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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
Q

common cause of urethritis

A

Chlamydia trachomatis, Neisseria gonorrhoeae, Trichomonas vaginalis, and Mycoplasma genitalium

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26
Q

repeat testing urethritis

A

3 months after treatment because of a high rate of reinfection

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27
Q

test of cure urethritis

A

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.

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28
Q

What pear-shaped protozoan has four flagella at its anterior end and can be seen on urine microscopy?

A

Trichomonas vaginalis

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29
Q

Acute uncomplicated cystitis

A

bacterial infection of the bladder and is much more common in women than in men due to the shorter length of the female urethra

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30
Q

sx acute uncomplicated cystitis

A

dysuria, frequent urination, lower abdominal pain, and urgency
may have gross hematuria

31
Q

dx acute uncomplicated cystitis

A

leukocytes, nitrites, and blood on urine dipstick.

32
Q

tx acute uncomplicated cystitis

A

sulfamethoxazole-trimethoprim twice daily for 3 days or nitrofurantoin 100 mg twice daily for 5 days

33
Q

glomerulonephritis

A

hematuria, mild proteinuria, and red blood cell casts secondary to glomerular inflammation

34
Q

Glomerulonephritis with proteinuria of 1–3.5 g/day is categorized as

A

nephritic syndrome

35
Q

nephritic syndromes

A

poststreptococcal glomerulonephritis, IgA nephropathy, Alport syndrome, membranoproliferative glomerulonephritis, and rapidly progressive glomerulonephritis (e.g., Goodpasture syndrome, microscopic polyangiitis, granulomatosis with polyangiitis)

36
Q

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

A

hernia

37
Q

most common site for a hernia

A

abdomen

38
Q

most common type of hernia

A

inguinal hernia

39
Q

indirect inguinal hernia

A

occurs through the deep inguinal ring, which is lateral to the inferior epigastric artery

40
Q

direct inguinal hernia

A

protrudes through the weakened posterior wall of the inguinal canal, which is medial to the epigastric artery

41
Q

RF hernia

A

previous hernia, male sex, chronic cough, chronic constipation, abdominal wall injury or surgery, older age, and smoking

42
Q

imaging hernia

A

When imaging is needed to clarify the diagnosis, ultrasound is the most appropriate initial modality

43
Q

definitive tx hernia

A

surgery

44
Q

which type of inguinal hernia is MC

A

indirect

45
Q

urease producing bacteria MC

A

proteus mirabilis

46
Q

what can urease producing bacteria cause

A

magnesium ammonium phosphate crystals –> nephrolithiasis secondary to struvite stones

47
Q

preferred diagnostic test for nephrolithiasis

A

Noncontrast CT of abdomen and pelvis
US preferred in pregnant pts

48
Q

Kidney stones are most commonly formed from

A

calcium oxalate

49
Q

Other types of stone composition

A

calcium phosphate, uric acid, struvite, and cysteine

50
Q

Struvite stones are associated with urinary tract infections secondary to

A

Proteus and Klebsiella species

51
Q

sx nephrolithiasis

A

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
Q

UA nephrolithiasis

A

hematuria

53
Q

stones that are what size will not pass spontaneously

A

> 5 mm

54
Q

what med can be given to facilitate expulsion of stone

A

Tamsulosin

55
Q

Prostatitis MC caused by

A

E coli

56
Q

sx prostatitis

A

fever, irritative voiding symptoms, and perineal, sacral, or suprapubic pain. Urinary retention may also be present

57
Q

DRE prostatitis

A

warm, edematous, exquisitely tender prostate

58
Q

what should be removed in pt w prostatitis

A

indwelling catheter

59
Q

tx prostatitis

A

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
Q

what is present on UA for pyelo

A

pyuria (pus in pee)
WBC casts

61
Q

Outpatient therapy pyelo

A

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
Q

inpatient tx pyelo

A

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
Q

failure to respond to therapy within what amount of hours warrants imaging in pyelo

A

48 hours

64
Q

MC neoplasm in men btwn 15 and 35 yo

A

testicular CA

65
Q

MC type of testicular CA tumor

A

germ cell tumors

66
Q

Major RF for testicular CA

A

cryptorchidism

67
Q

sx of testicular CA

A

painless enlargement of the testis or sensation of heaviness

68
Q

PE testicular CA

A

nontender, discrete mass or diffuse testicular enlargement

69
Q

sx of testicular CA that indicate metastatic dz

A

lower extremity edema (vena cava obstruction), back pain (retroperitoneal metastases), and cough (pulmonary metastases)

70
Q

labs associated w testicular CA

A

elevations in human chorionic gonadotropin, alpha-fetoprotein, and lactate dehydrogenase

71
Q

definitive dx testicular CA

A

inguinal orchiectomy

72
Q

MC cause orchitis

A

viral - mumps (paramyxovirus)

73
Q

gram stain Neisseria gonorrhoeae

A

gram negative intracellular diplococci

74
Q

gram stain chlamydia

A

> /= 2 WBCs/hpf and no organisms seen in suggestive of nongonococcal urethritis

EOR Family med (25 decks)

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