PrimaryCareExam3
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Questions and Answers

At what age is prostate screening typically recommended to start for men without additional risk factors?

  • 55 years old
  • 45 years old
  • 50 years old (correct)
  • 40 years old

Which of the following is a common symptom associated with prostate issues?

  • Urinary difficulty (correct)
  • Nausea and vomiting
  • Breast tenderness
  • Painless lump in the scrotum

What risk factor is NOT associated with an increased risk for testicular cancer?

  • Cryptorchidism
  • Excessive alcohol consumption (correct)
  • Family history
  • Genetic predispositions

Which of the following is a key component of the referral process for men with elevated PSA levels?

<p>Referral to a urologist (A)</p> Signup and view all the answers

What is a likely assessment finding in a patient with cryptorchidism?

<p>Absence of one or both testes upon palpation (C)</p> Signup and view all the answers

What action should be taken if a testicle has not descended by 6 months of age?

<p>Refer for urologic evaluation (C)</p> Signup and view all the answers

Which of the following findings in testicular cancer warrants immediate referral?

<p>Painless lump in the scrotum (D)</p> Signup and view all the answers

What is a common treatment option for testicular cancer?

<p>Surgery (D)</p> Signup and view all the answers

What is a common symptom associated with testicular torsion?

<p>Severe testicular pain (A)</p> Signup and view all the answers

Which of the following is a significant risk factor for erectile dysfunction?

<p>Cardiovascular disease (A)</p> Signup and view all the answers

What is the primary treatment for gonorrhea infection?

<p>IM Ceftriaxone (D)</p> Signup and view all the answers

What symptom is typical for a male suffering from gonorrhea?

<p>Pus-like discharge from the penis (D)</p> Signup and view all the answers

Which method is primarily used for testing HPV in men?

<p>Visual examination (D)</p> Signup and view all the answers

What is the recommended initial treatment for chlamydia?

<p>Doxycycline 100 mg oral, twice daily for 7 days (A)</p> Signup and view all the answers

What is a common symptom of a yeast infection in men?

<p>Burning sensation during urination (C)</p> Signup and view all the answers

What is the alternative regimen for treating chlamydia if the patient cannot take doxycycline?

<p>Azithromycin 1 g orally, single dose (A)</p> Signup and view all the answers

What is the primary treatment for herpes?

<p>Acyclovir 400mg TID for 7-10 days (D)</p> Signup and view all the answers

Which of the following is a common sign or symptom of Trichomonas?

<p>Vaginal discharge that is thin and frothy (A)</p> Signup and view all the answers

What is required for a diagnosis of Bacterial Vaginosis?

<p>At least three clinical criteria with specific symptoms (C)</p> Signup and view all the answers

Which of the following testing methods is the gold standard for diagnosing Trichomonas?

<p>Affirm test for BV, yeast, and trich (B)</p> Signup and view all the answers

What time frame is typical for the detection of HIV after exposure using an antigen/antibody test?

<p>18 to 45 days (B)</p> Signup and view all the answers

Which of the following is NOT a symptom of chlamydia?

<p>Dry mouth (A)</p> Signup and view all the answers

What is the recommended annual screening guideline for chlamydia?

<p>Females under age 25 and those with risk factors (A)</p> Signup and view all the answers

What treatment option is appropriate for bacterial vaginosis?

<p>Metronidazole 500mg orally BID for 7 days (B)</p> Signup and view all the answers

What occurs during the follicular phase of the menstrual cycle?

<p>A fully mature egg is released from the ovary. (C)</p> Signup and view all the answers

What is the primary hormone that triggers ovulation?

<p>Luteinizing hormone (LH) (B)</p> Signup and view all the answers

Which statement is true regarding the luteal phase of the menstrual cycle?

<p>It is relatively stable in length. (B)</p> Signup and view all the answers

Which combination of symptoms is necessary for the diagnosis of PCOS in adult women?

<p>Hyperandrogenism, Oligoovulation, and Polycystic ovaries (B)</p> Signup and view all the answers

What is a common treatment approach for managing PCOS?

<p>Hormonal contraceptives and lifestyle adjustments (A)</p> Signup and view all the answers

What is the recommended age for women to start mammogram screenings every two years?

<p>40 years old (B)</p> Signup and view all the answers

Which symptom is NOT typically associated with mastitis?

