Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Clin Med III > testicular torsion and GU infections > Flashcards

testicular torsion and GU infections Flashcards

1
Q

testicular torsion

A
  • urologic emergency
  • more common in neonates and postpubertal boys
  • irreversible damage after 12 hours, may result in infertility of both testes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

causes of testicular torsion

A
  • can occur spontaneously or after inciting damage
  • inadequate fixation of lower testes to tunica vaginalis
  • bell clapper deformity- testes lay horizontally
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

clinical manifestations of testicular torsion

A
  • mod- severe testicular pain
  • swelling
  • no cremasteric reflex
  • n/v
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

diagnosis of testicular torsion

A
  • H&P

- US with doppler flow- no arterial flow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

management of testicular torsion

A
  • manual detorsion- usu not successful

- detorsion surgery with gubernacular fixation to both sides

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

acute bacterial prostatitis

A
  • make up very small % of prostatitis
  • usu young an middle aged men
  • route of infection- ascend up urethra
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what are the most common pathogens in acute bacterial prostatitis

A
  • e coli

- pseudomonas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

risk factors for acute bacterial prostatitis

A
  • urogenital tract infections
  • prostate biopsy
  • instrumentation
  • structural abnormalities
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

clinical presentation of acute bacterial prostatitis

A
  • pt will look very ill
  • fever
  • dysuria
  • perineal, suprapubic and back pain
  • may have obstructive sx
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

PE for acute bacterial prostatitis

A
  • generalized pelvic tenderness
  • DRE -> exquisite pain
  • prostate is tender, edematous, warm
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

lab findings for acute bacterial prostatitis

A
  • leukocytosis with L shift
  • UA- pyuria, bacteriuria, hematuria
  • UC
  • elevated inflammatory markers
  • elevated PSA
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

imaging for acute bacterial prostatitis

A
  • usually none

- CT or MRI if no improvement in 48 hours- think prostatic abscess

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

indications for admission in acute bacterial prostatitis

A
  • signs of sepsis
  • cant tolerate PO abx
  • multiple comorbodities
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

treatment for acute bacterial prostatitis

A
  • empiric abx until culture results
  • cipro, levo
  • bactrim
  • gentamycin
  • abx X 4-6 weeks
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

chronic bacterial prostatitis

A
  • chronic or recurrent urogenital sx with evidence of infection of prostate
  • inadequate or too short tx for acute
  • common in young and middle aged men
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

risk factors for chronic bacterial prostatitis

A
  • acute episodes of bacterial prostatitis
  • prostate stones
  • same RF as acute
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

clinical presentation of chronic bacterial prostatitis

A
  • can be very subtle
  • irritative voiding sx that dont go away
  • low grade fever
  • dull pelvic or perineal pain
  • testicular pain
  • some asymptomatic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

PE for chronic bacterial prostatitis

A
  • often unremarkable
  • prostate may feel boggy, normal or firm
  • usu prostate is non-tender
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

lab findings for chronic bacterial prostatitis

A
  • UA normal
  • expressed prostate secretions tested by urology
  • increased leukocytes and bacteria
  • culture grows offending agent
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

imaging for chronic bacterial prostatitis

A
  • usu not necessary

- may see prostate calculi on plain film

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

treatment of chronic bacterial prostatitis

A
  • bactrim- assoc with best cure rate
  • quinolones of cephalexin as alternative due to resistance
  • tx for 6-12 weeks
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

inflammatory prostatitis

A
  • most common of prostatitis
  • unknown cause
  • most common in young and middle aged men
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

clinical presentation of inflammatory prostatitis

A
  • subtle sx
  • pain in perineum, lower abd, testicles, penis
  • voiding sx
  • blood in semen
  • ED, ejaculatory pain
  • depression
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

labs for inflammatory prostatitis

A
  • UA and UC normal
  • expressed prostate secretions- done by urology
  • prostate biopsy
  • dx of exclusion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

