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DU PA tors, orch,std

Duke PA Epididymitis, Orchitis, Torsion, STD

__ are classically described as abnormal dilation of the veins of the pampiniform plexus Varicoceles
Physical examination reveals the classic bag of worms, testicular atrophy, and tender scrotal contents Varicocele
Varicoceles are commonly __ sided Left
A clinical syndrome the produces fever, acute scrotal pain, and swelling as a result of inflammation and infection of the epididymis Epididymitis
Epididymitis is caused by __ Retrograde bacterial spread from bladder to urethra
What is the most frequent cause of epididymitis in men younger than 35 Gonococcus and chlamydia
What is the most frequent cause of epididymitis in men older than 35 E. coli and other coliforms
How can the causative organism of epididymitis be determined Gram stain and culture of urethral swab or midstream urine specimen
How can the clinician differentiate between testicular torsion and epididymitis Scrotal ultrasound with Doppler flow
A serous fluid collection within the parietal and visceral layers of the tunica vaginalis of the scrotum Hydrocele
Patients with __ usually come to the clinician complaining of heaviness in the scrotum, scrotal pain, and an enlarging scrotal mass Hydrocele
What are the arteries supplying the testicles Testicular artery, vasal artery, cremasteric artery
How are the arteries supplying the testicles transmitted to the testicles Via the spermatic cord
Characteristic symptoms of __ are acute scrotal pain, swelling, and N/V testicular torsion
__ occur in more advanced cases of testicular torsion, but the testis has infarcted by this point Ecchymosis and involvement of the scrotal skin
An antecedent history of __ is often present with testicular torsion Trauma or physical activity
What is the clinical picture of herpes genitalis Multiple painful vesicles on erythematous base, tender/soft adenopathy often bilateral, fever
What is the incubation period for HSV 2-7 days
How long do the primary lesions of HSV last 7-14 days
What is the incubation period of syphilis 10-90 days (mean 21 days)
What is the clinical picture of chancroid Vesicle or papule to pustule to ulcer, soft, not indurated, very painful.
Overall, genital recurrences of HSV develop in approximately __% of patients 60
What is the most common extra salivary site of mumps in adults Testes (testicular swelling and tenderness)
Symptoms of epididymitis Scrotal pain, urinary frequency/urgency/dysuria, urinary retention, nausea, fever and chills, ab or flank pain, urethral discharge
Signs of epididymitis Edematous tender epididymis, erythematous scrotum, edematous scrotum, usually unilateral (90%)
What is Prehn sign Decreased pain with scrotal elevation or support (epididymitis)
Supportive care for epididymitis Scrotal elevation and support, ice pack, spermatic cord block
Acute inflammatory reaction of the testis secondary to infection Orchitis
Most cases of orchitis are associated with __ Viral mumps
Clinical picture of orchitis Enlarged/indurated/tender/erythematous/edematous scrotal skin, soft boggy prostate, parotitis, fever
Imaging test of choice for the evaluation of an acute scrotum Color Doppler ultrasound
Supportive therapy for viral orchitis Bed rest, scrotal support, warm or cold packs for comfort, analgesics
Classic presentation of testicular torsion Sudden onset of sever pain (as if a switch had been flipped), patient appears very uncomfortable
Torsion is the result of trauma in <__% of cases 10
Ischemia from torsion can occur as soon as __ and is almost certain after __ 4 hours, 24 hours
Salvage rate is highly dependent on speed of detorsion with a 90% salvage rate if done in <__ 6 hours
Studies have shown that __% of boys with acute scrotal pain have testicular torsion 16-42%
Most cases of testicular torsion occur in boys aged __ 12-18
With scrotal trauma if pain lasts more than __ after the trauma the testicle should be evaluated for possible trauma induced torsion 1 hour
What are some giveaways to the presence of testicular torsion The testis may appear higher in the affected scrotum with an abnormal transverse lie, the affected testis may also appear larger, the cremasteric reflex is absent (99% sensitive)
Any patient with a history and physical examination suspicious for torsion should have __ Immediate surgery
In the case of testicular torsion what is recommended for the other testis Orchiopexy to prevent likely future torsion
Incubation period of Nongonococcal urethritis (NGU) 4-14 days
Chlamydia dysuria is worst __ During the first morning void and with ETOH
The preferred test for Chlamydia, more sensitive than traditional culture methods NAATS (ligase chain reaction and PCR)
Gonorrhea has an incubation period of __ 2-6 days
Purulent penile discharge, dysuria, erythematous meatus Gonorrhea
Test of choice for Gonorrhea Culture
What is the most common ulcerative STD Genital herpes
One or more painful ulcers, with painful adenopathy, with no evidence of syphilis, or herpes simplex Chancroid
Beefy red appearance, bleeds easily, painless, progressive ulcerative lesions without regional lymphadenopathy Granuloma inguinale (donovanosis)
Granuloma inguinale is difficult to culture, it requires the ID of __ on tissue crush prep or biopsy Donavan bodies
Tender inguinal and or femoral LAD, typically unilateral, a self limited genital ulcer or papule sometimes occurs (C. trachomatis) Lymphogranuloma Venereum
Created by: bwyche