<p>Nausea (D)</p> Signup and view all the answers

What is a key focus of breastfeeding support guidelines?

<p>Latch techniques and troubleshooting (A)</p> Signup and view all the answers

What is the recommended screening period for gestational diabetes in pregnant patients?

<p>24-28 weeks (A)</p> Signup and view all the answers

Which symptom is NOT commonly associated with a urinary tract infection (UTI)?

<p>Abdominal pain (A)</p> Signup and view all the answers

In the case of early pregnancy loss, what is the advised action regarding conception?

<p>Wait until beta HCG levels reach zero (A)</p> Signup and view all the answers

What should be done for a suspected ectopic pregnancy?

<p>Perform an emergency referral (A)</p> Signup and view all the answers

Which of the following statements about RhoGAM is true?

<p>It prevents alloimmunization in Rh-negative mothers (C)</p> Signup and view all the answers

What percentage of pregnant patients is likely to experience pregnancy complications?

<p>10-20% (D)</p> Signup and view all the answers

At what stage in pregnancy can a gestational sac typically be detected via ultrasound?

<p>4-5 weeks (C)</p> Signup and view all the answers

Which of the following is a common recommendation for patients experiencing light bleeding during the first trimester?

<p>Consult a healthcare professional if bleeding is significant (A)</p> Signup and view all the answers

What is the primary diagnostic tool used for confirming ectopic pregnancy?

<p>Ultrasound imaging (D)</p> Signup and view all the answers

At what gestational age should Group B Strep screening typically take place?

<p>35-37 weeks (A)</p> Signup and view all the answers

Which symptom is not considered an emergency sign in ectopic pregnancy?

<p>Dizziness (C)</p> Signup and view all the answers

What is the recommended treatment for a non-ruptured ectopic pregnancy in a hemodynamically stable patient?

<p>Methotrexate intramuscular (B)</p> Signup and view all the answers

According to Naegele's Rule, how is the due date estimated?

<p>Add one year, subtract three months, and add seven days to the LMP (B)</p> Signup and view all the answers

What is a significant concern when managing pregnant patients in primary care?

<p>Balancing pregnancy-related health needs (C)</p> Signup and view all the answers

Which statement about genetic screening is correct?

<p>It involves understanding indications and types. (B)</p> Signup and view all the answers

Gestational diabetes is primarily diagnosed using which method?

<p>Glucose tolerance tests (D)</p> Signup and view all the answers

What is the primary characteristic of Peyronie disease?

<p>Buildup of hardened fibrous tissue in the corpus cavernosum (B)</p> Signup and view all the answers

What is a common presenting symptom of Peyronie disease?

<p>Persistent penile pain (A)</p> Signup and view all the answers

Which factor is known to contribute to the development of Peyronie disease?

<p>Repetitive penile injury (B)</p> Signup and view all the answers

What is the recommended action if undescended testes are still non-palpable at the 4-6 month well-child exam?

<p>Refer to urology/surgery for evaluation and possible orchidopexy (D)</p> Signup and view all the answers

What advice is recommended for adolescents regarding testicular health?

<p>Perform monthly testicular self-examinations (A)</p> Signup and view all the answers

Complications associated with undescended testes include which of the following?

<p>Subfertility (B)</p> Signup and view all the answers

What is the significance of conducting a thorough GU exam for cryptorchidism?

<p>To attempt to 'milk' inguinally located testes into the scrotum (D)</p> Signup and view all the answers

What is a misconception about penises that pertains to Peyronie disease?

<p>Variations in shape and size are normal (A)</p> Signup and view all the answers

What percentage of male children with bilateral cryptorchidism may experience infertility?

<p>75% (B)</p> Signup and view all the answers

Which test is recommended if neither testicle is palpable at birth?

<p>Ultrasound (B)</p> Signup and view all the answers

Which phosphodiesterase inhibitor can remain effective for 24 to 36 hours?

<p>Tadalafil (Cialis) (D)</p> Signup and view all the answers

What is a common symptom of acute bacterial prostatitis?

<p>Boggy, warm, tender prostate (C)</p> Signup and view all the answers

In which age group is chronic prostatitis most commonly observed?

<p>40-70 years (D)</p> Signup and view all the answers

What action should be avoided if acute prostatitis is suspected?

<p>Massaging the prostate (D)</p> Signup and view all the answers

What is a significant risk factor for acute prostatitis?

<p>Young age (D)</p> Signup and view all the answers

What is the contraindication for using phosphodiesterase inhibitors?

<p>Use of nitrates (C)</p> Signup and view all the answers

Which of the following is NOT a cause of prostatitis?

<p>Injury from heavy lifting (B)</p> Signup and view all the answers

What type of prostatitis is characterized by an enlarged, nontender prostate during examination?

<p>Chronic prostatitis (C)</p> Signup and view all the answers

What is a common treatment regimen for epididymitis in patients less than 35 years old with suspected STD etiology?

<p>Ceftriaxone plus doxycycline (D)</p> Signup and view all the answers

Which finding is likely to be revealed by urinalysis and culture in a case of epididymitis?

<p>Pyuria and bacteriuria (C)</p> Signup and view all the answers

What is a critical characteristic of paraphimosis?

<p>Entrapment of the foreskin in the retracted position (A)</p> Signup and view all the answers

What may cause phimosis in adults?

<p>Scarring post-trauma or infection (A)</p> Signup and view all the answers

What is the initial management step for paraphimosis following urethral catheterization?

<p>Firm compression of the glans (A)</p> Signup and view all the answers

In which population is levofloxacin an alternative treatment for suspected enteric organisms in epididymitis?

<p>Men aged 35 and older (B)</p> Signup and view all the answers

What is a key reason for referring sexual partners for evaluation when treating epididymitis?

<p>To address potential STD exposure (A)</p> Signup and view all the answers

What is a consequence of unresolved paraphimosis?

<p>Vascular compromise and necrosis (D)</p> Signup and view all the answers

What is the most significant vascular cause of erectile dysfunction?

<p>Atherosclerosis (B)</p> Signup and view all the answers

Which hormonal condition may lead to erectile dysfunction?

<p>Hypogonadism (B)</p> Signup and view all the answers

What psychological assessment might be indicated for erectile dysfunction?

<p>Psychologic testing (A)</p> Signup and view all the answers

Which substance is likely to contribute to increased risk factors for erectile dysfunction?

<p>Alcohol (C)</p> Signup and view all the answers

Which examination is commonly performed to assess for signs of erectile dysfunction?

<p>Digital rectal examination (C)</p> Signup and view all the answers

Which of the following factors is NOT typically associated with erectile dysfunction?

<p>High physical activity level (A)</p> Signup and view all the answers

What laboratory test is recommended if hypogonadism is suspected?

<p>Prolactin levels (C)</p> Signup and view all the answers

What is one of the primary causes of veno-occlusive dysfunction related to erectile dysfunction?

<p>Pelvic trauma (A)</p> Signup and view all the answers

What is considered a normal PSA level?

<p>&lt; 4 (A)</p> Signup and view all the answers

What condition is most likely indicated by a PSA level greater than 4?

<p>BPH, prostate cancer, and prostatitis (C)</p> Signup and view all the answers

Which class of medications helps relieve symptoms by causing urethral relaxation?

<p>Alpha-blockers (B)</p> Signup and view all the answers

Which medication is an example of a 5-alpha reductase inhibitor used to treat BPH?

<p>Finasteride (B), Dutasteride (C)</p> Signup and view all the answers

What is the purpose of urinalysis in patients suspected of having BPH?

<p>To rule out other conditions (D)</p> Signup and view all the answers

What surgical procedure involves removing excess prostate tissue to relieve obstruction in advanced BPH cases?

<p>Transurethral resection of the prostate (TURP) (D)</p> Signup and view all the answers

Which of the following is a notable side effect associated with alpha-blockers used for BPH treatment?

<p>Dizziness and orthostatic hypotension (C)</p> Signup and view all the answers

What effect do PDE5 inhibitors have when used in men with BPH-related symptoms?

<p>Relax blood vessels and increase blood flow (B)</p> Signup and view all the answers

Flashcards

Prostate Screening Age

Generally recommended starting at age 50, or earlier with risk factors.

Testicular Cancer Screening

Self-exams crucial, especially for men aged 15-35.

Cryptorchidism Risk Factors

Premature birth, low birth weight, family history, possible environmental exposures and genetic.

Cryptorchidism Assessment

Physical examination to find missing testicles or in unusual locations.

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Cryptorchidism Referral

Urologist referral if testicles don't descend by 6 months.

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Prostate Screening Diagnostics

PSA test, digital rectal exam (DRE), and possible biopsy.

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Testicular Cancer Treatment

May involve surgery, chemotherapy, or radiation.

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Prostate Screening Symptoms

Common symptoms include urinary problems, pain or erectile dysfunction.

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Testicular Torsion

A surgical emergency where a testicle twists, causing severe pain and potentially damage.

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Gonorrhea

Infection from Neisseria gonorrhoeae, often causing painful urination and discharge from penis.

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Chlamydia Screening

Diagnosis of Chlamydia through urine or vaginal/cervical swab using NAATS test.

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Chlamydia Treatment

Treatment involves antibiotics like Doxycycline or Azithromycin, taken for a prescribed duration to eradicate infection

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Erectile Dysfunction Risk Factors

Factors like smoking, obesity, lack of activity, and psychological stress can contribute to erectile dysfunction.

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Yeast Infection Symptoms

Symptoms include itching, burning, thick white discharge, and redness in the vaginal area.

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HPV Treatment

Treatment for HPV usually involves topical creams or cryotherapy, and may resolve naturally within a year.

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Testicular Torsion Assessment

Assessment for testicular torsion includes identifying a noticeable bulge and discomfort, especially with movement.

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Follicular phase

Part of the menstrual cycle where a follicle develops an egg.

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Ovulation

Release of a mature egg from the ovary.

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Luteal phase

Phase after ovulation, preparing for pregnancy.

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PCOS diagnosis

Diagnosed with 2 of 3 indicators: irregular periods, hyperandrogenism, or polycystic ovaries on ultrasound. Hypersecretion of androgens is common

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PCOS Management

Lifestyle changes, hormones, or insulin control medications.

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Breast cancer screening

Mammograms and self exams based on age and risk factors.

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Mastitis symptoms

Breast pain, redness, and fever.

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Postpartum Care

Post-giving birth care for mother & baby.

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Chlamydia Symptoms

Chlamydia often has no symptoms (asymptomatic). When present, symptoms include burning during urination, pelvic pain, unusual discharge, and bleeding between periods.

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Chlamydia Testing

Annual screenings for those under 25, or for those with new partners, multiple partners, or a recent partner with an STI.

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Herpes Treatment (primary)

Acyclovir 400mg TID for 7-10 days or Famciclovir BID for 1 day (6 hours post-symptoms).

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Herpes Recurrence Treatment

Famciclovir twice daily for a year to help with suppressing recurrences; suppressive treatment with Acyclovir BID, Valacyclovir daily, or Valacyclovir once daily.

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Bacterial Vaginosis Testing

Diagnosed with 3 symptoms: thin white discharge, clue cells (on wet mount), pH >4.5, and a fishy odor.

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Bacterial Vaginosis Treatment

Treatment options include Metronidazole 500mg BID x 7 days, Metronidazole gel, or Clindamycin cream.

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Trichomoniasis Testing

Affirm test (Checks for BV, yeast, and trich) is the gold standard, but a wet mount can also be performed.

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Trichomoniasis Treatment

Metronidazole 2g single dose, Tinidazole 2g single dose, or Metronidazole 500mg BID for 7 days are possible treatments.

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Preeclampsia

A serious pregnancy complication characterized by high blood pressure and protein in the urine after 20 weeks of pregnancy.

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Labor Stages

The process of childbirth divided into three stages: Stage 1 (dilation and effacement), Stage 2 (pushing and delivery of the baby), and Stage 3 (delivery of the placenta).

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RhoGAM

A medication given to Rh-negative mothers during pregnancy to prevent their immune system from attacking their baby's red blood cells if the baby is Rh-positive.

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UTI Symptoms

A urinary tract infection can cause pain or burning during urination, frequent urination, and a feeling of needing to urinate urgently.

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Gestational Diabetes

A type of diabetes that develops during pregnancy due to hormonal changes.

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Early Pregnancy Loss

A pregnancy that ends before the 13th week, commonly known as a miscarriage.

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Ectopic Pregnancy

A pregnancy where the fertilized egg implants outside the uterus, usually in the fallopian tube.

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Placenta Previa

A condition where the placenta is positioned low in the uterus, covering or partially covering the cervix.

