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Genitourinary & Reproductive System > Urology/Gynecology: Male Genitalia and Reproductive Tract > Flashcards

Urology/Gynecology: Male Genitalia and Reproductive Tract Flashcards

1
Q

What are the common signs and symptoms of prostate cancer?

A

1) May be asymptomatic early in disease
2) Urinary sx: urgency, frequency, nocturia, hesitancy “dribbling”
3) Hematuria and hematospermia
4) Bone pain: indicates metastases

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2
Q

What does the prostate feel like or DRE in prostate cancer, BPH and prostatitis?

A

Prostate Cancer: Hard irregular nodule or diffuse dense induration involving one or both lobes, asymmetrical (painless)
BPH: Enlarged, smooth, and rubbery; loss of median sulcus , symmetric
Prostatitis: DRE contraindicated; tender (painful), enlarged, “boggy”

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3
Q

What are the common signs and symptoms of Late-Onset Hypogonadism (also: Testosterone Deficiency Syndrome)?

A

Fatigue
Decreased libido
Depressed mood
Decreased muscle mass
Decreased body hair

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4
Q

What are the diagnostic criteria of erectile dysfunction?

A

1) Persistent inability to attain or maintain an adequate erection
2) Disturbance causes marked distress or interpersonal difficulty
3) Not accounted for by another disorder other than sexual dysfunction
4) Is not due to physiological effects of drugs of abuse or general medication condition such as diabetes

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5
Q

What are some underlying causes of erectile dysfunction?

A

Vascular: Hypertension
Neurologic: Spinal cord injury, MS, Parkinson;s
Endocrine: Hypogonadism, DM
Pharmacologic: Medication side effect
Psychogenic: anxiety, partner dissatisfaction, hx of abuse
Surgery injury: prostatectomy

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6
Q

What medication is used to treat erectile dysfunction?

A

Sildenafil (phosphodiesterase inhibitor)

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7
Q

What is balanitis?

A

Inflammation of the glans penis

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8
Q

What are the causes of balanitis and balanoposthitis?

A

DM
Poor hygiene; uncircumcised
STI
Candidal Infection
HPV
Reactive Arthritis
Psoriasis; Lichen Sclerosis; Contact Dermatitis

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9
Q

What are the common signs and symptoms epididymitis?

A

Scrotal pain, swelling and redness
Painful ejaculation
Penile discharge
Dysuria
Enlarged inquinal lymph nodes
Blood found in semen

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10
Q

Which organisms are often implicated in acute epididymitis?

A

N.gonorrhoeare
C. Trachomatis

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11
Q

What is the inflammation of the testis called?

A

Orchitis

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12
Q

What infection is associated with orchitis?

A

Mumps or other virsuses (Echovirus, coxsackie or parvovirus) or bacteria (brucellosis)

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13
Q

A man comes to your clinic with obvious inflammation of the foreskin so that it cannot be retracted off the glans of the penis. What is your dx?

A

Phimosis

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14
Q

How does paraphimosis differ from phimosis?

A

Paraphimosis: When the cannot be moved out of retraction “Stuck in retraction)
Phimosis: When the foreskin cannot be retracted

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15
Q

What are some of the potential complications associated with paraphomisis?

A

Gangrene; constriction and possible necrosis of the glans penis

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16
Q

What is a good way of differentiating testicular torsion from epididymitis?

A

Prehn’s Sign: Pain may be relieved with elevation of testicles in epididymitis, but not in testicular torsion. (poor sensitivity in children)

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17
Q

How can varicocele lead to male infertility?

A

Common cause of low sperm production and decreased sperm quality

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18
Q

What’s a good diagnostic procedure to test for varicocele?

A

Varicocele= bag of worms

Inspection scrotum both standing and lying down. Have patient bear down whole standing to feel for enlarged veins. Varicocele will likely decrease while lying down

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19
Q

What are some causes of painLESS scrotal masses?

A

Tumor, Hydrocele, Spermatocele, Varicocele, Scrotal hernia

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20
Q

What are the causes of painFUL scrotal masses?

A

Epididymitis, Testicular torsion, Orchitis, testicular trauma, Hematocele

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21
Q

How does hydrocele respond to transillumination?

A

It transilluminates

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22
Q

How does spermatocele respond to transillumination?

A

It transilluminate

23
Q

What are the obstructive signs of BPH?

A

Decreased force of urinary stream
Dribbling
Urine retention

24
Q

What are the irritative signs of BPH?

A

Frequency, urgency, and nocturia

25
Q

Would you use a sedating antihistamine with a patient with BPH?

