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wk 14, lec 1 Flashcards

1
Q

non STI infections

A

epididymtitis
orchitis
balanitis

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2
Q

chylamydia cause and sx

A

chylamydia trachmoatis

often symptomatic

urethritis- urethra discharge, dysuria

epipydymitis- scrotal pain and swell

rectal infection

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3
Q

gonorrhea cause and sx

A

neisseria gonorrhoea

urethritis; dysuria and discharge

epipdidymitis

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4
Q

chancroid cause and sx

A

haemophilus ducreyi

genital ulcers (chancroids)

inguinal lymphadenopathy

systemic sx: fever, malaise

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5
Q

condyloma latum

cause and sx

A

secondary syphilis (treponema pallidum)

genital lesions that are highly infections

systemic; fever, malaise, lymphadenopathy

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6
Q

human papilloma virus (HPV)

A

genital warts (condyloma acuminatum) from low risk HPV

Cervical Abnormalities, Other Anogenital Cancers.
Oropharyngeal lesions

high risk cause cancer

vaccine!

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7
Q

syphlis cause and stages

A

treponema pallidum

primary syphilis: painless ulcers (chancers)

secondary: chancre heals and then get rash and lesions and lymphadenopathy

latent: asymptomatic

tertiary: (if untreated) destructive lesions in many organs, CV, CNS, skin…

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8
Q

trichomoniasis cause and sx

A

trichomonas vaginalis

urethritis, prostatic, epipdicymtiis, dysuria, pruritis

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9
Q

Lymphogranuloma Venereum (LGV)

cause and sx and stages

A

chlamydia trachomatis serotypes L1-3

invade lymph –> systemic spread

primary: ulcer (chancre) at site

secondary: inguinal or femoral adenopathy, fever and malaise

tertiary: fibrosis and scarring of lymphs, genital elephantiasis

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10
Q

Herpes Simplex Virus (HSV)

A

primary infection: oral or genital ulcer, fever, maliase

recurrent: vesicles and ulcers

then have latent phase in between; lifelong infection latent in sensory ganglia (trigeminal or sacral)

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11
Q

epipdidymitis

A

from bacterial infection mostly coming from urethra or bladder

edema, infalmmed,

acute: unilateral scrotal pain, fever, dysuria, positive prehns sign (pain relief with scrotal elevation)

chronic: scrotal pain, swelling, sx wax and wain, fertility impacted

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12
Q

preens signs (relief of scrotal pain) in epipdydmitis vs orchitis

A

epidydmtis: postive

orchitis: negative

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13
Q

orchitis

A

inflamed one or both testicals usually from bacterial or viral infection (common to be secondary to epididymitis)

acute: unilateral or bilateral testicle pain, erythema, pain radiation to back or ab, fever, malaise, neagtive prehn’s sign

chronic: testicular pain and enlargement for months

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14
Q

balanitis

A

inflamed glans penis ; infectious or non infectious (i.e. poor hygiene, uncircumcised, allergy)

itch, burn, dysuria, pain during sex, white cheesy (smegma) under foreskin, ulcers, vesicles –> chronic could be scarring or phimosis (tighten foreskin)

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15
Q

congenital vs non congenital hypogonadism tx

A

Congenital cases may require both LH and FSH (for spermatogenesis) while
acquired cases post-puberty respond to LH alone

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16
Q

primary hypogonadism characteritiscs

A

low T and high gonadotropins (LH and FSH)

congenital or acquired

congenital: klinefelter sx, androgen insensitivity, autoimmune etc.

acquired: radiation, chemo, orchitis, meds

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17
Q

secondary hypogonadism

A

congenital hypogonadotrophic hypogonadism, kallmann syndrome

acquired: more common; meds (steroids, opioids), hyperprolactinemia, hypothalamus/ pituitary tumors

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18
Q

hypogoand sx

A

ED, low sperm, infertile, less muscle more fat, decrease hair, low BMD, depressed, cognitive decline, metabolism (T2D, dyslipidemia), CV (heart fail, stroke)

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19
Q

andropause/ late onset hypogonad

A

age related testosterone decline

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20
Q

Lower Urinary
Tract Symptoms (LUTS) contributing factors

A

Bladder dysfunction (overactive bladder)

Bladder outlet obstruction (i.e. benign prostatic hyperplasia)

Neurogenic causes (i.e. SCI, MS)

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21
Q

common cause of LUTS in men

A

BPH is a common cause of LUTS, leading to
urinary flow obstruction due to prostate enlargement

22
Q

LUTS sx

A

Storage Symptoms: urgency, frequency, nocturia (increased urination at night), and urgency incontinence (leakage associated with urgency)

Voiding Symptoms: weak urinary stream, hesitancy (difficulty initiating urination), intermittency (stopping and
starting during urination), and incomplete emptying of
bladder

Postmicturition Symptoms: Post-void dribbling and the sensation of incomplete emptying

23
Q

Benign Prostatic Hyperplasia (BPH)

A

enlargement of transition zone in prostate gland

hormonal changes

overgrowth of prostatic epithelial
and stromal cells, leading to formation of
nodules –> mechanical obstruction of urethra)

