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Family Practice Nursing > Urology and Male Health > Flashcards

Urology and Male Health Flashcards

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1
Q

What is Testicular Torsion ?

A

Obstruction of blood flow to the testes due to twisting of the veins and arteries in the spermatic cord

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2
Q

What are s/s of Testicular Torsion?

A 
Sudden onset with unilateral scrotal pain
Abdominal Pain
Testis is tender
Palpation: Twisted spermatic cord
Scrotal edema & erythema
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3
Q

How is Testicular Torsion diagnosed and treated?

A

Doppler US: No blood flow sounds
on affected side
Emergency urological referral
Surgery: 80-100% blood flow re-established if within 6 hours of onset

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4
Q

What is Epididymitis ?

A

Inflammation of the epididymis

Most common intrascrotal infection

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5
Q

How is Epididymitis diagnosed and treated?

A

Urinalysis - Pyuria or bacteriuria (50%); urine culture indicated for prepubertal and elderly patients
Complete blood count (CBC) - Leukocytosis

Gram stain of urethral discharge, if present

Urethral culture, nucleic acid hybridization, and nucleic acid amplification tests (these tests aid in detection of N gonorrhoeae and C trachomatis)

Performance of (or referral for) syphilis and HIV testing in patients with a sexually transmitted etiology

US of the scrotum confirms diagnosis

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6
Q

How is Epididymitis treated (STI related)?

A

Treatment: Initial treatment consists of bed rest
with scrotal elevation, ice packs and appropriate antibiotic
Ceftriaxone 250 mg IM x one dose
Doxycycline 100 mg BID X 10 days
Azithomycin 1 gm

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7
Q

How is Epididymitis treated ( NON-STI related)?

A

Ciprofloxacin 500 mg BID x 10 days
Ofoxacin 200mg to 300mg PO BID
Bactrim DS one tablet PO BID

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8
Q

What is an indirect hernia?

A

Indirect Hernia
Occurs when tissue herniates through the internal inguinal ring and descends into the scrotum

Sort swelling within the internal ring

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9
Q

What is an direct hernia?

A

Direct Hernia
Hernial sac protrudes through the abdominal wall into the Hesselbach’s triangle

Usually presents as a bulge in the Hesselbach’s triangle
Usually painless
Easily reducible

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10
Q

What is a strangulated hernia?

A

Hernia in which the blood supply to the entrapped bowel is diminished which becomes an emergent surgery

Colicky abdominal pain
Abdominal distention
Nausea & vomiting

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11
Q

What is a incarcerated hernia?

A

Hernia’s contents cannot be replaced into the abdomen

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12
Q

What is a reducible hernia?

A

Hernia is easily replaced in the abdomen

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13
Q

What diagnostics are indicated for hernias and treatments?

A

Ultrasound

Refer to Surgeon for further evaluation

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14
Q

What is a hydrocele?

A

Fluid sack ( collection of peritoneal fluid within the scrotum and surrounding the testes within the layers of the tunica vaginalis

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15
Q

What is the difference between communicating and non communicating hydrocele?

A

Communicating: incomplete closure of processus vaginalis which results in temporary retention of peritoneal fluid
Non-communicating: Closure of the processus vaginalis which traps the peritoneal fluid

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16
Q

What are signs and symptoms of hydrocele?

A 
Painless swelling in the scrotum
Scrotum may feel heavy and is enlarged
Transillumination of scrotum
Hernia shows black
Hydrocele shows pink or red
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17
Q

What is treatment of hydrocele?

A

Communicating: Referral to Surgeon
Especially if it is a new hydrocele
Non-communicating: Observe

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18
Q

What is a Spermatocele ?

A

Cystic dilation of the epididymis

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19
Q

What are signs and symptoms of Spermatocele ?

A

Painless cystic mass (feels like a marble in scrotum)
Circumscribed mass in scrotum
Possible tenderness with palpation

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20
Q

What are indicated diagnostics and treatment for Spermatocele?

A

Scrotal Ultrasound
No therapy necessary unless mass is uncomfortable to patient
Refer to Urologist is patient is too uncomfortable

21
Q

What is a Varicocele ?

A

Dilation of the pampiniform plexus which is usually caused by incompetent spermatic vein valves

22
Q

What are signs and symptoms of Varicocele?

A

Sign & Symptoms include oligospermia, pain, infertility and decreased testicular growth

23
Q

What diagnostics are indicated for Varicocele?

A

Doppler US
Decrease Sperm count
Intravenous pyelography to R/O renal tumor or obstruction

24
Q

What is clinical treatment and management of Varicocele?

A 
Immediate evaluation for sudden appearance of left-sided varicocele to rule out renal tumor
If mild, left-sided varicocele in adult, observe
 Consult Urologist:
Right sided varicocele
New onset in adult
Large varicocele
Painful
Older males
Prepubertal boys
Infertility
Does not disappear when supine
25
Q

Testicular cancer assessment shows?

