urology part 2 Flashcards

(68 cards)

1
Q

Balanitis cause

A

Bacteria or candida

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2
Q

Balanitis sx

A

Dysuria, urgency, frequency, tender, itching, discharge

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3
Q

Balanitis

pe

A

Ulcers, pus, lesions, tenderness, smegma

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4
Q

Balanitis

dx

A

Swab, KOH for yeast, Tzanck prep for herpes

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5
Q

Balanitis

trmt

A

Hygiene, topical or oral ATB (bacitracin or Keflex), topical or oral antifungals, topical steroids (mycolog)
Circumcision

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6
Q

phimosis?

A

foreskin cant be pulled back

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7
Q

Phimosis

cause

A

Congenital

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8
Q

Phimosis

sx

A

Dysuria, dribbling, discharge, hx of UTI, bleeding or crackling at foreskin, pain with intercourse

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9
Q

Phimosis

pe

A

Crackling of skin, discharge, normal skin color

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10
Q

Phimosis

dx

A

Visual

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11
Q

Phimosis

trmt

A
Topical steroids (dexamethasone) 
Circumcision is curative
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12
Q

Paraphimosis?

A

Retracted foreskin is not pulled back to its normal position

UROLOGIC EMERGENCY bc it can lead to necrosis

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13
Q

Paraphimosis pe

A

Edema of the glans distal to constriction

Rule out hair

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14
Q

Paraphimosis dx

A

Visual

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15
Q

Paraphimosis trmt

A

Ice pack on head of penis for 5 min

Dorsal slit= circumcision

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16
Q

ED?

A

cant maintain erection

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17
Q

common in males under 35

A

ed

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18
Q

peyronie’s disease can cause this

A

ed

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19
Q

ed dx

A

Not necessary

US may help determine cause

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20
Q

pde 5 inhibitors ex

A

(viagra, levitra, cialis)

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21
Q

pde 5 inhibitors?

A

inhibit breakdown of cGMP which causes smooth muscle relaxation and arteries dilate (viagra, levitra, cialis)

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22
Q

se pde 5 inhibitors

A

SE= facial flushing, HA, dyspepsia

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23
Q

Sildenafil is a _____ that can cause

A

pde 5 inhibitors that can cause blurred and blue vision

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24
Q

Tadalafil is a _____ that can cause ____

A

pde 5 inhibitors that can cause back ache and myalgia

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25
trmt ed
PDE 5 inhibitors Intracavernous injection therapy- inject agent into corpa to get erection (Alprostadil) Intraurethral injection therapy- MUSE medicated urethral system erection; place pull in urethra Vacuum constriction IPP- inflatable penile prosthesis Penile revascularization Psychosexual therapy
26
priapism?
Erection longer than 4 hrs | Blood gets into penis but cant get out
27
priapism cause?
MCC intracavernous injection | Hematologic, idiopathic
28
PE priapism
Palpate penis, rigid and tender
29
Priapism dx
Color duplex doppler US- no blood in cavernous arteries
30
Priapism trmt
Aspirate corpus cavernosa until no more dark blood comes out | Phenylephrine- alpha agonist
31
Treat early so pt can have an erection in the future
Priapism
32
phenylephrine is an ______
alpha agonist
33
Spermatocele?
Benign cystic dilation of epididymis
34
Spermatocele cause
Trauma, infection, obstruction of epididymal tubule
35
Spermatocele sx
Asymptomatic, inc in side compared to testes, pain, point tenderness
36
Spermatocele PE
Cystic lesion | *+ transillumination
37
Spermatocele dx
Doppler color scrotal US | Epididymal cyst
38
Spermatocele trmt
None | Spermatocelectomy if inc in size and lots of pain
39
Spermatocele leads to
Leads to infertility
40
Epididymitis?
Inflammation of epididymis
41
acute Epididymitis?
Acute: sudden onset pain and swelling
42
chronic Epididymitis ?
Chronic: inflammation and pain for over 6 wks
43
MCC scrotal pain in outpt
Epididymis
44
Epididymitis cause
MCC acute bacterial from UTI or STD Viral, fingic, parasitic Idiopathic, traumatic
45
acute Epididymitis pathogeneisi
Spread from bladder, urethra, or prostate through ejaculatory ducts and vas deferens Goes from tail to body to head
46
chronic Epididymitis pathogenesis
Infections not treated properly Heterosexual males under 35- n gonorrhea and c trichomatosis Homosexual males or anal intercourse- e coli, H flu, TB, mycobacterium
47
Epididymitis PE
Tenderness Prehn's sign- no pain when testicle is elevated Pain with standing a long time
48
Epididymitis dx
Doppler scrotal US- inc blood flow
49
Epididymitis Acute Men under 35 trmt
Ceftriaxone or doxycycline
50
Epididymitis Acute Men over 35
Levofloxacin or ofloxacin
51
chronic Epididymitis trmt
4-6 wks atb | Analgesics, NSAIDS, scrotal support (lift up penis), nerve blocks
52
other Epididymitis trmt
Drain it | Epididymectomy
53
Testicular torsion?
Torsion of the spermatic cord so blood supply is compromised
54
what ages are at risk for Testicular torsion?
Ages 12-18
55
Cryptorchidism- only 1 testicle youre at risk for
Testicular torsion
56
Testicular torsion sx
Acute, sharp, testicular pain with scrotal swelling Resolves within minutes; long sx of free periods NV
57
Testicular torsion PE
May be normal if they are in a free period One testicle is higher- cord shortening *Loss of cremaster reflex- stroke upper thigh and testicle will rise Tender Red scrotum
58
Loss of cremaster reflex- stroke upper thigh and testicle will rise
Testicular torsion
59
Testicular torsion dx
Scrotal US with doppler
60
Testicular torsion trmt
Rotate testes to untwist Scrotal fixation of testicles on both sides Orchiectomy if necrotic Treat within 6 hrs! Over 24 hrs and its necrotic
61
what are the 2 surgical emergencies
testicular torsion and paraphimosis
62
Prehn's sign- no pain when testicle is elevated
epididymitis
63
what happens in Testicular appendage torsion?
Blood is occluded in one of the testicle appendages
64
Testicular appendage torsion risks
Males before puberty
65
Testicular appendage torsion sx
Gradual onset aching pain worse with activity | No NV
66
Testicular appendage torsion | PE
``` Cremaster reflex present Tender at superior pole Blue dot/dresner's sign- blue discoloration Erythema and swelling Palpable mass ```
67
Testicular appendage torsion | dx
US
68
Testicular appendage torsion trmt
Reassurance- pain will subside in 5-7 days | May need to remove it