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Questions and Answers
What is the recommended follow-up for patients under active surveillance for prostate issues?
What is the recommended follow-up for patients under active surveillance for prostate issues?
Which type of testicular cancer accounts for the majority of cases?
Which type of testicular cancer accounts for the majority of cases?
Which of the following is NOT a risk factor for testicular cancer?
Which of the following is NOT a risk factor for testicular cancer?
What symptom is commonly associated with testicular cancer?
What symptom is commonly associated with testicular cancer?
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What is the typical first-line treatment for stage 1 testicular cancer?
What is the typical first-line treatment for stage 1 testicular cancer?
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The majority of testicular cancer cases are classified under which sub-type?
The majority of testicular cancer cases are classified under which sub-type?
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What is an important consideration prior to initiating chemotherapy for testicular cancer?
What is an important consideration prior to initiating chemotherapy for testicular cancer?
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Which symptom can occur in 5% of patients with germ cell tumors?
Which symptom can occur in 5% of patients with germ cell tumors?
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What distinguishes an incarcerated hernia from a strangulated hernia?
What distinguishes an incarcerated hernia from a strangulated hernia?
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Which factor is NOT considered a risk factor for developing a hernia?
Which factor is NOT considered a risk factor for developing a hernia?
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What is a surgical procedure recommended for patients with refractory erectile dysfunction?
What is a surgical procedure recommended for patients with refractory erectile dysfunction?
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Which of the following is a potential side effect of sildenafil (Viagra)?
Which of the following is a potential side effect of sildenafil (Viagra)?
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What symptom might suggest a strangulated hernia?
What symptom might suggest a strangulated hernia?
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What is the recommended initial treatment for a minimally symptomatic hernia?
What is the recommended initial treatment for a minimally symptomatic hernia?
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What underlying condition can lead to the need for psychological support in managing erectile dysfunction?
What underlying condition can lead to the need for psychological support in managing erectile dysfunction?
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Which of the following medications is contraindicated in patients with heart failure?
Which of the following medications is contraindicated in patients with heart failure?
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Which of the following terms describes a hernia that can be replaced into the abdomen with gentle pressure?
Which of the following terms describes a hernia that can be replaced into the abdomen with gentle pressure?
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What post-operative instruction should be followed after hernia repair?
What post-operative instruction should be followed after hernia repair?
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What is the initial recommended dose of Tadalafil for on-demand use?
What is the initial recommended dose of Tadalafil for on-demand use?
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Which finding is characteristic of testicular torsion?
Which finding is characteristic of testicular torsion?
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Which factor requires caution when prescribing phosphodiesterase inhibitors?
Which factor requires caution when prescribing phosphodiesterase inhibitors?
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Which symptom would typically worsen as the day progresses in individuals with hernias?
Which symptom would typically worsen as the day progresses in individuals with hernias?
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What bacteria is responsible for Gonorrhea?
What bacteria is responsible for Gonorrhea?
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What type of therapy is primarily used as a second-line treatment for erectile dysfunction?
What type of therapy is primarily used as a second-line treatment for erectile dysfunction?
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What is the recommended caloric intake per kilogram per day for individuals with a body mass index (BMI) greater than 120% of normal?
What is the recommended caloric intake per kilogram per day for individuals with a body mass index (BMI) greater than 120% of normal?
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What is the standard pharmacological therapy for managing gestational diabetes?
What is the standard pharmacological therapy for managing gestational diabetes?
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During the puerperium, which physiological changes occur as the body adjusts back to its non-pregnant state?
During the puerperium, which physiological changes occur as the body adjusts back to its non-pregnant state?
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Which screening protocol is typically used for assessing gestational diabetes?
Which screening protocol is typically used for assessing gestational diabetes?
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What does the cremastic reflex indicate when absent in a patient?
What does the cremastic reflex indicate when absent in a patient?
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What is the typical duration of the luteal phase in the menstrual cycle?
What is the typical duration of the luteal phase in the menstrual cycle?
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Which hormone triggers ovulation?
Which hormone triggers ovulation?
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What must be present for the diagnosis of PCOS in adult women?
What must be present for the diagnosis of PCOS in adult women?
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What is NOT a treatment option for managing PCOS?
What is NOT a treatment option for managing PCOS?
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What are the early signs of preeclampsia typically monitored for?
What are the early signs of preeclampsia typically monitored for?
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Which symptom is characteristic of mastitis?
Which symptom is characteristic of mastitis?
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What is recommended for breast cancer screening for women aged 40 and over?
What is recommended for breast cancer screening for women aged 40 and over?
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Which aspect is crucial during labor assessment?
Which aspect is crucial during labor assessment?
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What is the primary purpose of administering RhoGAM to Rh-negative mothers?
What is the primary purpose of administering RhoGAM to Rh-negative mothers?
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Which of the following are common symptoms of a urinary tract infection (UTI)?
Which of the following are common symptoms of a urinary tract infection (UTI)?
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At what gestational weeks is screening for gestational diabetes typically performed?
At what gestational weeks is screening for gestational diabetes typically performed?
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What is advised after a spontaneous abortion (SAB) until the beta HCG levels return to 0?
What is advised after a spontaneous abortion (SAB) until the beta HCG levels return to 0?
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In which situation should a patient experiencing bleeding during pregnancy be evaluated immediately?
In which situation should a patient experiencing bleeding during pregnancy be evaluated immediately?
