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EOR Family med > Urology > Flashcards

Urology Flashcards

1
Q

Balanitis

A

glans penis becomes inflamed

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2
Q

in what population is balanitis MC

A

uncircumsized men

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3
Q

most common cause of balanitis

A

Candidal infections

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4
Q

sx balanitis

A

pain, tenderness, or pruritus of the glans penis

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5
Q

PE balanitis

A

candidal balanitis: white, cottage cheese-like exudate on the glans penis
Bacterial balanitis: thick, foul-smelling purulent exudate
Circinate balanitis: associated with reactive arthritis and will present with shallow ulcers on the glans

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6
Q

tx candidal balanitis

A

topical imidazole (e.g., clotrimazole, miconazole), nystatin cream, or oral fluconazole

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7
Q

tx bacterial balanitis

A

topical metronidazole, oral amoxicillin-clavulanate, or clindamycin topical cream if an anaerobe is suspected

Mupirocin cream, oral dicloxacillin, or oral cephalexin may be used if streptococcal or staphylococcal infection is suspected

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8
Q

Benign prostatic hyperplasia (BPH)

A

proliferation of the fibrostromal tissues of the prostate that results in prostatic urethral compression and urinary outlet obstruction

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9
Q

most common benign tumor in men

A

BPH

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10
Q

obstructive BPH sx

A

hesitancy, decreased force/caliber of urine, postvoid dribbling, a sensation of incomplete emptying, double voiding, straining to urinate

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11
Q

irritative BPH sx

A

dysuria, frequency, urgency, nocturia

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12
Q

DRE BPH

A

smooth, firm, elastic enlargement of the prostate

If the induration of the prostate is palpated, prostate cancer should be excluded by further testing

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13
Q

medical therapy for BPH

A

using alpha-blockers, 5-alpha-reductase inhibitors, phosphodiesterase-5 inhibitors, combination therapy, phytotherapy

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14
Q

Alpha-1 adrenergic antagonists for BPH

A
  • Terazosin
  • Doxazosin
  • Tamsulosin
  • Alfuzosin
  • Silodosin
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15
Q

5-alpha reductase inhibitors for BPH

A
  • Finasteride
  • Dutasteride
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16
Q

Anticholinergic agents for BPH

A
  • Tolterodine
  • Oxybutynin
  • Darifenacin
  • Solifenacin
  • Fesoterodine
  • Trospium
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17
Q

Phosphodiesterase type 5 inhibitors for BPH

A
  • Tadalafil
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18
Q

MC cause of epididymitis in a patient younger than 35 years

A

chlamydia

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19
Q

most common cause of scrotal pain

A

epididymitis

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20
Q

sx epididymitis

A

painful, swollen scrotum
frequency, urgency, and dysuria,

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21
Q

PE epididymitis

A

tenderness to palpation over the superior-posterior aspect of the testicle where the epididymis is located
erythematous scrotum
positive prehn sign
intact cremasteric reflex

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22
Q

dx epididymitis

A

urine culture
UA
urine nucleic acid amplification testing

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23
Q

tx epididymitis for patients under the age of 35 and patients who are at increased risk of STIs

A

ceftriaxone 500 mg intramuscular injection for one dose and doxycycline 100 mg orally twice daily for 10 days

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24
Q

tx epididymitis for pts 35 years of age and older and patients who are at low risk of STIs