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Ectopic Pregnancy Symptoms

Common symptoms include abdominal pain, vaginal bleeding, and missed period. Other signs may include dizziness, fever, and fainting.

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Ectopic Pregnancy Diagnosis

Ultrasound imaging helps determine the location of the pregnancy. Blood tests track hCG levels.

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Ectopic Pregnancy Treatment

Treatment depends on severity. Methotrexate medication can be used for non-ruptured cases, while surgery may be needed for unstable pregnancies.

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Group B Strep Screening

A routine test done between 35-37 weeks of pregnancy to check for Group B Strep bacteria in the vagina.

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Naegele's Rule

A method to estimate due date. Add one year, subtract 3 months from the Last Menstrual Period (LMP), then add 7 days.

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Puerperium

The postpartum period following childbirth, where the body recovers and returns to a non-pregnant state.

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Cryptorchidism

A condition where one or both testes fail to descend into the scrotum.

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Cryptorchidism Risk

Premature infants have a higher risk of cryptorchidism compared to full-term infants.

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Cryptorchidism Timing

Surgery (orchiopexy) to fix cryptorchidism is usually recommended if the testes haven't descended by 6 months of age.

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Cryptorchidism Complications

Undescended testes can lead to testicular cancer, infertility, or testicular torsion.

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Peyronie's Disease

A condition where hardened fibrous tissue builds up in the penis, causing pain and curvature, especially during erection.

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Peyronie's Disease Cause

Often caused by repeated penile injury, such as during sex or physical activity, or genetic predisposition.

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Peyronie's Disease Symptoms

Symptoms include penile pain, hardness, bending of the penis, shortening, and difficulty getting or maintaining an erection.

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Normal Penile Shape

Penises come in various shapes and sizes. A slightly curved erection isn't necessarily a problem.

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Testicular Self-Exam

A monthly check of your testicles for any abnormalities, recommended for men during adolescence and throughout life.

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Erectile Dysfunction (ED)

Inability to achieve or maintain an erection sufficient for sexual intercourse.

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Major Organic ED Causes

Vascular disorders (atherosclerosis), neurologic disorders, hormonal imbalances, medications, and psychological factors can contribute to ED.

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Atherosclerosis in ED

Narrowing of the arteries in the penis due to plaque buildup, often caused by smoking and diabetes, leading to reduced blood flow and difficulty achieving an erection.

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Veno-occlusive Dysfunction

Inability of the veins in the penis to properly trap blood, leading to leakage and difficulty maintaining an erection.

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ED Diagnosis Methods

Medical history, physical exam, laboratory tests, and specialized testing (e.g., nocturnal penile tumescence, vascular testing) are used to diagnose ED.

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Treat the Underlying Cause

Treating the root cause of ED, such as high blood pressure, diabetes, or medication side effects, is crucial for effective treatment.

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ED Treatment Options

Treatment options for ED may include lifestyle modifications, medications, therapy, and in some cases, surgery.

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ED Impact on Quality of Life

ED can significantly impact a man's self-esteem, relationship, and overall well-being.

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Phosphodiesterase Inhibitors

Medications like sildenafil (Viagra) that increase cGMP levels in the penis, causing relaxation of smooth muscle and improved blood flow, leading to erections.

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Sildenafil (Viagra)

A PDE inhibitor taken 30-60 minutes before intercourse, effective for 6-8 hours. Should be taken on an empty stomach.

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Tadalafil (Cialis)

A PDE inhibitor effective for 24-36 hours, taking about 2 hours to work. Can be taken with or without food.

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Vardenafil (Levitra)

A PDE inhibitor taken 1 hour before intercourse, effective for 6-8 hours. Can be taken with food, but avoid fatty meals.

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Prostatitis

Inflammation of the prostate gland, often causing urinary and pelvic pain, classified into different types based on severity and cause.

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Acute Bacterial Prostatitis

A more serious form of prostatitis, often occurring in younger individuals, characterized by fever, chills, urinary frequency, pain, and a tender, enlarged prostate.

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Chronic Prostatitis

A less severe, but persistent form of prostatitis, common in men aged 40-70 years. Can be bacterial or non-bacterial, often causing intermittent urinary symptoms and pelvic pain.

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Prostate Massage in Acute Prostatitis

Prostate massage is strictly contraindicated in acute bacterial prostatitis, as it can lead to sepsis.

