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Questions and Answers

Which condition is defined as content that cannot be replaced into the abdomen?

  • Incarcerated hernia (correct)
  • Painless hernia
  • Reducible hernia
  • Strangulated hernia

What is a common risk factor for developing a hernia?

  • High body mass index
  • Age over 60 (correct)
  • Daily exercise
  • Sedentary lifestyle

Symptoms of a strangulated hernia may include which of the following?

  • Colicky abdominal pain (correct)
  • Sudden unilateral scrotal pain
  • Reduced pain with lying down
  • Intermittent swelling

What is the appropriate action if a hernia is identified as strangulated?

<p>Refer immediately for surgery (A)</p> Signup and view all the answers

Which statement about reducible hernias is true?

<p>They can be easily replaced with gentle pressure. (B)</p> Signup and view all the answers

Which symptom indicates that a hernia may be worsening?

<p>Bulge in the groin increasing with sitting (A)</p> Signup and view all the answers

What follow-up measure is crucial after surgical hernia repair?

<p>Monitoring for recurrence or infection (C)</p> Signup and view all the answers

Which of the following findings is likely associated with testicular torsion?

<p>Severe pain in one side of the scrotum (A)</p> Signup and view all the answers

Which lifestyle modification may help address underlying causes of erectile dysfunction?

<p>Smoking cessation (A)</p> Signup and view all the answers

What is the maximum recommended dose of sildenafil for erectile dysfunction?

<p>100 mg (A)</p> Signup and view all the answers

What should patients avoid when taking tadalafil?

<p>Concomitant use of nitrates (B)</p> Signup and view all the answers

Which treatment is a second-line option for erectile dysfunction?

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

What is the success rate of alprostadil when used as an intracavernous injection?

<p>31-72% (C)</p> Signup and view all the answers

Which condition is contraindicated for the use of sildenafil?

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

Which sexually transmitted disease is caused by Neisseria gonorrhoeae?

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

What is a common psychological factor contributing to erectile dysfunction?

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

What is the optimal time to wait between pregnancies for better maternal and child health?

<p>18-24 months (D)</p> Signup and view all the answers

Which contraceptive method is especially convenient for long-term use without daily attention?

<p>Intrauterine devices (IUDs) (D)</p> Signup and view all the answers

Which of the following is a potential benefit of hormonal contraceptive methods?

<p>Menstrual regularity (A)</p> Signup and view all the answers

What is a common limitation of natural family planning methods?

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

What should individuals planning pregnancy discuss during preconception counseling?

<p>Folic acid supplementation (C)</p> Signup and view all the answers

Why is postpartum family planning important soon after delivery?

<p>To assure timely contraception initiation if desired (B)</p> Signup and view all the answers

What aspect of individual circumstances should be considered when discussing contraceptive options?

<p>Lifestyle factors and family planning goals (B)</p> Signup and view all the answers

What role should partners play in family planning discussions?

<p>They should engage in open communication regarding choices (A)</p> Signup and view all the answers

What happens to the fundus after 36 weeks of pregnancy?

<p>It begins to drop as the fetus descends into the pelvis. (C)</p> Signup and view all the answers

What is the recommended dosage of folic acid to prevent neural tube defects during pregnancy?

<p>400 mcg (A)</p> Signup and view all the answers

Which diagnostic test is appropriate for a patient suspected of infertility with a varicocele?

<p>Scrotal ultrasound with color Doppler imaging (C)</p> Signup and view all the answers

In men with varicocele, what effect might it have on sperm production?

<p>May lead to low sperm production or quality issues (B)</p> Signup and view all the answers

What is a characteristic feature of a Grade 1 varicocele?

<p>Palpable only when performing the Valsalva maneuver (C)</p> Signup and view all the answers

What is the significance of a semen analysis in the evaluation of a varicocele?

<p>It evaluates sperm quality and potential fertility issues. (C)</p> Signup and view all the answers

What is the primary consequence of untreated varicocele?

<p>Possible infertility or complications in sperm production (A)</p> Signup and view all the answers

What imaging technique is used to confirm the presence of a varicocele through visualizing testicular blood flow patterns?

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

When should a baby with a scrotal mass or hydrocele be reassessed by a doctor?

<p>If the swelling is firm, painful, or large by 1 year old (A)</p> Signup and view all the answers

What is cryptorchidism?

