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GU 9 (Male repro)


What are Randon's criteria in determining the prognosis in pts with acute pancreatitis? Admission criteria: glucose, AST, LDH, AGE, WBC. 48 hours after admission: calcium, Hct, oxygen, BUN, Base deficit, sequestration of fluid.
What diagnostic test differentiates central from nephrogenic DI? DDAVP & measure the urine osmolality. Urine osmolality rises then central DI, if is doesnt rise then nephrogenic DI
A pt is unable to inspire completely due to pain during palpation of the RUQ. What is this sign? What is the dx? Murphy's sign, acute cholecystitis
How is BPH diagnosed? symptomatic scoring system, r/o other pathologies with DRE, UA, serum Cr. Other useful but optional tests are PSA, postvoid residual, max urinary flow rate
What is the tx for BPH? Nonselective alpha-blockers(doxazosin, prazosin, terazosin), selective alpha blocker such as tamsulosin(has few SE), and 5-a-reductase inhibitors(finasteride, dutasteride)
What is the next step in the management of a 65 yr old man that presents to the ER with inability to urinate and painful bladder distention? decompressionof bladder with foley cath. If unable to pass urethral cath then do suprapubic cystotomy. If there is no one to do the cystotomy then aspirate the bladder.
A 60 y/o man presents to the clinic for a well exam and on digital rectal exam a hard nodule is palpated on the prostate. Lab work-up shows an elevated PSA. What is the next step in the management of this patient? Transrectal US guided prostate biopsy.
What is the treatment for urethritis in men? ceftriaxone IM + doxy x10 days
What are classic symptoms of BPH? urinary hesitancy, frequency, nocturia, urgency, weak or intermittent stream
Name the 2 classes of prescription medications used to treat BPH. alpha blocers and 5-alpha reductase inhibitors
In a pt suspected of having prostate CA, what might an elevated alkaline phosphatase indicate? Metz to bone
How is the onset of torsion different from epididymitis? torsion has an acute onset and often associated with physical activity. Whereas epididymitis is subacute and may be associated with STDs and/or anal intercourse
T/F One testicle may be raised and horizontal in epidiymitis? False. The testicle is in normal position and lie in epididymitis. Torsion has a testicle that may be raised and horizontal
T/F Providing support to the testicle in testicular torsion will help relieve the pain. False. There is no change in pain. Epididymitis has some relief from pain with support.
T/F The cremasteric reflex is intact in patients with epididymitis? True
What is the treatment for testicular torsion? surgical detorsion with b/l orchiopexy within 6 hours
What is the tx for epididymitis? <35yrs = GC/Chlamydia, treat with ceftriaxone IM + doxy x10 days. If >35 yrs or h/o anal intercourse = enterobacteriaceae, treat with fluoroquinolone x 10-14days
Right-sided varicocele may point to a ___________ cancer. Renal cell carcinoma
What are the characteristic features of a varicocele? dilation of pampiniform plexus in the scrotum, dull, aching scrotal pain usually on the left, may have testicular atrophy of the affected side, infertility is common, color doppler US shows retrograde flow to the scrotum
Which medications are known for causing ED? most antidepressants esp. SSRIs, spironolactone, sympatheic blockes(clonidine, guanethidine, methyldopa), thiazide diuretics, b-blockers, ketoconazole, cimetidine, antipsychotics
What are the first like medications for the treatment of ED? phosphodiesterase inhibitors(sildenafil AKA viagra, vardenafil, tadalafil)
What is the treatment for prostatitis? <35yrs treat with ceftriaxone + doxy x4-6 weeks. If >35 yrs or h/o anal intercourse treat with bactrim or fluoroquinolone x 4-6 weeks
undescended testes put a pt at a higher risk for what condition? testicular CA
What is the mc germ cell tumor of the testis? seminoma
What labwork is included in the work-up for ED? total testosterone, prolactin level, TSH, +/- PSA
T/F nonbacterial prostatitis is more common than bacterial prostatitis True
BPH develops in the ______zone of the prostate. Central
T/F BPH predisposes patients to prostate cancer False
________cancer is the mc cancer in men b/w the ages of 15 and 35 yrs Testicular cancer
What are the risk factors for testicular cancer? prior history of testicular CA, undescended testes, fam history
A patient with frequent infections in the presence of infertility should be worked up for which disease? CF
What is the treatment for testicular cancer? radical orchiectomy +/- chemotherapy and radiation therapy for early stage seminomas, +/- retroperitoneal lymph node dissection or chemo for early stage nonseminomas, chemo and possible postchemo debulking performed for more extensive dz.
Created by: shelybel



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