Help
Options
Didn't know it?
click below
click below
Knew it?
click below
click below
Don't Know
Remaining cards (0)
Know
retry
shuffle
restart
0:00
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
Topic in urology
Clinical Medicine II
| Question | Answer |
|---|---|
| Fluid-filled sac surrounding a testicle results in swelling of the scrotum | hydrocele |
| When do thetestes descend | through the inguinal canal about 1m before birth |
| What happens after the dedscent of the testes | processus vaginalis closes and testis is covered in what is now the tunica vaginalis |
| What is a non-communicating hydrocele | the hydrocele does not communicate w/ the abd cavity |
| Where is the fluid in a communicating hydrocele | anterior to the teste |
| What does a communicating hydrocele associated w/ | indirect inguinal hernia |
| What would an acute hydrocele result from | acute process in tunica vaginalis such as trauma, infection, tumor |
| Sxs of hydrocele | USUALLY PAINLESS |
| Dx of hydrocele | fluid filled sac, transillumination, cremasteric reflec intact,U.S.: r/o tumor |
| Tx o f hydrocele | observation in infancy, surgical intervention if symptomatic (aspiration not appropriate by itself) |
| Cystic swelling either of epididymis or of the rete testis | spermatocle |
| Where does a spermatocele occur | above, behind, or separate from the testis |
| Painless diverticulum of the epidydimis located b/w head of epidydmis and testes | spermatocele |
| Tx spermatocele | surgically removed if painful or large enough to cause significant discomfort |
| Are hydroceles, spermatoceles, and varicocels associated w/ infertility | only varicoceles |
| Abnormal dialation of a vein w/I spermatic cord “bag of worms” | varicocles |
| What are the venous plexus for R and L side | papiniform on the right→drains into internal spermativ viein then IVC, L drains into renal vein more acute angle |
| Where do most of varicocles occur | L almost 100% R warrants further investigation |
| Tx varicocele | surgery for relief of sxs, cosmetic? |
| What is RARE before puberty | epididymitis |
| Causes of epididymitis | reflux of urine or infections |
| In men <35 and >35 what are the MC pathogens for infx | <35: N. gonorrhea, C trachomatis anal intercourse, many more >35: enterobacteriaceae and pseudomonas |
| What s often found with epididymitis | 15-20% found with malignant lesions |
| Pain relieved by elevation of the affected testes | prehn sign |
| CP of epididymitis | painful palpation and prehn sign (painful, acute, only behind the teste) can do a UA/UC, aspiration |
| Dx of epididymitis | clinical, gram stain of urethral secretions >5WBC leukocyte esterase on first-void sediment>10, radionuclide scan more accurate, US has 70% sensitivity: R/O torsion/tumor |
| Tx for epididymitis | appropriate abx, anti-inflammatories, scrotal elevation to facilitate drainage, ice |
| Does epididymitis cause infertility | (can: scarring) |
| Abx tx <35mv>35 | <35: doxy 100mg bidx 10d consider adding ceftriazone 250mg x 1dose (N. gonorrhea, C> trachomatis) >35: TMP-SMX ds bid x10-14d (prostitis) cipro 500mg qd x10-14d enterbacteriacae, coliforms, enterococci |
| Uncommon acute inflammation of the testes | orchitis (usually an extension associated w/ epididymitis |
| Cause of orchitis | systemic infections: mups paramyxovirus MC |
| Tx orchitis | scrotal support/elevation, hot/cold packs, abx if deemed appropriate, anti-inflammatory including prednisone, |
| Does orchitis cause infertility | could yes + sterility |
| Testicular maldescent | cryptorchidism |
| When does it need surgical correction | indication if not resolved by one year of age (r/o rectractile physiologic cryptorchidism) |
| Rotation of the testis and spermatocord | testicular torsion |
| Tx testicular torsion | surgical emergency |
| S/S testicular torsion | acute scrotal pain, N/V/ anorexia (d/t pain), trauma? Riding high testes, swelling, extreme tenderness, ABSCENT cremasteric reflex, prehn sign (does not), |
| Dx of TT | US and radionuclide scan, if suspect emergent urology consult |
| When does necrosis occur w/ 360 and 1080 degrees | 360: 12-24hrs, 1080: 2hrs |
| How can we manually untwist the testicles | right clockwise, left counterclockwise, must f/u w/ orichidopexy |