treatment for inflammatory prostatitis

A
  • alpha blockers
  • abx
  • 5 alpha reductase inhibitors
  • usu tamsulosin + cipro X 6 weeks
  • dutasteride used in older men
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

epididymitis categories

A
  • sexually vs non-sexually transmitted
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

sexually transmitted epididymitis

A
  • most common in men < 35

- assoc with urethritis, gonorrhea, chlamydia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

non-sexually transmitted epididymitis

A
  • most common in older men

- assoc with UTI, prostatitis, e coli

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

what is the most common cause of acute onset scrotal pain in adults

A
  • epididymitis
30
Q

clinical presentation of epididymitis

A
  • unilateral pain
  • fever
  • scrotal swelling
  • pain radiates to flank
  • urethral d/c
  • dysuria
  • normal cremasteric reflex
31
Q

labs/imaging for epididymitis

A
  • UA, UC
  • urine for GC/ chlamydia
  • scrotal US
32
Q

treatment for epididymitis

A
  • bed rest
  • scrotal elevation
  • ice
  • if non-sexual- levoflox
  • if GC/chlamydia- doxy, ceftriaxone, azithromycin
33
Q

orchitis

A
  • acute inflammatory reaction of testes d/t infection
  • usu assoc with mumps
  • 70% of time unilateral
  • assoc with parotitis which presents 4-7 days prior
34
Q

clinical presentation of orchitis

A
  • fever
  • malaise
  • myalgias
  • swollen red testicle
  • rarely bilat
35
Q

diagnosis of orchitis

A
  • usually clinical

- may get scrotal US

36
Q

treatment for orchitis

A
  • supportive- mainly viral cause
  • scrotal elevation
  • NSAIDs
  • ice
37
Q

urethritis

A
  • inflammation of urethra
  • common manifestation of STI in men
  • usu young sexually active men
  • classified as gonococcal or non-gonococcal
  • common coinfection with chlamydia
38
Q

pathogens that cause urethritis

A
  • n gonorrhea
  • c trachomatis
  • m genitalium
  • trichomonas vaginalis
  • treponema pallidum
39
Q

clinical manifestations of urethritis

A
  • dysuria
  • pruritis and burning at urethral meatus
  • discharge- if purulent likely gonorrhea, if watery likely chlamydia
  • may be asymptomatic
40
Q

PE for urethritis

A
  • anxious
  • inguinal LAD
  • meatus may be red and tender
  • prurulent brown/ greenish penile d/c
  • white watery d/c
41
Q

labs for urethritis

A
  • UA
  • first catch urine without cleansing
  • pos for leukocytes
  • > 10 WBCs
  • can do genital swabs
42
Q

treatment for urethritis

A
  • usu treat sexually active men for gonorrhea and chlamydia
  • chlamydia- azithromycin
  • gonorrhea- ceftiraxone IM
  • treat partners within last 60 days
43
Q

cystitis

A
  • infection of bladder
  • lower UTI infection
  • colonization of vaginal introitus or urethral meatus
  • usu GN bacteria
44
Q

common pathogens that cause cystitis

A
  • e coli*
  • enterobacteriaecea
  • klebsiella pneumonia
  • proteus
45
Q

what bacteria can you assume are contaminants when testing for cystitis

A
  • lactobacilli
  • group B strep
  • enterococci
  • coag neg staph
46
Q

clinical manifestations of cystitis

A
  • dysuria, frequency, urgency
  • suprapubic pain
  • hematuria
  • older women sx more subtle- falls, confusion, change in functional status
47
Q

diagnosis of cystitis

A
  • H&P
  • UA
  • +/- HCG
  • urinalysis- look for leukocyte esterase and nitrites
  • test for gonorrhea and chlamydia in men
48
Q

management of cystitis

A
  • macrobid
  • bactrim
  • cefpodoxime (vantin)
  • cipro
  • symptomatic tx with pyridium
49
Q

risk factors for cystitis in women

A
  • intercourse
  • hx of UTI
  • spermicide coated condoms
  • diaphragms
  • urinary tract abnormalities
50
Q