A

They are contraindicated due to worsening of urinary tract obstruction with symptomatic aggravation

26
Q

What drug is used for male pattern baldness, BPH, and hirsutism in women?

A

Finasteride

27
Q

What accessory nutrients are indicated for BPH?

A

Omega 3 FAs, Vitamin C, Vitamin D, Zinc

28
Q

What herbs are indicated for BPH?

A

Cucurbita pepo
Prunus Africanum
Serenoa repens
Urtica dioica root

29
Q

What herbs are indicated for acute prostatitis?

A

Treat like severe infectious cystitis
Urinary antiseptic herbs (Juniperus ssp., Arctostaphylos uva-ursi)
Diuretics (Taraxacum or Urtica Leaf, Juniperus
Inflammation Modulators (solidago canadensis, juniperus)
Analgesics (Salix or Betula)

30
Q

What physical therapy treatment is indicated for chronic prostatitis?

A

Diathermy

31
Q

What are the contraindications for performing a digital prostate exam?

A

In (bacterial ) prostatitis or (acute proctitis: inflammation of rectum) , no prostate message or catheterization as it increase risk sepsis

32
Q

How do you evaluate your patient is suspected prostatitis?

A

Urine Culture
Three glass urinalysis (urine from one continuous micturition) with culture and Gram-stain if needed
Serum PSA often elevated

33
Q

What organism causes chancroid?

A

Haemophilus ducreyi

34
Q

How would you described a chancroid ulcer?

A

Painful, superficial (usually LAO in position),
Red papule that progresses to pustule that can ulcerate

35
Q

Can a routine culture be used to dx chlamydia?

A

No, use Nucleic Acid Amplification Tests (NAATs)- are sensitive and be used non-invasively

36
Q

How is Chlamydia transmitted?

A

Direct sexual contact

37
Q

What antibiotics are indicated for Chlamydia?

A

Azithromycin
Doxycycline

38
Q

How do you diagnose a Chlamydia infection?

A

DNA probe of urine or discharge

39
Q

What are the common signs and symptoms of Lymphogranuloma venereum?

A

1) Associated with chlamydia trachomatis infections
2) Begins with small, painless, papule that heals within 1-2 weeks
3) 2-6 weeks later develop painful inguinal and femoral lymph nodes
4) Can coalesce to form buboes (lymph node comes together to form one mass) which may rupture then heal slowly
5) Last stage is proctocolitis with fever, blood purulent discharge, rectal pain and tenesmus

40
Q

What’s the quality of the discharge in Gonococcal (GC) urethritis?

A

Purulent

41
Q

Can a routine culture be used to dx Gonorrhea?

A

No

42
Q

How do you diagnose a GC infection?

A

(NAATs) DNA probe or urine or discharge

43
Q

What antibiotics are indicated for GC?

A

Ceftriaxone 250 mg intramusucular (IM) single dose or Cefixime 400 mg oral (PO) single dose
If these are not available then a single dose of an injectable cephalosporin PLUS
Azithromycin 1 g PO single dose or Doxycycline 100 mg PO twice a day for 7 days

44
Q

What are some of the homeopathic remedies to consider for GC?

A

Medorrhinum

45
Q

A patient comes to you concerned because they had unprotected intercourse last night. Today they want to be tested for STI’s. What do you tell them?

A

Must wait at least 3 weeks before any testing can be done

46
Q

What’s in the DDx for recurrent UTIs in men?

A

Bladder carcinoma
Bladder stones
Prostatic Obstruction
DM

47
Q

How do you describe the ulcers in herpes simplex virus?

A

Painful, vesicular (red mucosal) lesions that last 7-10 days. Typically rupture after 2 days and ooze fluid (this fluid contains virus)

48
Q

What are the common conventional treatments for HSV?

A

Acyclovir
Valacyclovir

49
Q

Describe the lesion of primary syphilis?

A

Chancre: painless ulcers; highly infectious

50
Q

What is the lesion of secondary syphilis called?

A

Condyloma lata/latum with generalized rash this is also on palms and soles

Difference from condyloma acuminata “genital warts, HPV)

51
Q

What happens when tertiary syphilis is untreated?

A

Neurosyphilis

52
Q

If a patient with primary or secondary syphilis does not receive treatment, do their symptoms resolve?

A

Yes, but then they progress to the next stage

53
Q

What presents on a pelvic exam of a person infected with Trichomoniasis?

A

Red “strawberry” spots

54
Q

What is the treatment for Trichomoniasis? Do you treat, if asymptomatic?

A

Metronidazole; Yes

Genitourinary & Reproductive System (3 decks)

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