A

Solid firm non-tender testicular mass
Hydrocele
Mass does not transilluminate
Fullness or heaviness in scrotum

26
Q

What diagnostics are indicated for probable testicular cancer?

A

Scrotal US ( gold standard)

27
Q

What is management and treatment for testicular cancer?

A

Refer to oncologist for treatment
Chemotherapy
Radiation
Surgical intervention; radical orchiectomy

28
Q

What is Balanitis and it s/s?

A 
Inflammation of the glans penis
Etiology
Bacterial or Fungal
Symptoms & Signs
Pain & Discharge (Purulent exudate; ulcerations) 
Edema & Inflammation
29
Q

What is treatment for Balanitis?

A

Treatment
Gentle retraction of foreskin daily and soak in warm water
Topical antifungal (Add Keflex for mixed infection), steroid cream

30
Q

What is Phimosis and its cause?

A

a condition of the penis where the foreskin cannot be fully retracted over the glans penis.
Etiology: Congenital Defect, Yeast Infection, Poor Hygiene

31
Q

What is the treatment for Phimosis?

A

Acute Infections
Hot compresses or soaks
Antibiotic therapy(Tetracycline or Defadroxil)
Steroid Therapy: Betamethasone Dipropionate 0.1-0.05% BID x 4-6 weeks

32
Q

What is Paraphimosis and s/s?

A

Foreskin retracted from glans & trapped proximal to coronal edge of glans
Signs & Symptoms
Edema
Swollen prepuce & glans

33
Q

What is treatment of Paraphimosis?

A 
Treatment
Reduction of foreskin (early/mild case)
Dorsal slit (severe)
34
Q

What is BPH and its signs and symptoms?

A 
Noncancerous enlargement of the prostate gland
 Urinary frequency
Increased frequency during the night
Weak urinary stream
Difficulty starting to urinate
Possible loss of bladder control
Strong urge to urinate
35
Q

What are indicated diagnostics for BPH?

A 
UA
PSA
US of prostate
Needle biopsy
IVP, CT or MRI of prostate
DRE-digital rectal exam
Cystoscopy
Urinary flow measurement
Post-void volume measurement
Ultrasound & Biopsy to R/O Cancer
36
Q

When to intervene in BPH?

A 
Absolute indications
urinary retention
recurrent urinary tract infection
renal insufficiency
gross hematuria

Relative indications
Elevated post-void residual
urodynamic evidence of obstruction

37
Q

What is treatment for BPH?

A 
Mild: closely observe
Treatment of Absolute Indications 
TURP
TUIP
Open Prostatectomy
Transurethral Vaporization of the Prostate
Trial of a-blockers
38
Q

What medication are used to treat BPH?

A

5-a reductase inhibitor
Proscar
Avodart

a-blockers
Terezosin(Hytrin)
Doxazosin(Cardura)
Tamsulosin(Flomax)
Alfuzosin(Uroxatral)
39
Q

What are signs and symptoms Acute Prostatitis?

A

Local
Lower back & perineum

Systemic
Fever
Nausea
Malaise
Painful intercourse or decreased libido

Signs
Enlarged tender prostate
Don’t massage

40
Q

What are diagnostics for Acute Prostatitis?

A

UA

Urine Culture

41
Q

What are treatments for Acute Prostatitis?

A

Bactrim DS BID for 28 days
Cipro 500mg QD for 28 days
Doxycycline 100mg BID once and then daily for 28 days

Good hydration
Sitz bath
Refrain from sexual intercourse until symptoms resolve

42
Q

What are s/s for Chronic Prostatitis?

A 
Signs & Symptoms
Early a.m. penile discharge
vague urinary discomfort
Prostate slightly enlarged & tender
No nodules
43
Q

What are the indicated diagnostics for Chronic Prostatitis?

A

Urine Culture
CT and/or US
PSA: Elevated
Cystoscopy

44
Q

What are the treatments for Chronic Prostatitis?

A

Sitz Bath
Good hydration
Avoid tea, coffee, alcohol and other beverages which can cause diuresis

Fluoroquinolone daily for 4-12 weeks
Floxin 300mg BID for 4-12 weeks
Cipro 400mg BID for 4-12 weeks

45
Q

What are s/s of Prostate Cancer?

A 
Prostate feels hard and may be nodular
Hematuria
Lymphedema
Lympadenopathy
Anemia
Urinary retention
46
Q

What are diagnostics for Prostate Cancer?

A 
US
PSA elevated but can also be normal
Alkaline Phosphatase: Elevated with metastasis
CT
MRI
Biopsy
47
Q

When do PSA and DRE screenings begin for men?

A

Annual digital rectal exam beginning at age 40 years
Annual PSA and DRE beginning at age 50 years

Early screening at 45 years of age for high risk groups

48
Q

What are treatments for Prostate Cancer?

A 
Prostatectomy
Radiation Therapy
ADT
Chemotherapy
Cryosurgery
Immunotherapy

Family Practice Nursing (9 decks)

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