24
Q

hormonal influence of BPH

A

testosterone –> DHT via 5-alpha reductase

stimulates prostate growth

aging can increase DHT levels and make prostate sensitive to androgens –> BPH

25
consequences of BPH
LUTS, urinary retention, bladder dysfunction
26
scrotal conditions
Inguinal and Femoral Hernia Hydrocele Spermatocele Varicocele Hematocele
27
inguinal and femoral hernia
weak abdominal wall muscles cause ab contents to protrude down risks: old age, men, obese, chronic cough, heavy lift surgery: hernioplasty
28
hydrocele
fluid accumulates in layers of tunica vaginalis in scrotum (imbalance of fluid production and absorption) communicating (with peritoneal cavity) or non communicating painless scrotal swelling possible needle aspiration
29
spermatocele
fluid filled cysts in the epidermis possible needle aspiration
30
varicocele
enlarged spermatic vein in the scrotum; impaired drainage or blood reflux dull aching pain, heavy sensation; feels like a bag of warms valsava maneuver accentuates it
31
hematocele
blood accumulates in tunica vaginalis (sac surrounding the testicle)
32
testicular disorders
Testicular Torsion Orchitis Testicular Cancer
33
testicular torsion
torsion of spermatic cord (abnormal attachment of testes to scrotum) sx: pain, N/V, high riding testicle
34
testicular cancer
risks: cryptorchidism (testicle doesnt descend in puberty), family history, genetics Types: Germ cell tumours (seminoma and non-seminomas) and non-germ cell tumours (i.e. Leydig cell tumour) sx: painless testicular mass, scrotal swelling, heavy
35
erection
engorge and stiffen penis Leads to the relaxation of smooth muscle cells and increased blood flow to the erectile tissue
36
nitric oxide and vasodilation of penile arteries
sexual stimulation --> release NO --> guanylyl class --> covert GTP into cGMP --> relax smooth muscles --> increase blood flow and vasodilate
37
erectile tissue (2)
corpora cavernosa corpus spongiosum
38
corpora cavernosa and corpus spongiosum
cavernosa: 2 cylinders on dorsal penis; majority of penile rigidity in erection spongiosum: 1 ventral structure around urethra, maintain erection
39
PNS vs SNS in erections
PNS: vasodilation of arteries, relax smooth muscle -S2-S4 --> release Ach -NO release SNS: constrict penile arteries and contract smooth muscle; inhibit erection -T11-L2 --> release NE
40
emission phase of erection
emit seminal fluid into posterior urethra to prepare for ejactulation
41
components of seminal fluid
spermatozoa (genetic material) seminal vesicles secret seminal fluid (fructose, prostaglandins, nutrients) prostate: prostatic fluid (enzymes, citric acid, zinc; sperm activation and neutralize vaginal acidity)
42
ejaculation which muscles
explosion of semen out at sexual climax bulbospongiosus muscle: expel semen from urethra; at bulb of penis ischiocavernosus muscle: for penile rigidity and to expel semen, compress deep dorsal vein of penis to maintain penile engorgement
43
spinal cord in ejaculation
ejaculatory reflex; (brainstem centers modulate and regulate the process) L1-L2 contain ejaculatory center; coordinate reflex arc sensory input from genitalia activates spinal reflex pathways for rhythmic contractions of pelvic floor muscles
44
brainstem and ejaculation nuclei?
sacral parasympathetic nucleus and thoracolumbar sympathetic nucleus --> modulate spinal ejaculatory center hypothalamus and limbic system for emotional and cognition
45
where is the ejactulatory cneter
L1-L2
46
factors effecting ejactulation
serotonin, dopamine, testosterone MS, spinal cord injury SSRIs, antipsychotics, alpha blockers anxiety, depression alcohol, tobacco
47
Premature Ejaculation (PE)
from anxiety, perforamcen pressure genetics, serotonin neurotransmitter dysfunction behavioural; infrequent sex treat: psychotherapy (CBT), drugs (SSRIs, PDE-5 inhibitors), behavioral (stop/start, pelvic floor)
48
retrograde ejactulation
semen goes up bladder instead of out urethra neurological (diabetes, MS), meds, prostate or bladder surgery, congenital, radiation, trauma causes: infertility (no ejaculate out penis), sexual dysfunction
49
peryronies disease (3 SX)
CT disorder; fibrous plaques in tunica albuginea --> curved penis, pain and ED causes: microvascular trauma, inflammation, abnormal wound healing
50
priapism
prolonged and painful erection; without sexual arrousal causes: meds, sickle cell disease, pelvic trauma... complications: ischemia and permanent ED, necrosis of tissue
51
2 types of priapism (prolonged erection)
ishcemic/ low flow: impaired venous outflow, hypoxia, acidosis non-ishcemic/ high flow: unregulated arterial inflow, from traumatic arteriovenous shunting
52
treat priapism
emergency if ishemic tx: aspiration of blood, inject sympathomimetic agents

BMS250 (52 decks)

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