Witwer - Male GU Flashcards

1
Q

tight foreskin that can not be pulled back

A

phimosis

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2
Q

phimosis can be normal in __ patients,

and usually resolves by __ yo

A

young

7

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3
Q

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

A

16

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4
Q

phimosis predisposes pt to

A

infxn

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5
Q

fibromatosis

painful contracture/erection

plaque formation

curved penis

A

peyronie’s dz

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6
Q

what is fibromatosis

A

multiple fibromas

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7
Q

persistent painful erection

thrombosis w. fibrous replacement

A

priaprism

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8
Q

rf for priaprism (2)

A

SSA

trauma

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9
Q

mc STIs in males

A

gonorrhea

chlamydia

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10
Q

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

A

gonorrhea

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11
Q

what do you think when you see dysuria and penile discharge

A

chlamydia

AND

gonorrhea

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12
Q

scarring that narrows the urethra → causes inflammation/infxn

A

urethral strictures

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13
Q

causes of urethral strictures (5)

A

injury

instrumentation

gonococcal infxn

chronic urethritis

congenital

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14
Q

urethral strictures were common before

A

abx

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15
Q

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

A

non specific urethritis (NSU)

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16
Q

what is NSU

A

infxn caused by multiple uncommon organisms

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17
Q

how do you treat NSU

A

refer to Schoenwald

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18
Q

mc developmental defect of the male genitalia

A

cryptochordism

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19
Q

lack of descent of testes

A

cryptochordism

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20
Q

80% of cryptochordism descends by __

and 90% involve the __

A

1 yo

inguinal canal

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21
Q

__% of cryptochordism is truly cryptic

A

10

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22
Q

complications of cryptochordism

A

infertility

increased risk for seminoma

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23
Q

tx for cryptochordism

A

watchful waiting

orchiopexy

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24
Q

accumulation of fluid around a testicle in the tunica vaginalis

A

hydrocele

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25
Q

the tunica vaginalis is a remnant of the __

carried to the testes by the __

during testes descent

A

peritoneum

gubernaculum

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26
Q

2 types of hydrocele

A

primary

secondary

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27
Q

mc cause of scrotal enlargement in kids

A

primary hydrocele

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28
Q

primary hydroceles are __ with no underlying cause

A

spontaneous

29
Q

if there is no __,

primary hydroceles resolve spontaneously

A

hernia

30
Q

what hernia are primary hydroceles associated w.

A

indirect

31
Q

causes of secondary hydrocele

A

epididymo-orchitis

testicular torsion

testicular tumor

hematocele 2/2 to trauma

filarial parasite → elephantitis

post herniorraphy

hydrocele of hernial sac

32
Q

dx for hydrocele

A

transillumination

US

33
Q

3 mc pathogens associated w. orchitis

A

mumps

chlamydia

gonorrhea

34
Q

t/f: orchitis is mc unilateral

A

T!

35
Q

sx of orchitis

A

hematospermia

hematuria

severe pain

swelling

36
Q

orchitis mc occurs w.

A

epididymitis → epididymo-orchitis

37
Q

dx for epididymo-orchitis

A

PE

US

38
Q

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

A

epididymo-orchitis

39
Q

what is your control when evaluating US for epididymo-orchitis

A

normal testis

40
Q

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

A

chlamydia

gonorrhea

41
Q

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

A

e.coli

pseudomonas

42
Q

epididymitis can also be associated w.

A

AIDS

CMV

toxoplasmosis

salmonella

43
Q

sx of epididymitis

A

pain

swelling

44
Q

US findings for epididymitis

A

increased blood flow in epididymis

45
Q

testicular torsion mc occurs in __

to __ yo

A

12 - 18

46
Q

3 mc causes of testicular torsion

A

violent movement/trauma

cryptorchid testis

testicular atrophy

47
Q

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

A

bell clapper deformity

48
Q

complication of testicular torsion

A

hemorrhagic infarction of testicle

49
Q

tx for testicular torsion

A

surgery w.in 12 hr

50
Q

3 sx of testicular torsion

A

sudden onset of pain

absent cremasteric reflex

testical drawn into inguinal canal

51
Q

dx for testicular torsion

A

large avascular testis compared to normal side

52
Q

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

A

torsion of appendix testis

53
Q

mc cause of left scrotal enlargement in young adult males

A

varicocele

54
Q

mc location for prostate ca

A

peripheral zone

55
Q

the peripheral zone can be palpated on

A

DRE

56
Q

t/f: prostate ca is asymptomatic until advanced

A

T!

57
Q

rf for prostate ca

A

age

fam hx

race

58
Q

what does obstructive uropathy indicate in regards to prostate ca

A

spread to base of bladder

59
Q

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

A

metastasis to bone

60
Q

what does increased ALP indicate in regards to prostate ca

A

bone metastasis

61
Q

dx for prostate ca

A

DRE vs PSA

62
Q

as they age, the majority of men will develop

A

BPH

63
Q

BPH occurs where there is hyperplasia of __

and __ elements

that form __ and hypertrophy

A

glandular

stromal

nodules

64
Q

2 mc zones for BPH

A

transitional

periurethral

65
Q

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

A

median bar

66
Q

consequence of median bar

A

urine outflow obstruction

67
Q

DRE detects __% of BPH

A

50

68
Q

6 sx of BPH

A

obstructive uropathy

post renal azotemia

bilateral hydronephrosis

bladder wall hypertrophy

bladder infxn

elevated PSA