risk factors for cystitis in men

A
  • anal intercourse

- uncircumcised

51
Q

pyelonephritis

A
  • infection of kidney
  • upper UTI, complicated
  • less common than acute cystitis
  • involves kidney parenchyma and renal pelvis
52
Q

causes of pyelonephritis

A
  • e coli*
  • klebsiella pneumonia
  • proteus
  • pseudomonas if due to health care instrumentation
53
Q

how does pyelonephritis occur

A
  • ascend to kidneys via ureters

- seeding from bacteremia

54
Q

clinical manifestations of pyelonephritis

A
  • dysuria, frequency, urgency
  • suprapubic pain
  • hematuria
  • fever, chills
  • flank pain, CVA tenderness
  • n/v
  • more systemic sx than cystitis
55
Q

diagnosis of pyelonephritis

A
  • H&P
  • UA, UC
  • CBC- elevated with L shift
  • blood cultures and lactate
  • imaging not usu necessary but may use if suspicious of stone or unsure of dx
56
Q

indications for hospitalization in pyelonephritis

A
  • sepsis
  • persistent fever
  • pain control
  • unable to maintain PO intake
  • urinary tract obstruction
  • pt adherence
57
Q

inpatient management of pyelonephritis

A
  • ceftriaxone
  • zosyn
  • cipro, levo
  • vanco for MRSA
  • imipenem- saved for critically ill pts
58
Q

outpatient management of pyelonephritis

A
  • cipro, levo

- ceftriaxone IV loading dose then PO bactrim, augmentin, or vantin

59
Q

symptomatic treatment of pyelonephritis

A
  • pyridium
  • motrin, APAP
  • anti-emetics
  • IVF
60
Q

UTI and pregnancy

A
  • considered complicated
  • commonly asymptomatic
  • incidence same as nonpregnant females but more likely to be recurrent
  • usu early in pregnancy
61
Q

risk factors for UTI in pregnancy

A
  • hx of prior UTI
  • preexisting DM
  • increased parity
  • lower SES
62
Q

diagnosis of UTI in pregnancy

A
  • requires 2 positive UC
63
Q

treatment for UTI in prengnacy

A
  • macrobid
  • augmentin
  • cefpodoxime
  • fosfomycin
  • quinolones NOT recommended
64
Q

follow up for UTI in pregnancy

A
  • 30% fail to clear asymptomatic bacteriruria after short course tx
  • f/u culture recommended
  • repeat cultures monthly until end of pregnancy
65
Q

pyelonephritis and pregnancy

A
  • considered complicated
  • usu d/t anatomic changes during pregnancy and immunosuppression
  • most in 2nd and 3rd trimester
66
Q

risks of pyelonephritis in pregnancy

A
  • obstetric complications
  • septic shock
  • anemia
  • bacteremia
67
Q

clinical manifestations of pyelonephritis in pregnancy

A
  • flank pain
  • n/v
  • fever
  • CVA tenderness
  • with or without typical sx
68
Q

diagnosis of pyelonephritis in pregnancy

A
  • H&P
  • UA, UC
  • +/- blood cultures and lactate
  • renal US considered
69
Q

management of pyelonephritis in pregnancy

A
  • based on site of care and potential complications
  • tx with beta lactams, penicillins, cephalosporins
  • quinolones NOT recommended
70
Q

asymptomatic bacteriuria

A
  • isolation of bacteria without si/sx
  • increased prevalence with age
  • most common in pregnant women
71
Q

diagnosis of asymptomatic bacteriuria

A
  • in women need 2 consecutive clean catch voided urine samples
  • in men nee one single clean catch voided urine sample
72
Q

treatment for asymptomatic bacteriuria

A
  • appropriate to treat and screen in pregnant women and pts undergoing procedures
  • renal transplant
  • use of abx same as cystitis
  • older pts often colonized- do not treat

Clin Med III (26 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions