-
prevalence of ED in men 40-70
30%
-
labs if testiticular mass confirmed on u/s
"beta-HCG, lactate dehydrogenase (LDH), and alpha-fetoprotein (AFP)"
-
labs for suspected epididimytis
"UA, culture, urethral swab for STD, scrotal u/s"
-
USPSTF recommendations on prostate CA screening
against ; better test needed
-
acc to AUA what is threshold PSA for further eval
there is no set threshold ; individualized
-
PSA threshold for further eval
4.0 ng/nL
-
labs for suspected kidney stone
"CBC, BMP, UA and culture"
-
what drugs should not be taken with viagra b/c of risk of hypotension
nitrates or nitroglycerin
-
ACS recommended age to begin prostate CA screening in men at avg risk
50
-
ACS recommended age to begin prostate CA screening in AA men
45
-
recommended age to begin prostate CA screening in men at high risk
40
-
acc to ACS prostate CA screening should consist of what?
PSA with or without DRE
-
recommended prostate CA screening freq in men with PSA LT 2.5 ng/mL
q2yrs
-
recommendations if PSA betw 2.5 and 4 ng/mL
individualized dec-making
-
most common cause of epididymitis in men LT 35
gonorrhea/chlamydia
-
most commona cause of epididimytis in men GT 35
E. coli
-
key clinical finding with epididimytis
painful mass behind testicle
-
tx for epididimytis
cipro or ceftriaxone/doxy
-
ddx for LUTS
"BPH, prostatitis, prostate CA, UTI, overactive bladder"
-
labs for BPH
"UA and culture, DRE, PSA and cytology"
-
first line meds for BPH that ease urine flow
alpha blockers like Flomax
-
first line meds for BPH that decrease size of prostate
5 alpha reductase inhibitors like Finasteride
-
surgery for BPH
TURP transurethral resection of the prostate
-
do alpha blocker and 5ARIs work right away to relieve sx of BPH
no. alpha blockers 1-3 mos ; 5 ARIs 3-6 mos
-
mass on scrotum what is ddx ; initial dx test
scrotal CA until proven otherwise ; scrotal u/s
-
sudden severe testicular pain in young man or boy likely what?
testicular torsion ; emergency b/c of ischemia
-
clinical findings in testicular torsion
"elevated testicle, neg cremaster reflex, neg Phrehn sign (lifting testes does not relieve pain as would in epididimytis"
-
assume what with gross painless hematuria
CA
-
in men some nonCA causes of hematuria
"prostatitis, BPH"
-
how does bacterial prostatitis usu present
"acute febrile illness with rectal, perineal, or LB pain"
-
how much more prevalent is abacterial prostatitis than bacterial prostatitis
8x
-
BPH prevalence in men at 60 yo ; 85 yo?
50% ; 90%
-
how do 5 alpha reductase inhibitors like finasteride work?
inhibit conversion of testosterone to dihydrotestosterone and cause prostatic atrophy
-
meds for premature ejaculation
tricyclics ; SSRIs ; topical lidocaine
-
how is Cialis taken? one-off and maintenance?
works in 30-60 min ; lasts 3 days; usu dose is 5 mg ; may take 2.5-5mg daily as maintenance
-
gross hematuria is a common presenting sx of what?
bladder or renal CA
-
if microscopic hematuria consistently found what labs should be considered (think kidneys too)
"UA, culture, serum creatinine"
-
with finasteride tx PSA should decrease by how much at 6 mos
50%
-
what dz class can give a false positive bladder tumor androgen test
STIs
-
What neurological dz's cause UUI
"Parkinsons, MS"
-
Causes of functional UI
"fecal impactioin, immobility, lack of manual dexterity"
-
2 drugs that block FSH and LH that used as androgen ablators in prostate CA tx
Zoladex (goserelin) and Lupron (leuprolide)
-
Can acyclovir cure gential herpes?
no
-
What is NPTR test and what is it used for
Nocturnal Penile Tumescence and Rigidity test used to determine if there is organic cause of ED
-
AUA BPH scale
0-7 no tx ; 20+ medical or surgical tx indicated
-
Can bowel sounds be heard over a hernia or a hydrocele
hernia
-
Can all hernias be reduced
no
-
Balanitis
inflammation of glans
-
balanoposthitis
inflammation of glans and prepuce
-
what is reserpine?
sympatholytic used to block sympathetic vasoconstriction and also used as anti-psychotic ; may contribute to ED
-
How long does it take a boy to progress thru all Tanner Stages
3 yrs
-
Boys Tanner Stg 1
vellus hair in pubic area
-
Boys Tanner Stg 2
pigmented hair at base of penis with enlargement of testes and reddening of scrotum
-
Boys Tanner Stg 3
penis lengthens but does not broaden
-
Boys Tanner Stg 4
penis lengthens and broadens and pubic hair spreads but not to thighs yet
-
Boys Tanner Stg 5
pubic hair spreads to inner thighs ; penis and scrotum adult size
-
lifestyle factors that predispose to prostatitis
vigorous exercise
-
Hormonal disorders that contribute to low testosterone
DM and hyperTH
-
how soon should pt wash off podophyllum in benzoic for gential warts
1-2 hrs after application
-
normal prostate volume
20-30mL
-
most common cause of gross hematuria
bladder infctn
-
what d/o begins with painful tender on penis
genital herpes
-
what do seminal vesicles produce
fluid rich in fructose
-
urinary stones pt may have what presenting symptoms
n/v
-
when do testes descend in fetus
3rd trimester
-
1st line tx for priapism
phenylephrine intracavernosal injection
-
when does fetus develop sex organs
12 mos
-
most common hernia
indirect inguinal
-
what is bulbacavernous reflex
squeeze glans and anal sphincter should contract ; sx that autonomic arch innervating bladder is working
-
what is phimosis
inability to retract foreskin
-
what is paraphimosis
permanent retraction of foreskin
-
when should you be able to fully retract foreskin of baby
by 1 yo
-
race/ethnicity most at risk for testicular CA
white/Scandinavian
-
which type of hernia may descend into scrotum
indirect inguinal
-
2 yo boy with undescended testes. Advice?
needs orchiopexy by age 6
-
most common cause of male infertility
varicocele
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