<p>A condition where one or both testicles have not descended into the scrotum (D)</p> Signup and view all the answers

What is the recommended age range for performing an orchiopexy?

<p>6 months to 1 year of age (C)</p> Signup and view all the answers

What is a common cause of erectile dysfunction?

<p>High cholesterol (A)</p> Signup and view all the answers

Why is early surgical intervention for cryptorchidism important?

<p>To reduce the risk of infertility and testicular cancer (D)</p> Signup and view all the answers

What are the potential risks of leaving undescended testicles untreated?

<p>Impaired sperm production and risk of testicular cancer (B)</p> Signup and view all the answers

Which medication is known as the first FDA-approved treatment for erectile dysfunction?

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

What condition is NOT typically associated with erectile dysfunction?

<p>Chronic fatigue (A)</p> Signup and view all the answers

What is the impact of aging on erectile dysfunction?

<p>Aging increases the likelihood of developing ED without causing it (A)</p> Signup and view all the answers

What is the primary first-line medication used for managing depression during pregnancy?

<p>Selective serotonin reuptake inhibitors (SSRIs) (A)</p> Signup and view all the answers

Which of the following is a key symptom of hypertensive disorders in pregnancy?

<p>Visual disturbances (A)</p> Signup and view all the answers

What is the main advantage of insulin as a treatment for diabetes during pregnancy?

<p>It does not cross the placenta (D)</p> Signup and view all the answers

Which medication is known for having the longest track record of safety in treating high blood pressure during pregnancy?

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

What condition is characterized by excessive nausea in pregnancy, likely due to elevated hormone levels?

<p>Hyperemesis Gravidarum (A)</p> Signup and view all the answers

Which of the following is a common dermatologic disorder during pregnancy?

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

What is a common management strategy for hyperemesis gravidarum?

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

Which of the following blood pressure medications needs to be administered only once a day in its extended-release form?

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

What is a key characteristic of chronic bacterial prostatitis?

<p>Can be asymptomatic (A)</p> Signup and view all the answers

Which statement about taking sildenafil is correct?

<p>It should be taken on an empty stomach one hour before intercourse (A)</p> Signup and view all the answers

Which factor most commonly causes acute bacterial prostatitis in younger men?

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

What should NOT be done if acute prostatitis is suspected?

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

How long can tadalafil remain effective after taking it?

<p>24 to 36 hours (C)</p> Signup and view all the answers

What is one of the follow-up visit schedules for testicular cancer after initial treatment?

<p>Every 2 to 6 months for the first 3 years (D)</p> Signup and view all the answers

What is a primary reason for referring a child for urologic evaluation regarding cryptorchidism?

<p>If the testicle has not descended by age 6 months (D)</p> Signup and view all the answers

Which of the following statements is true regarding the likelihood of cure for testicular cancer?

<p>Even late-stage testicular cancer has a high likelihood of being cured (B)</p> Signup and view all the answers

What is a common risk factor for cryptorchidism?

<p>Low birth weight (A)</p> Signup and view all the answers

What characteristic finding is associated with cryptorchidism during a physical exam?

<p>One or both testicles absent upon palpation (A)</p> Signup and view all the answers

What physical examination finding is commonly associated with benign prostatic hyperplasia (BPH)?

<p>A uniformly enlarged, firm, and rubbery prostate (D)</p> Signup and view all the answers

Which symptom is NOT typically associated with BPH?

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

What situation may lead to acute urinary retention in men with BPH?

<p>Use of anticholinergics (B)</p> Signup and view all the answers

Which imaging technique is used for diagnosing a varicocele?

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

What is the likely size change of a varicocele when the patient is in a supine position?

<p>Decrease in size (D)</p> Signup and view all the answers

What is the likely result of a urine culture in a case of acute prostatitis?

<p>Positive for E. coli (A)</p> Signup and view all the answers

Which antibiotics are recommended for treating prostatitis in men younger than 35 years?

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

What is a classic physical sign associated with epididymitis?

<p>Prehn's sign (B)</p> Signup and view all the answers

What blood tests might be necessary for a patient with suspected prostatitis and urinary retention?

<p>Blood cultures and PSA levels (D)</p> Signup and view all the answers

In cases of acute epididymitis, what pathogen is commonly identified in men over 35 years old?

