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Clin med A 2 > trigger - penile/scrotal disorder > Flashcards

trigger - penile/scrotal disorder Flashcards

1
Q

needle aspiration of fluid +/- sclerotherapy to tunica vaginalis is the treatment for what condition?

A

hydroceles!
(high rate of recurrence with this)

reminder! Only treat if:
- communicating
- persists>12-18 mo
- acute onset
- symptomatic!

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2
Q

hydrocelectomy is treatment for what condition?

A

hydrocele! this is definitive!

reminder! Only treat if:
- communicating
- persists>12-18 mo
- acute onset
- symptomatic!

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3
Q

most surgically correctable cause of male infertility

A

varicocele

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4
Q

this condition is increased with standing and valsalva and alleviated with supine position.

A

varicoceles

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5
Q

what positions increase and decrease the presentation of varicoceles?

A
  • increased with standing and valsalva
  • may improve w supine position
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6
Q

feels like a bag of worms

A

varicoceles

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7
Q

what confirms dx of varicoceles

A

US

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8
Q

bell clapper deformity is a risk for which condition

A

testicular torsion

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9
Q

cryptorchidism is a risk factor for which conditions

A
  • testicular torsion
  • testicular tumor
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10
Q

sudden onset of severe unilateral scrotal pain and swelling

A

testicular torsion

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11
Q

which conditions present (or can present) with nausea/vomiting

A
  • testicular torsion
  • orchitis
  • testicular tumor
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12
Q

presents with lack of voiding

A
  • testicular torsion
  • priapism (emergent if present)
  • phimosis (emergent if present)
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13
Q

negative prehn’s sign

A

testicular torsion

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14
Q

positive prehn’s sign

A
  • Orchitis
  • epididymitis
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15
Q

what treatment MUST be done in testicular torsion

A

surgical detorsion and fixation of the involved testis and contralateral testis

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16
Q

a patient presents with symptms of N/V and on exam you see a swollen left testicle that is hard to palpation. The affected testicle is at the same level as the contralateral testicle and has an intact cremasteric reflex.

what is this patients TWIST score and what is his risk for testicular torsion

A

this patient has a TWIST score of 5, this puts him at high risk.

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17
Q

blue dot sign is seen in which condition

A

testicular appendage torsion

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18
Q

US shows small hyperechoic region adjacent to the testis

A

testicular appendage torsion

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19
Q

in older adults can be d/t chronic balanoposthitis from diabetes

A

phimosis

20
Q

ballooning of prepuce during urination

A

phimosis

21
Q

what is the treatment of phimosis caused by infection

A
  • fungal → topical clotrimazole or nystatin or oral fluconazole
  • Bacterial → topical bacitracin, oral metronidazole (Flagyl)
  • Cellulitis or extends to shaft → cephalexin (Keflex)
22
Q

if acute, treat with hemostat dilation, catheter, and topical steroids

A

phimosis

(called the frenar stretch)

if this doesnt work then you can surgically incise the dorsal slit

23
Q

complications of this condition includes preputial calculi and squamous cell carcinoma

A

phimosis

24
Q

a cause of this condition is plasmodium falciparum

A

paraphimosis

25
Q

“donut sign”

A

paraphimosis

26
Q

what is the treatment for phimosis

A
  • emergent urology consult for manual reduction!!!! (manual pressure on glans for 5 min to reduce edema then push glans proximally while pulling prepuce distally!)
  • refractory to manual reduction may need needle decompression, dorsal slit of foreskin, or osmotic agents.
  • circumcision after inflammation subsides!
27
Q

true or false. priapism is often associated with sexual stimulation

A

FALSE

not commonly associated with sexual stim

28
Q

MCC of priapism in children

A

sickel cell and other hematologic diseases

29
Q

what type of priapism is assocaited with physiologic obstruction of venous drainage

A

low flow!

high flow is associated with loss of penile arterial regulation

30
Q

pt presents with prolonged erection. Among penile aspiration, the blood has high O2 and low CO2. which type of priapism is this

A

HIGH flow

low flow will have low O2 and high CO2

31
Q

treated with narcotics or epidural/spinal anesthesia

A

priapism

also used:
subcutaneous terbutaline and corporal aspiration of viscous blood with irrigation

32
Q

treated with subcutaneous terbutaline

A

priapism

also used:
narcotics, epidural/spinal anesthesia and corporal aspiration of viscous blood with irrigation

33
Q

when is the winter procedure used

A

refractory priapism

creates a fistula between corpora cavernosa and spngiosum

also used in treatment: excision of tunica albuginea, cavernosa-spongiosum shunt, saphenous vein cavernous shunt.

34
Q

when would we treat with excision of tunica albuginea, cavernosa-spongiosum shunt, or saphenous vein cavernous shunt.

A

refractory priapism

also used: winter procedure

35
Q

peyronies disease causes fibrosis of what part of the penis

A

tunica albuginea

36
Q

which disease is associated with vasculitis, connective tissue disease, and DM

A

peyronie’s

also assocaited with: smoking, ETOH, hypercholesterolemia

37
Q

presents with palpable lesions on penis and inguinal LAD

A

penile cancer

38
Q

bone pain, cough, skin lesions

A

metastatic penile cancer

39
Q

can be caused by STDs, infections, or amiodarone!

A

epididymitis

40
Q

which conditions present with fever

A
  • epididymitis
  • orchitis
41
Q

prevention includes minimizing use of foley catheters

A
  • orchitis
  • epididymitis
42
Q

can be caused by viruses

A

orchitis

43
Q

when do we treat with ceftriaxone and levo

A

for men with orchitis who practice anal sex

44
Q

this is associated with DES use during pregnancy and Von Hippel-Lindau disease

A

epididymal cyst

45
Q

epididymal cyst>2cm

A

spermatocele

46
Q

risks include exogenous estrogen use during pregnancy and infertility

A

testicular tumors

also see;
fam hx
HIV
cryptorchidism (10%)

47
Q

painless enlargement of the testis is the MC symptom of what

A

testicular tumor

Clin med A 2 (30 decks)

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