stressors)
Blood pressure; genital exam
Total and free testosterone, fasting lipid panel

23
Q

Erectile Dysfunction (ED) tx

A

relax cavernosal smooth muscle

Pills – PDE inhibitors (Viagra, Levitra, Cialis)
Injectable PGE1 (Caverject)
Penile PGE1 suppository (MUSE)
Vacuum erectile device
Surgery (prosthetics – rigid or inflatable)

24
Q

penili wartz =

A

Penile Condyloma

25
Q

Penile Condyloma etiology

A

HPV-related

26
Q

Penile Condyloma presentation

A

bulky, solitary/multiple
Can be superinfected
Check anus
(may i check your anus please)

27
Q

Penile Condyloma diagnosis

A

largely clinical

Biopsy if atypical features (large, pigmentation, induration), refractory to treatment, immunocompromised, etc.

28
Q

Penile Condyloma tx

A

Lesions:
Chemical/physical destruction: podofilox, cryotherapy
Immuno: Veregen, imiquimod (cytokine induction)
Surgical excision, laser ablation (CO2, Holmium)

Counseling: chronicity of the disease (no cure), partner notification, condoms can decrease (but not eliminate) risk, can be associated with other STIs

29
Q

Penile Cancer epidemiology

A

rare

30
Q

Penile Cancer etiology

A

Associated HPV (16, 18, 31, 33), rare in circumcised men, it’s a skin cancer (squamous)

31
Q

Penile Cancer presentation

A

Condylomata, penile swelling, balanitis, phimosis

32
Q

Penile Cancer tx

A

surgical
Circumcision, partial penectomy, radical penectomy with urinary diversion (perineal urethrostomy) and lymph node dissection

33
Q

Penile Cancer prognosis

A

stage-dependent

34
Q

Penile Cancer prevention

A

?circumcision ; HPV vaccine

35
Q

Urethral Strictures

A

Congenital

Iatrogenic

36
Q

Urethral Strictures tx

A

Dilation
Internal urethrotomy
Urethroplasty

37
Q

Priapism cause and tx

A

Idiopathic
Systemic disease
Trauma
Medications

repo med tes 2 (3 decks)

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