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Clin Med III Exam II > Testicular Torsion, Prostate and Scrotal Infections > Flashcards

Testicular Torsion, Prostate and Scrotal Infections Flashcards

1
Q

What is testicular torsion

A

inadequate fixation of the lower pole of the testes to the tunica vaginalis

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2
Q

What are the complications of testicular torsion

A
  • ischemia–>infertility

- disruption of the immunologic blood-testis barrier

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3
Q

Clinical manifestations of testicular torsion

A
  • testicular pain
  • swelling
  • negative cremasteric reflex
  • nausea/vomiting
  • high riding testis with long axis oriented horizontally instead of longitudinally
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4
Q

Imaging done for testicular torsion

A

US with doppler

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5
Q

How do you treat testicular torsion

A
  • manual detorsion

- detorsion surgery with gubernacular fixation (bilateral)

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6
Q

What makes up seminal fluid

A
  • protein
  • fructose
  • enzymes
  • mucus
  • vit C
  • flavins
  • phosphorylcholine
  • prostaglandins
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7
Q

Is seminal fluid alkaline or acidic

A

alkaline

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8
Q

Where is the seminal vesicle

A

right below the bladder

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9
Q

Function of the vas deferens

A

propels sperm forward during ejaculation

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10
Q

What does the epididymis connect

A

the testes and the vas deferens

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11
Q

The prostate is made of what

A

smooth muscle and glandular tissue

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12
Q

What is Denovillier’s fascia

A

lies between the prostate and rectum, barrier that prevents prostate cancer from penetrating the rectum

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13
Q

What pathogens cause acute bacterial prostatitis

A
  • e coli
  • proteus
  • enterobacteria
  • psuedomonas
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14
Q

What is typically the route of infection for acute bacterial prostatitis

A

ascent up the urethera, reflex of infected urine into prostatic ducts

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15
Q

Risk factors for acute bacterial prostatitis

A
  • urogenital tract infection
  • prostate bx
  • instrumentation
  • structural abnormality
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16
Q

Common presentation of acute bacterial prostatitis

A
  • fever
  • irritate voiding symptoms
  • perineal, suprapubic, and back pain
  • may have obstructive urinary sx
17
Q

What will a DRE show for acute bacteriala prostatitis

A

tender, edematous, warm prostate

18
Q

Labs with acute bacterial prostatitis

A
  • leukocytosis with left shift
  • UA–> pyuria, bacteriuria, hematuria
  • elevated inflammatory markers
  • elevated PSA
19
Q

When is imaging done for acute bacterial prostatitis? Why? What?

A
  • if no improvement after 48 hours
  • suspect prostate abscess
  • do CT or MRI
20
Q

Treatment of acute bacterial prostatitis

A
  • cipro
  • levoflox
  • bactrim
  • gentamycin
21
Q

Risk factors for chronic bacterial prostatitis

A
  • acute episode of bacterial prostatitis

- prostate stones

22
Q

Big difference between chronic and bacterial prostatitis

A

chronic will not have tender prostate (may feel normal)

23
Q

Treatment for chronic bacterial prostatitis

A

-bactrium (preferred)

quinolones or cephalexin if resistance

24
Q

Presentation of inflammatory prostatis

A
  • perineum, lower abd, testicle/penile pain
  • voiding difficulty
  • erectile dysfunction
  • ejaculatory pain
25
Q

Treatment of inflammatory prostatitis

A
  • tamsulosin
  • cipro
  • dutasteride in older men
26
Q

What are the two categories of epididymitis

A
  • sexually transmitted (chlamydia and gonorrhea)

- non sexually transmitted (UTI and prostatitis)

27
Q

Clinical presentation of epididymitis

A
  • unilateral scrotal swelling and pain
  • radiation of pain to flank
  • urethral discharge
  • dysuria
28
Q

How to tell the difference between testicular torsion and epididymitis

A

cremasteric reflex in unaltered in epididymitis

29
Q

Treatment of epididymitis

A
  • bed rest
  • scrotal elevation
  • ice

if gonorrhea and chlamydia
-doxy, ceftriaxone, azithro

if non sexually trans
-levoflox

30
Q

Orhcitis is most commonly associated with what

A

mumps

31
Q

Clinical presentation of orchitis

A
  • fever
  • malaise
  • myalgia
  • swollen red testicle
32
Q

Treatment for orchitis

A
  • scrotal elevation
  • ice
  • NSAIDs
33
Q

What are the most common causes of urethritis

A
  • n gonorrhoeae

- c trachomatis

34
Q

Clinical presentation of urethritis

A
  • dysuria
  • pruitus and burning at urethral meatus
  • prurulent discharge (gonococcal)
35
Q

Physical exam findings with urethritis

A
  • anxious
  • inguinal LAD
  • purulent brown/green penile dischage
  • white watery discharge
  • red/tender urethral meatus
36
Q

What would the gram stain of urethral discharge of urethritis caused by chlamydia

A

PMN

37
Q

What would the gram stain of urethral discharge of urethritis caused by gonorrhea

A

intra cellular gram negative diplococci

38
Q

What is the treatment for urethritis?

A
  • NGU: azithro (one dose) or 7 days of doxy

- GU: ceftriaxone and azithro

Clin Med III Exam II (11 decks)

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