<p>E. coli (D)</p> Signup and view all the answers

What is the recommended treatment duration for chronic prostatitis?

<p>6-12 weeks (A)</p> Signup and view all the answers

Which imaging study is primarily utilized to evaluate significant voiding dysfunction in patients suspecting prostatitis?

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

What key symptom distinguishes testicular torsion from epididymitis?

<p>Rapid onset of pain (A)</p> Signup and view all the answers

What is one advantage of minimally invasive hernia repair over open surgery?

<p>It may result in quicker recovery and less discomfort. (D)</p> Signup and view all the answers

Which is the primary method used to perform minimally invasive hernia repair?

<p>Laparoscopic or robotic instruments. (D)</p> Signup and view all the answers

What is the role of gas in minimally invasive hernia repair?

<p>It inflates the abdomen for better visibility of organs. (C)</p> Signup and view all the answers

After a minimally invasive hernia repair, what should patients expect regarding their ability to resume normal activities?

<p>A quicker return to normal activities compared to open surgery. (C)</p> Signup and view all the answers

Which medication is typically used to treat gonorrhea?

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

What is one characteristic symptom of gonorrhea in men?

<p>Blood tinged urethritis. (C)</p> Signup and view all the answers

How are HPV infections typically diagnosed?

<p>Clinical findings. (C)</p> Signup and view all the answers

What is often true about the lesions caused by HPV?

<p>They are usually asymptomatic. (B)</p> Signup and view all the answers

What is the recommended application frequency for Podofilox solution or gel?

<p>Twice daily three times per week until resolved (B)</p> Signup and view all the answers

Which treatment is NOT a recommended provider-administered option for external warts?

<p>Podofilox solution application (D)</p> Signup and view all the answers

What is the potential side effect reported by patients using Podofilox?

<p>Itching or pain (D)</p> Signup and view all the answers

Which of the following is a treatment option for yeast infections?

<p>Not mentioned in the content (D)</p> Signup and view all the answers

How often is Sinecatechins 15% ointment applied for treating warts?

<p>Three times a day for 16 weeks (B)</p> Signup and view all the answers

What common symptom might females report when infected with Chlamydia?

<p>Mucopurulent vaginal discharge (B)</p> Signup and view all the answers

What is the duration of treatment using Imiquimod cream for external warts?

<p>16 weeks (A)</p> Signup and view all the answers

Which of these is a common route of administration for Azithromycin in treating Chlamydia infection?

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

Flashcards

Femoral hernia

A hernia located below the inguinal ligament, protruding through the femoral ring. Often, 40% become incarcerated or strangulated.

Incarcerated hernia

A hernia where the contents cannot return to the abdomen.

Strangulated hernia

A hernia where the blood supply to the bowel is cut off; urgent surgical need.

Symptoms of Strangulation

Severe, out-of-proportion pain, redness, swelling, wound drainage - potentially nausea, vomiting, and abdominal distension.

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Reducible hernia

Easily pushed back into the abdomen.

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Risk factors for hernias

Premature birth, male gender (8-10 times more common), age over 60, smoking, family history, connective tissue disorder, low BMI.

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Testicular torsion

Sudden, severe, one-sided scrotal pain.

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Treatment for hernias

Surgical repair usually needed, especially for painful, enlarging, or complications. Watchful waiting for minor/low risk cases.

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Radical Prostatectomy

Surgical removal of the prostate gland.

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Erectile Dysfunction Treatment

Various methods, including medication (PDE5 inhibitors), vacuum constriction devices, and even surgery, to improve or restore erectile function.

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PDE5 Inhibitors

Medicines like sildenafil (Viagra) and tadalafil (Cialis) that improve blood flow to the penis.

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Gonorrhea

Sexually transmitted infection causing inflammation in the mucous membranes.

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Sildenafil (Viagra)

PDE5 inhibitor, often used for ED. Dose: initial 50mg, max 100mg, 30-60 minutes before sex. Avoid nitrates and alpha-blockers.

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Tadalafil (Cialis)

PDE5 inhibitor, often used for ED. Dose: initial 10 mg, max 20mg daily or 1 dose every 72 hours if CYP384 present. Avoid nitrates.

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Intracavernous Injection

Injection of medicine directly into the penis to increase blood flow.

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Alprostadil

Medicine used to treat erectile dysfunction by injecting it into the penis to increase blood flow.

