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Wang Flashcards

1
Q

Testicular Masses vs Scrotal masses

A

Testicular masses: painless, do not transilluminate, malignant
Scrotal masses: painful, transilluminate, benign

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2
Q

Penile anatomy

A

Corpus cavernosum= erectile tissue
Corpus spongiosum= contains urethra
Tunica Albuginea= CT that surround erectile tissue

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3
Q

Current recommendations regarding circumcision?

A

Not enough evidence to make it standard procedure

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4
Q

Seminal vesicles?

A

Continuation of the vas deferens. Contributes 70% of semenal fluids

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5
Q

What hormones are necessary to stimulate spermatogenesis?

A

LH -> Testicles -> Testosterone + FSH -> spermatogenesis

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6
Q

Leukoplakia of the shlong

A

Scaly white patches. Need biopsy!

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7
Q

Bowens Disease

A

Thick, scaly, horny, pinkish brown intraepidermal pre-cancerous lesions

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8
Q

Two types of inflammation of the foreskin

A

Phimosis- cannot retract foreskin

Paraphimosis- cannot move foreskin foreward

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9
Q

Congenital abnormalities of urethra

A

Hyposadius- urethra on ventral surface of wang

Episadius- urethra on dorsal surface of wang

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10
Q

Priapism?

A

Non-erotic, painful sustained erection. Usually self-resolves within a few hours. Unknown etiology.

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11
Q

Peyronie’s disease

A

Plaque on the corpus cavernosum that causes a curvature in the erection. Sometimes they look like figure eights (jk). Unknown etiology, usually self-resolve.

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12
Q

M/C location for penile cancer?

A

Glans and foreskin

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13
Q

Ectopic testi location

A

Testi descends into the perineum, femoral area, inguinal area.

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14
Q

Testicular torsion prognosis?

A

80% good prognosis if surgically repaired within 6-8 hours of onset. If not taken care of can lead to atrophy and hormonal issues.

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15
Q

Lifting of testi and testicular torsion vs epididymitis

A

Lifting twisticle causes increase in pain

Lifting testi with epididymitis decreases pain

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16
Q

Hydrocele definition and age range

A

Fluid in sheath that surround testicles. Often painless and will transluminate. M/C in older men.

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17
Q

Varicocele- definition and age range

A

Blood backs up in the spermatic veins d/t faulty venous valves. Does not transilluminate. M/C younger men. Treatment is usually just supporting the testis.

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18
Q

Causes of orchitis

A

Bacterial infection or mumps virus. Can lead to atrophy and decreased hormone production.

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19
Q

What is the m/c cancer in males 15-35? Dx test? Tx?

A

Testicular cancer. Dx with US, usually also take Chx x-ray and abdominal CT. Treatment is orchectomy with surrounding lymph nodes.

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20
Q

Size of the average prostate?

A

4cm

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21
Q

Two types of prostatitis and their subtypes if there are any? Associated microorganisms and Dx tests

A

Acute bacterial prostatitis- usually E. Coli

Chronic Prostatitis: Bacterial (ureaplsma urealyticum). Non-bacterial (unknown etiology)

PSA levels, WBC in urine, ^ pH of prostatic fluid.

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22
Q

Prostadynia?

A

Prostatitis symptoms without infection or inflammation. Finesteride (BPH med) may help. May be d/t MSK spasm or nerve entrapment.

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23
Q

Pudendal nerve entrapment. Locations of entrapment?

A

Dx of exclusion.

  1. B/t sacrospinous and sacrotuberous ligs
  2. B/t falciform ligament of sacrotuberous lig
  3. In obturator fascia
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24
Q

Etiology of BPH. Who is at risk? Findings on DRE?

A

Decrease testosterone with increase estorogen and increased sensitivity of prostate to DHT causes BPH.

African American men high risk.

Soft and boggy DRE.

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25
Q

Does BPH increase risk of cancer?

A

No

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26
Q

At what age should you start DRE?

A

50

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27
Q

What produces PSA?

A

Prostate capsule and periurethral glands

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28
Q

What PSA values indicate you shoulder refer your patient?

A

4-10 ng/mL with abnormal DRE

>10 ng/mL

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29
Q

Treatment of BPH?

A 
Finesteride
5 alpha reductase inhibitors (prevents production of DHT)
Alpha blockers (relax smooth muscles)
TURP
Saw palmetto (weak evidence)
30
Q

What symptoms are considered male sexual dysfunction?

A

Decreased libido
Ejaculatory disturbances
Erectile dysfunction

31
Q

What is ADAM? Sx? Dx tests?

A

Androgen Decline in Aging Men

Mood changes, atrophy, osteoporosis, cognitive changes

Tests: testosterone levels

32
Q

DRE findings in prostate cancer? Other test? Survival rate?

A

Rock hard pebble feel

Tests: PSA, 12 point biopsy, TRUS

80-90% 10 year survival rate when no metastsis. 10-15% 10 year survival rate when there’s mets.

33
Q

What three hormones does the kidney produce?

A

Calcitrol (active V-D), Renin, EPO

34
Q

When kidney function drops to what percentage is kidney replacement of some kind necessary (organ transplant or dialysis?)?

35
Q

M/C causes of kidney disease?

A

DM and/or HTN

36
Q

What are the 4 types of glomerulonephritis?