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Epididymitis Treatment (< 35 yrs, STD)

Ceftriaxone (500mg IM) plus doxycycline (100mg PO BID x 10 days) for suspected gonorrhea and Chlamydia. Refer sexual partners.

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Epididymitis Treatment (≥ 35 yrs, Enteric)

Levofloxacin 500mg PO for 10 days or Trimethoprim-sulfamethoxazole (double-strength BID x 10 days) for suspected enteric infection.

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Epididymitis Treatment (Anal Intercourse)

Ceftriaxone (500mg IM) plus Levofloxacin (500mg PO once daily x 10 days) due to multiple potential organisms.

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Phimosis vs. Paraphimosis

Phimosis: Foreskin can't be retracted, usually normal. Paraphimosis: Foreskin trapped in retracted position - medical emergency.

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Paraphimosis: Why Emergency?

Constriction of the foreskin restricts blood flow, leading quickly to swelling and potential glans necrosis.

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Paraphimosis: Management

Immediate treatment needed. Manual reduction of swelling by compressing glans may allow foreskin repositioning.

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Phimosis: Common Causes

Scarring from trauma, infection (balanitis), or prolonged irritation can cause Phimosis in adults.

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Phimosis: Urethral Catheterization

Always remember to reduce the foreskin back to its normal position after any urethral catheterization.

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BPH Screening

Testing is recommended for patients with symptoms or a palpable prostate abnormality.

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PSA Levels and BPH

PSA levels are often elevated in Benign Prostatic Hyperplasia (BPH).

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Normal PSA Level

A PSA level less than 4 is considered normal.

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High PSA and Potential Causes

A PSA level greater than 4 could indicate BPH, prostate cancer, or prostatitis.

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BPH Management: Observation

Observation is an option for mild BPH symptoms, with annual monitoring.

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Alpha-Blockers for BPH

Alpha-blockers relax the urethra, providing rapid symptom relief in BPH.

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5-Alpha Reductase Inhibitors

These inhibitors shrink an enlarged prostate by reducing the conversion of testosterone.

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PDE5 Inhibitors for BPH

PDE5 inhibitors can help men with BPH-related symptoms and erectile dysfunction.

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Study Notes

Men's Health

  • Prostate Screening: Generally involves PSA test and digital rectal exam (DRE). Typically recommended starting at age 50 or earlier if additional risk factors exist. Rarely indicated in young patients without urinary complaints. Older patients with BPH symptoms may require a prostate exam.
  • Risk Factors for Prostate Cancer: Higher risk in men over 50, African American men, and those with family history.
  • Prostate Cancer Diagnostics: PSA levels, DRE and if needed biopsy.
  • Prostate Cancer Referral and Follow-up: Patients with elevated PSA or abnormal DRE results should be referred to a urologist.
  • Common Prostate Cancer Symptoms: Urinary difficulty, pain, or erectile dysfunction.

Testicular Cancer

  • Screening: Self-exams are essential, especially for men between 15-35.
  • Risk Factors for Testicular Cancer: Cryptorchidism, family history, and genetic predispositions.
  • Assessment of Testicular Cancer: Presence of a painless lump, swelling, or heaviness in the scrotum.
  • Treatment for Testicular Cancer: Surgery, chemotherapy, and/or radiation.
  • Testicular Cancer Referral and Follow-up: Early referral to oncology or urology is crucial for effective treatment.

Cryptorchidism

  • Risk Factors for Cryptorchidism: Premature birth, low birth weight, family history, hypospadias, prenatal exposure to endocrine disruptors (e.g., pesticides), maternal smoking or diabetes, high maternal alpha-fetoprotein levels, and Kleinefelter syndrome.
  • Assessment Findings for Cryptorchidism: Absence of one or both testes upon palpation of the scrotum, or both testicles in a location other than the scrotum (infant examination: supine, frog-leg or sitting position; older child: supine or sitting upright cross-legged position). Most patients have an inguinal hernia.

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Description

This quiz covers essential information regarding prostate and testicular cancer, including screening methods, risk factors, and diagnostic procedures. It is tailored for individuals interested in understanding these important health topics, particularly men aged 15 to 50 and above. Test your knowledge on symptoms and follow-up protocols for prostate health and testicular self-examinations.

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