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Ideal Pregnancy Spacing

Waiting 18-24 months between pregnancies is generally considered optimal for maternal and child health, reducing risks of preterm birth, low birth weight, and infant mortality.

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Individualized Contraception Counseling

Tailoring contraception advice to each person's unique circumstances, including age, health, lifestyle, and family planning goals, is crucial.

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Long-Acting Reversible Contraception (LARC)

Effective and convenient methods like IUDs and implants offer long-term birth control without daily medication.

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Preconception Counseling

Encouraging individuals planning pregnancy to discuss healthy lifestyle habits, folic acid, and addressing any medical conditions for optimal health.

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Postpartum Family Planning

Discussing contraception options after delivery ensures timely initiation of birth control if desired.

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Contraceptive Method Options

Different contraceptive methods exist, including hormonal methods, barrier methods, and natural family planning, each with benefits and limitations.

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Medical History in Contraception

Evaluating potential health risks associated with different contraceptive methods based on individual medical history.

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Access to Contraceptive Care

Discussing the availability and cost of different contraception methods in the individual's area is essential for informed choices.

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Hypertension in Pregnancy

High blood pressure during pregnancy, categorized as chronic hypertension, gestational hypertension, preeclampsia, or eclampsia.

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Hyperemesis Gravidarum

Excessive nausea and vomiting in pregnancy, often linked to increased hormones like hCG, estrogen, and thyroid levels.

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Anemia in Pregnancy

A condition where the blood doesn't have enough red blood cells, which can affect oxygen transport to the fetus.

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PUPP, PG, and ICP

Common skin conditions in pregnancy: Pruritic Urticarial Papules and Plaques of Pregnancy (PUPP), Pemphigoid Gestationis (PG), and Intrahepatic Cholestasis of Pregnancy (ICP).

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Group B Strep (GBS)

A bacterium commonly found in the vagina and rectum of pregnant women, which can cause serious infections in newborns during labor and delivery.

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SSRIs for Depression in Pregnancy

Selective serotonin reuptake inhibitors, like citalopram, escitalopram, fluoxetine, and sertraline, are often used to treat depression during pregnancy.

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Insulin for Diabetes in Pregnancy

Insulin is the preferred treatment for diabetes during pregnancy due to its effectiveness and safety for the baby.

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Safe Blood Pressure Medications in Pregnancy

Methyldopa, labetalol, and nifedipine are generally recognized as safe for managing high blood pressure during pregnancy.

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Cryptorchidism

A condition where one or both testicles haven't descended into the scrotum naturally.

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Orchiopexy

Surgery performed to reposition an undescended testicle into the scrotum.

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Why is orchiopexy recommended?

Early surgery reduces the risk of infertility and potential testicular cancer.

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Ideal timing for orchiopexy

Most experts recommend performing orchiopexy between 6 months and 1 year of age.

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Fertility concerns with cryptorchidism

An undescended testicle can impair sperm production, increasing the risk of infertility.

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Cancer risk with cryptorchidism

Some studies suggest a slightly increased risk of testicular cancer associated with undescended testicles.

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Erectile Dysfunction (ED)

Difficulty getting or keeping an erection firm enough for sex.

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Common causes of ED

ED can be caused by various factors, including medical conditions, medications, substance use, psychological factors, aging, and other factors.

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Contraindications for ED medications

ED medications are not suitable for everyone, especially those taking nitrates or alpha-blockers.

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Fundal Height Before 20 Weeks

The distance from the top of your uterus to the pubic bone is typically not very high before 20 weeks of pregnancy.

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Fundal Height After 36 Weeks

The distance from the top of your uterus to the pubic bone starts to decrease after 36 weeks of pregnancy as the baby drops lower in your pelvis.

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Breech Presentation

A baby who is positioned with their bottom or feet first in the uterus.

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Varicocele

An enlargement of the veins in the scrotum, often causing blood to pool instead of circulating efficiently.

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Varicocele Diagnosis

A scrotal ultrasound with color Doppler imaging is the primary diagnostic test to assess blood flow in the affected veins.

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Varicocele Impact on Sperm

Varicoceles can lead to poor sperm development, low sperm production, and infertility.

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Varicocele Grading

Varicoceles are graded based on their palpability, from only noticeable with strain (Grade 1) to visible (Grade 3).

