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Repro med test 2 > The Dick > Flashcards

The Dick Flashcards

1
Q

Balanitis:

A

Inflammation of glans penis

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2
Q

Posthitis:

A

inflammation of penile foreskin

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3
Q

Balanitis/Posthitis etiology

A

typically monilial (yeast; usually in poorly controlled DM)

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4
Q

Balanitis/Posthitis presentation:

A

glossy flat lesions of penis/foreskin; blotchy erythema; penile adhesions; smegma; phimosis
-usually can’t retract foreskin so don’t try!!!

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5
Q

Balanitis/Posthitis work-up:

A

visual inspection; ?HgbA1c, ?STI testing

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6
Q

Balanitis/Posthitis tx:

A

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

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7
Q

Phimosis:

A

inability to retract foreskin

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8
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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9
Q

Phimosis presentation:

A

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

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10
Q

Phimosis work-up:

A

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

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11
Q

Phimosis Tx:

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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12
Q

Paraphimosis:

A

-Foreskin is stuck in retracted position, cannot be reduced

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13
Q

paraphimosis etiology:

A

Iatrogenic – frequent feature of poor catheter care

Tight phimosis with retraction of prepuce

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14
Q

Paraphimosis presentation

A

Edema, redness, pain
Glans can potentially be compromised
Need to ask patient, family, caregiver: “Circumcised?”
if they’re cicumcised they can’t have this!!!!

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15
Q

paraphimosis tx:

A 
Manual compression/reduction of edematous tissue
Dorsal slit (incise the foreskin in the OR)
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16
Q

Urethritis:

A

inflammation of the urethra

17
Q

urethritis etiology:

A

STI, usually gonococcal or chlamydial

18
Q

urethritis presentation:

A

diffuse purulent d/c w/ dysuria

19
Q

urethritis work-up

A

urine probes, swabs

20
Q

urethritis tx:

A

treat as if for both G&C

Ceftriaxone/Cipro + Azithro/Doxy

21
Q

ED

A

-inability to obtain or maintain an erection

22
Q

ED etiology:

A

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

RFs: DM, HTN, CAD, hyperlipidemia, smoking; surgery (radical prostatectomy); pelvic XRT

Exacerbated by hormonal milieu (low testosterone)

Up to 20% of patients with undiagnosed vascular disease will present with ED

23
Q

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

24
Q

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)

25
Q

penile condyloma:

A

warts

-HPV related

26
Q

penile condyloma presentation:

A

bulky, solitary/multiple
Can be superinfected
Check anus

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:

A
  • rare
  • associated with HPV
  • rare in circumcised men because its squamous skin cancer
30
Q

penis ca presentation:

A

Condylomata, penile swelling, balanitis, phimosis

31
Q

penis ca tx:

A

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

32
Q

Penis ca prognosis

A

stage-dependent

33
Q

penis ca prevention

A

Prevention: ?circ ; HPV vaccine

34
Q

Urethral strictures:

A 
Congenital
Iatrogenic
Treatment:
-Dilation
-Internal urethrotomy
-Urethroplasty
35
Q

Priapism

A

Idiopathic
Systemic disease- sickle cell, system cancers lymphomas
Trauma- from venous blood flow
Medications-trasadone,

36
Q

Peyronies dz:

A

Plaque deposition in tunica albugenia

Repro med test 2 (7 decks)

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