A

levofloxacin 500 mg orally once daily for 10 days

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25
common cause of urethritis
Chlamydia trachomatis, Neisseria gonorrhoeae, Trichomonas vaginalis, and Mycoplasma genitalium
26
repeat testing urethritis
3 months after treatment because of a high rate of reinfection
27
test of cure urethritis
3 weeks after treatment is completed is only indicated in patients who are pregnant, have persistent symptoms, or receive an antibiotic regimen with inferior cure rates.
28
What pear-shaped protozoan has four flagella at its anterior end and can be seen on urine microscopy?
Trichomonas vaginalis
29
Acute uncomplicated cystitis
bacterial infection of the bladder and is much more common in women than in men due to the shorter length of the female urethra
30
sx acute uncomplicated cystitis
dysuria, frequent urination, lower abdominal pain, and urgency may have gross hematuria
31
dx acute uncomplicated cystitis
leukocytes, nitrites, and blood on urine dipstick.
32
tx acute uncomplicated cystitis
sulfamethoxazole-trimethoprim twice daily for 3 days or nitrofurantoin 100 mg twice daily for 5 days
33
glomerulonephritis
hematuria, mild proteinuria, and red blood cell casts secondary to glomerular inflammation
34
Glomerulonephritis with proteinuria of 1–3.5 g/day is categorized as
nephritic syndrome
35
nephritic syndromes
poststreptococcal glomerulonephritis, IgA nephropathy, Alport syndrome, membranoproliferative glomerulonephritis, and rapidly progressive glomerulonephritis (e.g., Goodpasture syndrome, microscopic polyangiitis, granulomatosis with polyangiitis)
36
protrusion or bulge of an organ, part of an organ, or tissue through an opening in the anatomical structure that is supposed to hold it in
hernia
37
most common site for a hernia
abdomen
38
most common type of hernia
inguinal hernia
39
indirect inguinal hernia
occurs through the deep inguinal ring, which is lateral to the inferior epigastric artery
40
direct inguinal hernia
protrudes through the weakened posterior wall of the inguinal canal, which is medial to the epigastric artery
41
RF hernia
previous hernia, male sex, chronic cough, chronic constipation, abdominal wall injury or surgery, older age, and smoking
42
imaging hernia
When imaging is needed to clarify the diagnosis, ultrasound is the most appropriate initial modality
43
definitive tx hernia
surgery
44
which type of inguinal hernia is MC
indirect
45
urease producing bacteria MC
proteus mirabilis
46
what can urease producing bacteria cause
magnesium ammonium phosphate crystals --> nephrolithiasis secondary to struvite stones
47
preferred diagnostic test for nephrolithiasis
Noncontrast CT of abdomen and pelvis US preferred in pregnant pts
48
Kidney stones are most commonly formed from
calcium oxalate
49
Other types of stone composition
calcium phosphate, uric acid, struvite, and cysteine
50
Struvite stones are associated with urinary tract infections secondary to
Proteus and Klebsiella species
51
sx nephrolithiasis
paroxysms of severe flank pain, pain with urinating akin to “passing gravel,” or inability to urinate altogether (suggestive of an acute obstruction). Pain that radiates to the groin is suggestive of a stone in the lower ureter. Other associated symptoms include hematuria, nausea, and vomiting.
52
UA nephrolithiasis
hematuria
53
stones that are what size will not pass spontaneously
> 5 mm
54
what med can be given to facilitate expulsion of stone
Tamsulosin
55
Prostatitis MC caused by
E coli
56
sx prostatitis
fever, irritative voiding symptoms, and perineal, sacral, or suprapubic pain. Urinary retention may also be present
57
DRE prostatitis
warm, edematous, exquisitely tender prostate
58
what should be removed in pt w prostatitis
indwelling catheter
59
tx prostatitis
intravenous administration of ampicillin and an aminoglycoside (e.g., gentamicin) in hospital Patients who are afebrile for 48 hours may be transitioned to a 6-week course of oral antibiotics (e.g., trimethoprim-sulfamethoxazole, ciprofloxacin).
60
what is present on UA for pyelo
pyuria (pus in pee) WBC casts
61
Outpatient therapy pyelo
ceftriaxone 1 g intramuscular with the addition of trimethoprim-sulfamethoxazole, amoxicillin-clavulanate, a cephalosporin, or a fluoroquinolone, all of which can be given orally for 10–14 days (with the exception of the fluoroquinolones, which are given for 5–7 days).
62
inpatient tx pyelo
antipseudomonal carbapenem (imipenem, meropenem, doripenem) and vancomycin may be used for patients with critical illness, urinary tract obstruction, and high risk of multidrug-resistant organisms. For patients with no risk factors for multidrug-resistant organisms, ceftriaxone or piperacillin-tazobactam is used.
63
failure to respond to therapy within what amount of hours warrants imaging in pyelo
48 hours
64
MC neoplasm in men btwn 15 and 35 yo
testicular CA
65
MC type of testicular CA tumor
germ cell tumors
66
Major RF for testicular CA
cryptorchidism
67
sx of testicular CA
painless enlargement of the testis or sensation of heaviness
68
PE testicular CA
nontender, discrete mass or diffuse testicular enlargement
69
sx of testicular CA that indicate metastatic dz
lower extremity edema (vena cava obstruction), back pain (retroperitoneal metastases), and cough (pulmonary metastases)
70
labs associated w testicular CA
elevations in human chorionic gonadotropin, alpha-fetoprotein, and lactate dehydrogenase
71
definitive dx testicular CA
inguinal orchiectomy
72
MC cause orchitis
viral - mumps (paramyxovirus)
73
gram stain Neisseria gonorrhoeae
gram negative intracellular diplococci
74
gram stain chlamydia
>/= 2 WBCs/hpf and no organisms seen in suggestive of nongonococcal urethritis

EOR Family med (25 decks)

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