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Varicocele and Fertility

Approximately 65-75% of men with varicoceles experience a decline in fertility.

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Testicular Self-Exam

Regularly checking your testicles for lumps or changes in size or shape.

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Risk Factors for Cryptorchidism

Factors that increase the chance of a boy having cryptorchidism include premature birth, family history, low birth weight, and exposure to certain chemicals before birth.

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Cryptorchidism and Fertility

An undescended testicle can affect sperm production and increase the risk of infertility.

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Acute Bacterial Prostatitis

A serious condition where the prostate gland is inflamed due to a bacterial infection, typically affecting younger men.

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Chronic Prostatitis

A long-term inflammation of the prostate, often caused by bacteria or other factors, commonly affecting men between 40 and 70 years old.

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Prostatitis Causes

Causes of prostatitis include ascending urinary tract infections, spread from the rectum, and rare occurrences from bloodstream infections. Procedures like catheterization or prostate surgery can also contribute.

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Prostate Massage for Prostatitis?

If you suspect acute prostatitis, DO NOT massage the prostate. This can lead to sepsis.

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Prostatitis

Inflammation of the prostate gland, a common condition causing urinary discomfort and pain.

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Prostatitis Diagnosis: Urine Analysis

In acute prostatitis, urine analysis shows white blood cells (pyuria) and sometimes blood (hematuria).

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Prostatitis Diagnosis: Cultures

Urine cultures are positive in acute prostatitis, indicating bacteria infection. In chronic cases, cultures might be negative.

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Prostatitis Treatment: Young Men

For men under 35, treat prostatitis with ceftriaxone and doxycycline to cover chlamydia and gonorrhea.

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Prostatitis Treatment: Older Men

For men over 35, treat with fluoroquinolones or Bactrim for extended periods (4-6 weeks) to ensure infection eradication.

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Epididymitis

Inflammation of the epididymis, the coiled tube behind the testes, causing scrotal pain and swelling.

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Epididymitis: Prehn's Sign

Relief with elevation of the scrotum is a classic sign of epididymitis.

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Testicular Torsion vs. Epididymitis

Testicular torsion causes sudden intense pain, while epididymitis pain is gradual. Torsion has higher testicle, absent cremasteric reflex, and decreased blood flow on ultrasound.

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What causes a varicocele?

The spermatic vein, which drains blood from the testicle, becomes dilated and twisted, leading to blood pooling.

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How is a varicocele diagnosed?

A scrotal ultrasound with color Doppler imaging is essential to assess blood flow and confirm the diagnosis.

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What are the symptoms of a varicocele?

A painless, soft, and often palpable mass in the scrotum that feels like a bag of worms, often worsening with prolonged standing or straining.

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BPH

Benign Prostatic Hyperplasia, an enlargement of the prostate gland common in aging men, often causing urinary symptoms.

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Minimally Invasive Hernia Repair

A surgical procedure using small incisions and a laparoscope to repair a hernia with minimal disruption to the body.

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Laparoscope

A thin, telescope-like instrument with a camera attached, used in minimally invasive surgery to visualize internal organs.

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Synthetic Mesh

A material used in hernia repair to reinforce the weakened area and prevent recurrence.

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Bilateral Hernia

Hernias on both sides of the body.

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STI tests

Tests to detect sexually transmitted infections (STIs).

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Ceftriaxone

An antibiotic used to treat gonorrhea.

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Podofilox

A topical medication used to treat external genital warts. It's applied twice daily for three times per week until the warts are resolved, with a maximum treatment duration of four weeks.

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Imiquimod

A topical cream used to treat external genital warts by stimulating the immune system to fight the virus. It's applied at bedtime three times per week for 16 weeks.

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Sinecatechins

A topical ointment made from green tea extract, used to treat external genital warts. It's applied three times a day for 16 weeks.

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Cryotherapy

A treatment for external genital warts using liquid nitrogen to freeze the warts and destroy the infected tissue. It's usually repeated every 1-2 weeks.

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Azithromycin

An antibiotic used to treat chlamydia infection. A single 1-gram oral dose is typically sufficient.

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Doxycycline

An antibiotic used to treat chlamydia infection. It's taken orally twice a day for seven days.

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NAATs

Nucleic acid amplification tests, used to diagnose chlamydia infection by detecting the presence of the chlamydia bacteria's genetic material.