A

Autoimmune (IgA kidney, SLE, Good Pasture’s syndrome)
Infection (post-strep, bacterial endocarditis, HIV)
Sclerotic disease (SLE, DM, glomerulosclerosis)
Inherited (PCKD)

Membranous neuropathy is another cause, often idiopathic

37
Q

Constant vs intermittent urinary symptoms

A 
Constant= infx
Intermittent= obstruction
38
Q

What conditions lead to increased urinary output? Decreased?

A

DM/I, diuretics, excess fluids

Obstructions, anxiety, neurogenic, extrinsic compression

39
Q

Symptoms of obstructive voiding

A

Post-void dribble, decrease force, hesitancy, intermittancy

40
Q

What is a sensitive test for proteinuria?

A

Albumin:creatinine ratio

41
Q

How do you diagnose proteinuria? What does severe proteinuria usually indicate?

A

Retest 1-2 weeks after first positive test.

Severe glomerulonephritis

42
Q

What condition(s) are associated with microscopic hematuria? Macroscopic hematuria?

A

Lower UTIs

Upper UTIs

43
Q

What must you assume hematuria indicates until proven otherwise?

44
Q

What is pseudohematuria?

A

Reddish urine d/t beet or berry consumption

45
Q

Hematuria during onset, duration, or end of urination indicates

A

Onset- urethra or prostate
Throughout- kidney, ureter, bladder
End- bladder, prostate

46
Q

What does SITT stand for?

A

Stone, infection, trauma, tumor

M/C causes of hematuria

47
Q

Casts and what they indicate

A 
Epithelial- AVN of tubules
WBC- pyelonephritis
RBC- glomerulonephritis
Hyaline- normal or chronic kidney disease
Waxy- severe kidney dz
Granular- severe kidney dz
Fatty- nephrotic syndrome
48
Q

What test is more accurate than creatinine levels for determining kidney disease?

A

GFR. Creatinine levels can be influenced by a number of different factors.

49
Q

Stages of Kidney disease

A
  1. Kidney damage with normal GFR
  2. Kidney damage with mild decrease in GFR
  3. Kidney damage with moderate decrease in GFR (anemia and bone problems)
  4. Kidney damage with severe decrease in GFR (kidney transplant or dialysis)
  5. Kidney failure (kidney transplant or dialysis)
50
Q

Definition of chronic or recurrent kidney UTI

A

> 2 in 6 months

51
Q

UTIs in kids

A

Girls- recurrent may indicate abnormality in UT

Boys- even one episode means there needs to be evaluation for abnormality of UT

52
Q

What is the most common organism to cause UTI?

A

90-95% E. Coli

53
Q

Sx of lower UTI and upper UTI

A

Lower: suprapubic pain, frequency, urgency, dysuria, macroscopic hematuria

Upper: fever, chills, aches, CVA pain, flank pain, odorous urine, macroscopic hematuria

54
Q

Sx of pyelonephritis

A

M/C secondary to ascending UTI

Fever >102, chills, aches, N/V, tachycardia

55
Q

Urinary Stones m/c in who?

A

Cracker men folk

56
Q

Risk factor for urinary stones?

A 
Prego
Obese
HTN
DM
Stress
UT abnormalities
Meds (thyroid, diuretics, antacids)
57
Q

Size of stone and sx

A

Size of stone is not an indication of pain levels

58
Q

Dx tests for urinary stones?

A 
Hematuria (85%)
Electrolyte levels
Ca2+
Uric acid
Oxalate
Creatinine
Phosphorus

X-ray and CT (more sensitive and specific)

59
Q

Tx of urinary stone

A

MUST RULE OUT OBSTRUCTION and INFECTION

60
Q

Stats on size of stones and passage

A

> 75% of stones will pass spontaneously
2mm pass in 8 days; 2-4mm pass in 12 days; 4mm pass in 22 days
<5mm 85% pass in 3 weeks
5mm refer to urologist

61
Q

Treating hyperoxalaria

A

Mg2+ may prevent absorption of oxalate

Pyridoxine (B6) may prevent formation of oxalate

62
Q

How is incontinence defined?

A

By the patient!

63
Q

4 types of incontinence

A

Stress- coughing, sneezing, etc. Weak sphincter.
Urge- overactive detrusor muscle
Mix- both stress and urge
Overflow- paralysis of detrusor muscle

64
Q

Causes of incontinence

A 
Vaginal birth
Lifting weights
Estrogen deficiency
BPH
Pelvic organ prolapse
Smoking
DM
Meds
UTI
65
Q

Tx of incontinence

A

Pelvic floor rehab
E-stim
Meds
Behavioral mods (drink less water, more trips to bathroom)
Pessaries/urethral barriers
Meds (anticholinergic, antispasmodics, trigs, Ca2+ blockers, bet agonists, estrogen)

66
Q

Definition of interstitial cystitis
M/C in who?
Sx?

A

Aka Painful Bladder Syndrome
Women 90%
Mild pain, pressure and tenderness over bladder
Dx based on ruling out, etiology is unknown

67
Q

Tx for interstitial cystitis

A

Avoid tomatoes, spicy foods, caffeine, citrus fruits, artificial sweeteners

68
Q

M/C symptom of bladder cancer

69
Q

Two types of bladder cancer and survival rate

A

Superficial 85% 5 year survival rate

Invasis 5% 2 year survival rate

70
Q

M/C type of renal carcinoma

A

Renal adenocarcimona
50-70yo men
Often asymptomatic at first

71
Q

What is paraneoplastic syndrome

A

Condition associated with renal cancer

Weight loss, decrease appetite, night sweats, HTN

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