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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
Does BPH increase risk of cancer?
No
26
At what age should you start DRE?
50
27
What produces PSA?
Prostate capsule and periurethral glands
28
What PSA values indicate you shoulder refer your patient?
4-10 ng/mL with abnormal DRE | >10 ng/mL
29
Treatment of BPH?
``` Finesteride 5 alpha reductase inhibitors (prevents production of DHT) Alpha blockers (relax smooth muscles) TURP Saw palmetto (weak evidence) ```
30
What symptoms are considered male sexual dysfunction?
Decreased libido Ejaculatory disturbances Erectile dysfunction
31
What is ADAM? Sx? Dx tests?
Androgen Decline in Aging Men Mood changes, atrophy, osteoporosis, cognitive changes Tests: testosterone levels
32
DRE findings in prostate cancer? Other test? Survival rate?
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
What three hormones does the kidney produce?
Calcitrol (active V-D), Renin, EPO
34
When kidney function drops to what percentage is kidney replacement of some kind necessary (organ transplant or dialysis?)?
10-15%
35
M/C causes of kidney disease?
DM and/or HTN
36
What are the 4 types of glomerulonephritis?
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
Constant vs intermittent urinary symptoms
``` Constant= infx Intermittent= obstruction ```
38
What conditions lead to increased urinary output? Decreased?
DM/I, diuretics, excess fluids Obstructions, anxiety, neurogenic, extrinsic compression
39
Symptoms of obstructive voiding
Post-void dribble, decrease force, hesitancy, intermittancy
40
What is a sensitive test for proteinuria?
Albumin:creatinine ratio
41
How do you diagnose proteinuria? What does severe proteinuria usually indicate?
Retest 1-2 weeks after first positive test. Severe glomerulonephritis
42
What condition(s) are associated with microscopic hematuria? Macroscopic hematuria?
Lower UTIs Upper UTIs
43
What must you assume hematuria indicates until proven otherwise?
Cancer
44
What is pseudohematuria?
Reddish urine d/t beet or berry consumption
45
Hematuria during onset, duration, or end of urination indicates
Onset- urethra or prostate Throughout- kidney, ureter, bladder End- bladder, prostate
46
What does SITT stand for?
Stone, infection, trauma, tumor M/C causes of hematuria
47
Casts and what they indicate
``` 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
What test is more accurate than creatinine levels for determining kidney disease?
GFR. Creatinine levels can be influenced by a number of different factors.
49
Stages of Kidney disease
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
Definition of chronic or recurrent kidney UTI
>2 in 6 months
51
UTIs in kids
Girls- recurrent may indicate abnormality in UT | Boys- even one episode means there needs to be evaluation for abnormality of UT
52
What is the most common organism to cause UTI?
90-95% E. Coli
53
Sx of lower UTI and upper UTI
Lower: suprapubic pain, frequency, urgency, dysuria, macroscopic hematuria Upper: fever, chills, aches, CVA pain, flank pain, odorous urine, macroscopic hematuria
54
Sx of pyelonephritis
M/C secondary to ascending UTI | Fever >102, chills, aches, N/V, tachycardia
55
Urinary Stones m/c in who?
Cracker men folk
56
Risk factor for urinary stones?
``` Prego Obese HTN DM Stress UT abnormalities Meds (thyroid, diuretics, antacids) ```
57
Size of stone and sx
Size of stone is not an indication of pain levels
58
Dx tests for urinary stones?
``` Hematuria (85%) Electrolyte levels Ca2+ Uric acid Oxalate Creatinine Phosphorus ``` X-ray and CT (more sensitive and specific)
59
Tx of urinary stone
MUST RULE OUT OBSTRUCTION and INFECTION
60
Stats on size of stones and passage
>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
Treating hyperoxalaria
Mg2+ may prevent absorption of oxalate | Pyridoxine (B6) may prevent formation of oxalate
62
How is incontinence defined?
By the patient!
63
4 types of incontinence
Stress- coughing, sneezing, etc. Weak sphincter. Urge- overactive detrusor muscle Mix- both stress and urge Overflow- paralysis of detrusor muscle
64
Causes of incontinence
``` Vaginal birth Lifting weights Estrogen deficiency BPH Pelvic organ prolapse Smoking DM Meds UTI ```
65
Tx of incontinence
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
Definition of interstitial cystitis M/C in who? Sx?
Aka Painful Bladder Syndrome Women 90% Mild pain, pressure and tenderness over bladder Dx based on ruling out, etiology is unknown
67
Tx for interstitial cystitis
Avoid tomatoes, spicy foods, caffeine, citrus fruits, artificial sweeteners
68
M/C symptom of bladder cancer
Hematuria
69
Two types of bladder cancer and survival rate
Superficial 85% 5 year survival rate | Invasis 5% 2 year survival rate
70
M/C type of renal carcinoma
Renal adenocarcimona 50-70yo men Often asymptomatic at first
71
What is paraneoplastic syndrome
Condition associated with renal cancer | Weight loss, decrease appetite, night sweats, HTN

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