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Yeast Infection

An infection caused by an overgrowth of the Candida fungus, commonly in the vaginal area. Individuals may experience symptoms like vaginal discharge, itching, and burning.

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Study Notes

Prostate Screening Guidelines

  • USPSTF recommends against routine screening.
  • ACS and AUA guidelines recommend an individualized approach with shared decision-making.
  • For most men, screening with PSA and DRE should begin at age 50.
  • Consider screening at 45 for men at high risk (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 involves PSA testing and digital rectal examination (DRE).
  • PSA levels above 4 ng/mL may warrant further investigation (e.g., biopsy or imaging).
  • Screening frequency depends on risk factors (age, family history, and ethnicity).

Risk Factors

  • Age: Risk increases after age 50.
  • Family history of prostate cancer.
  • African American ethnicity.
  • Diet high in red meat and low in fruits and vegetables.

Diagnostics

  • Digital Rectal Exam (DRE): Palpable abnormalities suggest malignancy.
  • Prostate-Specific Antigen (PSA) Testing: Elevated levels require follow-up. PSA is usually <4 ng/mL. Evaluate change in PSA velocity in conjunction with DRE. A PSA value > 10ng/mL necessitates biopsy. A PSA value of 4-9.9ng/mL is often biopsied, but only 20% of these patients have prostate cancer.
  • Prostate cancer antigen 3 (PCA3), TMPRSS2-ERG gene fusion, and prostate health index are adjunctive tests to use with PSA.
  • Alkaline phosphatase: elevated with metastasis.
  • Testosterone and liver function tests if androgen deprivation is suspected.
  • Transrectal biopsy with transrectal ultrasound (TRUS) guidance.
  • CT, primarily to evaluate prostate size and pelvic lymph node involvement in the preoperative stage, or for evaluating metastasis.

Testicular Cancer

  • Malignant tumor of the testicle.
  • Two types: germ cell (most common) and non-germ cell.
  • Germ cell types: seminoma, teratoma, teratocarcinoma, embryonal carcinoma.
  • Non-germ cell types: Leydig cell, gonadoblastoma, adenocarcinoma.
  • Screening: Early detection is crucial.
  • Risk Factors: history of cryptorchidism, family history, White race.
  • Assessment Findings: painless testicular mass, swelling, discomfort, feeling of heaviness, possible loss of libido or erectile dysfunction, enlargement of testicle.

Testicular Torsion

  • Sudden, severe, unilateral scrotal pain.
  • Scrotal edema and erythema.
  • Firm tender mass (may be retracted upward).
  • No pain relief with testicular elevation.
  • Lower abdominal pain.
  • Reactive hydrocele.
  • High-riding testicle with "bell-clapper" deformity.
  • Horizontal lie within the scrotum.
  • Nausea and vomiting.
  • Absent cremasteric reflex.
  • Negative Prehn's sign.

Active Surveillance and Follow-up

  • Clinical examinations with PSA every 6 months for first 5 years, then annually; DRE annually.
  • Repeat prostate biopsies 1 year after original diagnosis, and then every 2-4 years.
  • Evaluation for CVD and prevention in patients treated with ADT.
  • Screening for urinary tract dysfunction, sexual dysfunction, depression, anxiety, suicidality, and caregiver distress in patients treated with adjuvant therapy.

Erectile Dysfunction

  • Inability to achieve or maintain an erection sufficient for sexual performance.
  • Risk Factors: Cardiovascular disease, hypertension, diabetes, smoking, hyperlipidemia, radiation of the pelvis, COPD, sleep apnea, neurologic disorders, injuries to spinal cord/brain, Parkinson's disease, Alzheimer's, multiple sclerosis, stroke, Peyronie's disease, cavernous fibrosis, penile fracture, epispadias, priapism, hypogonadism, hyper/hypothyroidism, hyperprolactinemia.
  • Drug-induced: antihypertensives, antidepressants, antipsychotics, antiandrogens, recreational drugs, pain medication (especially opioids and anticholinergics), 5-alpha reductase inhibitors, and alcohol use.
  • Psychogenic: performance anxiety, PTSD, relationship problems, lack of arousal, anxiety, depression, etc.
  • Surgical procedures which lead to postoperative disruption in neurologic function, atherosclerosis, smoking, hypertension, diabetes.

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