Men’s Health

  1. At what age is the finding of BPH most likely?
    Age 80 - 80% of patients

    (Age 50 - 50% of men)
  2. The prostate shrinks by 50% while on what drug?
    Proscar (Finastride)
  3. What drug is a 5-alpha reductase inhibitor that is given for BPH?
    Proscar (Finasteride)
  4. How do you determine the effectiveness of Proscar?
    Obtain a PSA & multiply by 2 - the value should be below baseline
  5. Older male who complains of gradual urinary obstructive symptoms such as weak stream, postvoid dribbling, feeling of incompetent emptying, and urinary retention. What is the most likely diagnosis? Tx?

    Proscar (Finasteride)
  6. What is a special consideration given when handling Proscar (Finasteride?
    Category X - should not be touched barehanded by reproductive-aged female because it can adversely affect the male fetus
  7. What should you start a patient on who has BPH & Hupertension?
    Give alpha-blocker Terazosin (Hytrin) or Tamulosin (Flomax) first
  8. A elderly male with a history of several weeks of Suprapubic or perineal discomfort that has irritative voiding symptoms such as dysuria, frequency, & nocturia. Does not have systematic symptoms & and could even be asymptomatic. What is the most likely diagnosis?
    Chronic Bacterial Prostatitis
  9. Adult to older male complains of sudden onset of high fever and chills with suprapubic pain. Accompanied by UTI symptoms such as dysuria, frequency, nocturia with cloudy urine. What is the most likely diagnosis?
    Acute Prostatitis
  10. DRE of Acute Prostatitis vs Chronic?
    Acute - extremely tender, warm, boggy

    Chronic - normal, possibly boggy but not tender
  11. Tx for chronic Prostatitis?
    Bactrim P.O. for 4-6 wks -OR- Levaquin
  12. Treatment for patients < 35 with acute Prostatitis?
    Rocephin 250mg IM + Doxy 100mg BID x 10 days
  13. Treatment for someone > 35 with acute Prostatitis?
    Ciprofloxacin/Ofloxacin/Levaquin P.O. x 4-6 weeks
  14. Why should you never vigorously palpate or massage the prostate when assessing for Prostatitis?
    Can cause Septicemia
  15. Firm, smooth, symmetrically enlarged prostate gland. What is the most likely diagnosis?
  16. What can falsely elevate a PSA?
    Acute Prostatitis
  17. Nodular, assymetrical enlargement of the prostate. What is the most likely diagnosis?
    Prostate Cancer
  18. How do you illicit the cremasteric reflex?
    Stroke the inner thigh
  19. A patient with a testicular torsion will have a missing _____ reflex on the affected side.
  20. #1 most common Cancer in men?
    Prostate Cancer
  21. Using transillumination and there is no dull to no glow throughout the scrotum... concerned for?
    Testicular Cancer
  22. Most patients who have prostate cancer have what?
    No symptoms but have a Elevated PSA
  23. Bright red glow in transillumination... likely diagnosis?
  24. Positive Prehn’s sign is a helpful physical exam tool for what?
  25. What sign do you check for in patients who you suspect may have a epididimytis?
    Prehn’s Sign.... painful scrotum should be relieved when lifting the scrotum
  26. Who is at highest risk for epididymitis?
    Truck drivers —- someone who sits a lot!
  27. Undescended testicles that remain in the abdominal cavity is called what?
    Cryptoorchidism (refer @ 6 months if undescended)
  28. What # is considered an elevated PSA?
    > 4
  29. An inflammatory & localized disorder of the penis that results in fibrotic plaques on the tunica aluginea. Results in penile pain that primarily occurs during erection, palpable nodules & penile deformity.
    Peyronie’s Disease
  30. How to differentiate between Epididymitis & torsion?
    Epididymitis is gradual onset & has positive Prehn’s Sign

    Torsion - Acute onset, negative cremasteric reflex (Emeegency!!!)
  31. What is the initial tests for most scrotal issues?
  32. What is a blue dot sign?
    Located underneath skin of testicle & appears round, blue to purple mass. Can resemble testicular torsion, therefore Refer to ED.
  33. Boggy prostate is associated with what?
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Men’s Health