Prostate Screening Guidelines Overview
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What is the recommended follow-up for patients under active surveillance for prostate issues?

  • Consultation with a urologist every year.
  • Repeat prostate biopsies every year for the first 5 years.
  • Urinary tract and sexual dysfunction screening only.
  • Repeat prostate biopsies 1 year after diagnosis, then every 2 to 4 years. (correct)
  • Which type of testicular cancer accounts for the majority of cases?

  • Germ cell tumors. (correct)
  • Gonadoblastoma tumors.
  • Nongerm cell tumors.
  • Seminoma tumors.
  • Which of the following is NOT a risk factor for testicular cancer?

  • Chronic kidney disease. (correct)
  • Family history of testicular cancer.
  • History of cryptorchidism.
  • Previous history of testicular cancer.
  • What symptom is commonly associated with testicular cancer?

    <p>Painless testicular mass.</p> Signup and view all the answers

    What is the typical first-line treatment for stage 1 testicular cancer?

    <p>Radical orchiectomy followed by radiation.</p> Signup and view all the answers

    The majority of testicular cancer cases are classified under which sub-type?

    <p>Germ cell tumors.</p> Signup and view all the answers

    What is an important consideration prior to initiating chemotherapy for testicular cancer?

    <p>Cryopreservation of sperm.</p> Signup and view all the answers

    Which symptom can occur in 5% of patients with germ cell tumors?

    <p>Gynecomastia.</p> Signup and view all the answers

    What distinguishes an incarcerated hernia from a strangulated hernia?

    <p>Incarcerated hernia content cannot be replaced into the abdomen.</p> Signup and view all the answers

    Which factor is NOT considered a risk factor for developing a hernia?

    <p>Age less than 30 years.</p> Signup and view all the answers

    What is a surgical procedure recommended for patients with refractory erectile dysfunction?

    <p>Penile prosthesis</p> Signup and view all the answers

    Which of the following is a potential side effect of sildenafil (Viagra)?

    <p>Headaches</p> Signup and view all the answers

    What symptom might suggest a strangulated hernia?

    <p>Colicky abdominal pain and nausea.</p> Signup and view all the answers

    What is the recommended initial treatment for a minimally symptomatic hernia?

    <p>Watchful waiting with regular follow-up.</p> Signup and view all the answers

    What underlying condition can lead to the need for psychological support in managing erectile dysfunction?

    <p>Stress and depression</p> Signup and view all the answers

    Which of the following medications is contraindicated in patients with heart failure?

    <p>Sildenafil (Viagra)</p> Signup and view all the answers

    Which of the following terms describes a hernia that can be replaced into the abdomen with gentle pressure?

    <p>Reducible hernia.</p> Signup and view all the answers

    What post-operative instruction should be followed after hernia repair?

    <p>Do not lift more than 5 pounds until cleared by a surgeon.</p> Signup and view all the answers

    What is the initial recommended dose of Tadalafil for on-demand use?

    <p>10 mg</p> Signup and view all the answers

    Which finding is characteristic of testicular torsion?

    <p>Sudden and severe unilateral scrotal pain.</p> Signup and view all the answers

    Which factor requires caution when prescribing phosphodiesterase inhibitors?

    <p>Diminished renal function</p> Signup and view all the answers

    Which symptom would typically worsen as the day progresses in individuals with hernias?

    <p>Intermittent bulge that is painful.</p> Signup and view all the answers

    What bacteria is responsible for Gonorrhea?

    <p>Neisseria Gonorrhoeae</p> Signup and view all the answers

    What type of therapy is primarily used as a second-line treatment for erectile dysfunction?

    <p>Intracavernous injection therapy</p> Signup and view all the answers

    What is the recommended caloric intake per kilogram per day for individuals with a body mass index (BMI) greater than 120% of normal?

    <p>24 kcal per kilogram per day</p> Signup and view all the answers

    What is the standard pharmacological therapy for managing gestational diabetes?

    <p>Insulin therapy</p> Signup and view all the answers

    During the puerperium, which physiological changes occur as the body adjusts back to its non-pregnant state?

    <p>Uterine involution</p> Signup and view all the answers

    Which screening protocol is typically used for assessing gestational diabetes?

    <p>Glucose tolerance test</p> Signup and view all the answers

    What does the cremastic reflex indicate when absent in a patient?

    <p>Testicular torsion</p> Signup and view all the answers

    What is the typical duration of the luteal phase in the menstrual cycle?

    <p>14 days</p> Signup and view all the answers

    Which hormone triggers ovulation?

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

    What must be present for the diagnosis of PCOS in adult women?

    <p>Hyperandrogenism</p> Signup and view all the answers

    What is NOT a treatment option for managing PCOS?

    <p>Surgical intervention</p> Signup and view all the answers

    What are the early signs of preeclampsia typically monitored for?

    <p>High blood pressure and proteinuria</p> Signup and view all the answers

    Which symptom is characteristic of mastitis?

    <p>Breast pain, redness, and fever</p> Signup and view all the answers

    What is recommended for breast cancer screening for women aged 40 and over?

    <p>Mammograms every two years</p> Signup and view all the answers

    Which aspect is crucial during labor assessment?

    <p>Recognizing signs of labor onset</p> Signup and view all the answers

    What is the primary purpose of administering RhoGAM to Rh-negative mothers?

    <p>To prevent alloimmunization</p> Signup and view all the answers

    Which of the following are common symptoms of a urinary tract infection (UTI)?

    <p>Dysuria, frequency, and urgency</p> Signup and view all the answers

    At what gestational weeks is screening for gestational diabetes typically performed?

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

    What is advised after a spontaneous abortion (SAB) until the beta HCG levels return to 0?

    <p>Do not try to conceive</p> Signup and view all the answers

    In which situation should a patient experiencing bleeding during pregnancy be evaluated immediately?

    <p>More than 2 pads per hour for more than 2 hours</p> Signup and view all the answers

    What is a common treatment for gestational trophoblastic disease (GTD)?

    <p>Dilation and curettage (D&amp;C)</p> Signup and view all the answers

    What is one of the leading causes of neonatal mortality linked to pregnancy?

    <p>Preterm labor and birth</p> Signup and view all the answers

    What is the significance of repeating beta HCG levels every 2-3 days in early pregnancy?

    <p>To monitor for viable pregnancy</p> Signup and view all the answers

    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.

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