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What is a common treatment for gestational trophoblastic disease (GTD)?
What is a common treatment for gestational trophoblastic disease (GTD)?
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What is one of the leading causes of neonatal mortality linked to pregnancy?
What is one of the leading causes of neonatal mortality linked to pregnancy?
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What is the significance of repeating beta HCG levels every 2-3 days in early pregnancy?
What is the significance of repeating beta HCG levels every 2-3 days in early pregnancy?
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Study Notes
Prostate Screening Guidelines
- USPSTF recommends against routine screening.
- ACS and AUA guidelines advocate individualized approaches with shared decision-making to determine if PSA and DRE screening is in the patient's best interest.
- For most men, annual screening begins at age 50 with PSA and DRE.
- Consider screening at age 45 for high-risk individuals (first-degree relative with prostate cancer before age 65 or Black ethnicity).
- Men with more than one first-degree relative with a history of prostate cancer should begin screening at age 40.
- Asymptomatic men with a 10-year life expectancy should not be offered PSA testing.
- Routine screening includes PSA testing and DRE.
- PSA levels above 4 ng/mL often warrant further investigation (biopsy, imaging).
- Screening frequency depends on risk factors like age, family history, and ethnicity.
Risk Factors
- Age: Risk increases after 50.
- Family history of prostate cancer.
- African American ethnicity.
- Diet high in red meat and low in fruits/vegetables.
Diagnostics
- DRE: Palpable abnormalities suggest malignancy.
- PSA: Elevated levels require follow-up; typically <4 ng/mL. Velocity of change in PSA and DRE should be considered. A PSA of >10 ng/mL usually warrants biopsy; 20% of those with PSA 4-9.9 ng/mL have prostate cancer.
- Adjunctive tests include prostate cancer antigen 3, TMPRSS2-ERG gene fusion, and prostate health index.
- Elevated alkaline phosphatase indicates metastasis.
- Testosterone and liver function tests for androgen deprivation suspicion.
- TRUS with transrectal biopsy for prostate biopsy.
- CT scans primarily assess prostate size and pelvic lymph node involvement; used for pre-operative staging/metastasis evaluation.
Testicular Cancer
- Malignant testicle tumor.
- Two main types:
- Germ cell (seminoma, teratoma, teratocarcinoma, embryonal carcinoma; 90-95% of cases)
- Nongerm cell (Leydig cell, gonadoblastoma, adenocarcinoma; 5-10% of cases).
- Screening: Early detection improves prognosis.
- Risk factors: Cryptorchidism, family history, white race.
- Assessment findings: Painless testicular mass, swelling, discomfort; testicle may feel harder.
- Treatment: Usually involves surgical removal (orchiectomy), followed by chemotherapy/radiation if cancer has spread.
Inguinal Hernia
- Tissue protrusion through the inguinal or femoral canal.
- Types: Indirect, direct, femoral.
- 40% are incarcerated (cannot be returned) or strangulated (blood supply compromised).
- Reducible hernias return spontaneously.
- Risk factors: Prematurity, age >60, smoking, family history, connective tissue disorders.
- Assessment: Painful or painless swelling or lump in the groin/scrotum; symptoms worsen with straining.
- Treatment: Usually surgical repair.
Testicular Torsion
- Sudden, severe, unilateral scrotal pain; commonly seen in young males.
- Findings: Scrotal edema, erythema, firm tender mass, possibly retracted upward, no relief with testicular or scrotal elevation, reactive hydrocele, high-riding testicle ("bell-clapper" deformity), nausea and vomiting, absent cremasteric reflex (negative Prehn's sign).
- Twist score >4 is a medical emergency.
- Treatment: Immediate surgical intervention (within 6 hours), manual detorsion if surgery unavailable), bilateral orchiopexy, surgical exploration and orchiopexy/orchiecomy for non-viable testicle.
Erectile Dysfunction
- Inability to achieve or maintain a rigid erection.
- Causes can be vascular (cardiovascular disease, hypertension, diabetes, smoking, pelvic radiation), neurological (COPD, sleep apnea, stroke, spinal cord injuries), psychological (performance anxiety, relationship issues), or hormonal/drug induced.
- Risk factors: vascular, respiratory (COPD), neurological, penile conditions, hormonal, drug-induced (antihypertensives, antidepressants, antipsychotics, antiandrogens).
Sexually Transmitted Infections (STIs)
- Gonorrhea (Neisseria gonorrhoeae): asymptomatic frequently in women; diagnosed by Nucleic Acid Amplification Test (NAT) of secretions. Treatment: Ceftriaxone 250mg IM + Azithromycin 1g PO.
- Chlamydia (Chlamydia trachomatis) Symptoms: Asymptomatic; diagnosed with NAAT or culture. Treatment: Azithromycin 1g PO OR Doxycycline, 100 mg BID x 7 days.
Other conditions addressed
- Various other conditions were addressed: Bacterial vaginosis, Trichomoniasis, Herpes, HPV, Yeast infections.
- Testing and treatment specifics were included, often differentiating between genders and risk factors for individual conditions.
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Description
This quiz covers the latest prostate screening guidelines recommended by various organizations, including the USPSTF, ACS, and AUA. It includes information on the different risk factors, recommended ages for screening, and the importance of individualized approaches. Test your knowledge on when to start screening and the significance of PSA and DRE tests.