| Surgery to keep undescended teste down | orichidopexy |
| Pain over the upper pole of the testis, nl testicular orientation, pain, blue appearing lesion over upper pole | appendix testes torsion |
| Tx ATT | analgesics |
| When does testicular malignancy peak | 20-40 years, |
| What is testicular malignancy associated w/ | epididymitis, epidiymorchitis may delay dx, |
| Two major groups of germ cell tumors | seminoma and seminomatous |
| What arises from epithelial cells | carcinoma |
| Arises from connective tissues and are often named for the specific type of tissue | sarcoma |
| What increases testes malignancy chance | cryptorchidism (10-40fold), abdominal testis: siminoa,orchiplexy: non semino |
| What a lab findings w/ malignancy | AFP and beta-human chorionic gonadotropin |
| Imaging for examination | US and CT |
| Tx testicular malignancy | beam radiation, surgery, platinum-based chemo |
| Inflammation of the prostate | prostatitis |
| Prostadynia | pain in the prostate |
| Causes of prostatitis | ascending urethral infx d/t meatalinoculation, reflux of infected urine, invasion of colonic bacteria, |
| Sxs of ABP | acute febrile illness, perineal pain, ↑ urinary frequency, dysuria, urgency, nocturia |
| Stranger signs with CBP | penile pain, pain w/ ejaculation, hematospermia, scrotal pain, perianal pain |
| Inflammatory bp | similar to CBP, tx w/ NSAIDS? |
| Tx ABP <35 | doxy 100mg bid x 10d (ceftriaxone 250mg IM x1) |
| Tx ABP >35 | cipro 500mg bid or TMP-STXbid x 10-14d |
| Tx CBP | cipro 500 mg bid x28days |
| BPH | hyperplasia of the prostatic epithelium |
| Sxs with BPH | dysuria, nocturia, urgency, sxs of bladder outlet obstruction, weak stream and post-void dribbling |
| Txof BPH | testosterone and dihydrotestosterone control |
| What may be elevated d/t BPH | PSA (prostatic specific antigen) |
| Will cancer develop if casterated before puberty | no need testosterone to devlope this |
| When does prostate cancer show up | (RARE) before 50 |
| What type of cancer is prostate cancer most often | 95% adenocarcinomas |
| Where are MC mets of prostate cancer | pelviclymph nodes and skeleton, visceral mets, lungs, liver, adrenal glands |
| Causes of urethritis | NGU: chlymydia trachomatis, caffeine, spermatocides, lotions, soaps,condoms |
| NGU definition | urethral discharge/dysuria AND urethral inflammation w/ mucopurulent discharge or leukocytes |
| S/s of NGU | mucoid or watery discharge common, dysuria, 42% asymptomatic |
| Tx urethristis | abx, metronidazole (sxs persist and trichamonas) ↓ caffeine, avoid irritants |
| Inflammation of the glans penis | blanitis |
| What does balanitis sometimes associate w/ | posthitis (inflammation of foreskin), poor hygiene |
| Smegma | glandular secretions |
| Cause of balanitis | candida, (circumcision prevent recurrances) |
| Foreskin too tight to retract | phyimosis, hygiene issues and sex fxn issues |
| Too tight to get back over the glans | paraphimosis, may need emergent relief |
| RF’s for penile cancer | HPV, smoking, tx of penile psoriatic lesions w/ psoralen and ultraviolet radiation, |
| Persistent inability to obtain or maintain sufficient rigidity of the penis to allow satisfactory sexual performance | erectile dysfunction (subjective data) |
| Causes of failure to iniciate erection | endocrinologic, psychogenic, neurogenic |
| Failure to fill the erection | ateriogenic |
| Failure to store blood for an erection | venoocclusive dysfunction |
| Vasculogenic E.D causes | atherosclerotic dz, DM, excessive outflow |
| Neurogenic E.D causes | spinal cord lesions, MS peripheral neuropathy, pelvic surgery |
| Endocrinologic causes E.D. | testosterone leves, prolactin excess (suppress libido) |
| Diabetic E.D. causes | primarily secondary to vascular and nero complications of DM, ↓ Nitric oxide in endothelial tissues |
| Causes of performance anxiety | loss of attraction, relationship conflict, depression, sexual inhibition, fear of STD, preggo, commitment |
| Two casues of psychogenic E.D. | performance anxiety, excess sympathetic tone |
| Medication causes E.D> | diuretics, antiHTN, hormones, antidepressants, H2 blockers, ETOH, cocain, THC |
| Tx E.D. | oral phosphodiesterase type 5 inhibitors (tadalafil, sildenafil, vardenafil) |
Created by:
becker15
Popular Clinical Skills sets