Witwer - Male GU Flashcards by Alice Richards

tight foreskin that can not be pulled back

phimosis

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phimosis can be normal in __ patients,

and usually resolves by __ yo

young

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if phimosis has not resolved by __ yo, pt needs tx

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phimosis predisposes pt to

infxn

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fibromatosis

painful contracture/erection

plaque formation

curved penis

peyronie’s dz

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what is fibromatosis

multiple fibromas

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persistent painful erection

thrombosis w. fibrous replacement

priaprism

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rf for priaprism (2)

SSA

trauma

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mc STIs in males

gonorrhea

chlamydia

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what do you think when you see: watering can urethra, multiple sinuses, fistulae, abscesses extending from urethra

gonorrhea

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what do you think when you see dysuria and penile discharge

chlamydia

AND

gonorrhea

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scarring that narrows the urethra → causes inflammation/infxn

urethral strictures

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causes of urethral strictures (5)

injury

instrumentation

gonococcal infxn

chronic urethritis

congenital

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urethral strictures were common before

abx

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what do you think when you see a pt w. persistent, treatment resistant urethritis

non specific urethritis (NSU)

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what is NSU

infxn caused by multiple uncommon organisms

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how do you treat NSU

refer to Schoenwald

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mc developmental defect of the male genitalia

cryptochordism

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lack of descent of testes

cryptochordism

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80% of cryptochordism descends by __

and 90% involve the __

1 yo

inguinal canal

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__% of cryptochordism is truly cryptic

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complications of cryptochordism

infertility

increased risk for seminoma

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tx for cryptochordism

watchful waiting

orchiopexy

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accumulation of fluid around a testicle in the tunica vaginalis

hydrocele

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the tunica vaginalis is a remnant of the \_\_ carried to the testes by the \_\_ during testes descent

peritoneum gubernaculum

2 types of hydrocele

primary secondary

mc cause of scrotal enlargement in kids

primary hydrocele

primary hydroceles are __ with no underlying cause

spontaneous

if there is no \_\_, primary hydroceles resolve spontaneously

hernia

what hernia are primary hydroceles associated w.

indirect

causes of secondary hydrocele

epididymo-orchitis testicular torsion testicular tumor hematocele 2/2 to trauma filarial parasite → elephantitis post herniorraphy hydrocele of hernial sac

dx for hydrocele

transillumination US

3 mc pathogens associated w. orchitis

mumps chlamydia gonorrhea

t/f: orchitis is mc unilateral

sx of orchitis

hematospermia hematuria severe pain swelling

orchitis mc occurs w.

epididymitis → epididymo-orchitis

dx for epididymo-orchitis

PE US

what do you think when you see: marked increased blood flow in abnormal testis

epididymo-orchitis

what is your control when evaluating US for epididymo-orchitis

normal testis

mc pathogen associated w. epididymitis in \<35 yo (2)

chlamydia gonorrhea

mc pathogen associated w. epididymitis in \> 35 yo (2)

e.coli pseudomonas

epididymitis can also be associated w.

AIDS CMV toxoplasmosis salmonella

sx of epididymitis

pain swelling

US findings for epididymitis

increased blood flow in epididymis

testicular torsion mc occurs in \_\_ to __ yo

12 - 18

3 mc causes of testicular torsion

violent movement/trauma cryptorchid testis testicular atrophy

testis inadequately affixed in scrotum due to tunica vaginalis entirely surrounding testicle

bell clapper deformity

complication of testicular torsion

hemorrhagic infarction of testicle

tx for testicular torsion

surgery w.in 12 hr

3 sx of testicular torsion

sudden onset of pain absent cremasteric reflex testical drawn into inguinal canal

dx for testicular torsion

large avascular testis compared to normal side

what do you think when you see: painful blue dot on scrotum

torsion of appendix testis

mc cause of left scrotal enlargement in young adult males

varicocele

mc location for prostate ca

peripheral zone

the peripheral zone can be palpated on

DRE

t/f: prostate ca is asymptomatic until advanced

rf for prostate ca

age fam hx race

what does obstructive uropathy indicate in regards to prostate ca

spread to base of bladder

what does low back/pelvic pain indicate in regards to prostate ca

metastasis to bone

what does increased ALP indicate in regards to prostate ca

bone metastasis

dx for prostate ca

DRE vs PSA

as they age, the majority of men will develop

BPH

BPH occurs where there is hyperplasia of \_\_ and __ elements that form __ and hypertrophy

glandular stromal nodules

2 mc zones for BPH

transitional periurethral

projection of hyperplastic hypertrophied prostate gland that projects into posteroinferior portion of the bladder at the internal urethral orifice

median bar

consequence of median bar

urine outflow obstruction

DRE detects \_\_% of BPH

6 sx of BPH

obstructive uropathy post renal azotemia bilateral hydronephrosis bladder wall hypertrophy bladder infxn elevated PSA