Term
| Is the pain of infection constant or intermittent? Is the pain of obstruction constant or intermittent? |
|
Definition
infection - constant
obstruction - intermittent |
|
|
Term
| Upper ureteral obstruction may result in pain referred to where? |
|
Definition
| scrotum in males or to the labium in females |
|
|
Term
| Midureteral obstruction may cause pain where? |
|
Definition
| ause pain in the lower quadrant - can be confused with appendicitis (on R side) and diverticulitis (on L side) |
|
|
Term
| What does severe suprapubic discomfort indicate? |
|
Definition
|
|
Term
| What does a Painless distended bladder indicate? |
|
Definition
|
|
Term
| What does Distal urethral pain with urination indicate? |
|
Definition
|
|
Term
| Where does prostatic pain radiate to? |
|
Definition
lumbosacral ,
inguinal canals,
lower extremities |
|
|
Term
| What is Pain in the flaccid penis is secondary to usually? |
|
Definition
|
|
Term
| What does pain in the erect penis secondary to usually? |
|
Definition
| Peyroine disease or priapism |
|
|
Term
| How long may pain from treated acute epididymitis last? |
|
Definition
|
|
Term
| What is the normal measurement of a testicle and what is the normal consistency? |
|
Definition
measure 4.5 x 2.5
Rubbery Consistency |
|
|
Term
| Where does the epididymus lie in relationship to the testis? |
|
Definition
|
|
Term
| Are masses arising from within the testes usually malignant or benign? |
|
Definition
|
|
Term
| Are masses arising from the epididymis and spermatic cord structures usually malignant or benign? |
|
Definition
|
|
Term
| What is tranillumination used for? |
|
Definition
| distinguishing solid and cystic lesions |
|
|
Term
| If a pt presents with usually painless, firm, solid lesions within the substance of the testis that do not transilluminate, what condition do you suspect? |
|
Definition
|
|
Term
| 14 y/o male pt presents with intense pain in scrotum that began this morning and has increasingly worsened. Scrotum is enlarged, red, and edematous. He is N/V and has a temp of 99.7F. The testicle is quite tender, is located high in scrotum with a transverse lie and the cremasteric reflex is absent. What condition do you suspect? |
|
Definition
|
|
Term
| In what age do 2/3rds of testicular torsion cases occur? |
|
Definition
|
|
Term
| What type of invagination is described as a torsion occurring within the tunica vaginalis? |
|
Definition
|
|
Term
| What type of invagination is described as a torsion involving twisting testis, cord and processus vaginalis? |
|
Definition
|
|
Term
| In which type of pts is Extravaginal torsion MC? |
|
Definition
| particular in newborns, and in undescended testis |
|
|
Term
| What imaging should be used for testicular torsion? |
|
Definition
| Doppler US is diagnostic. Decreased flow is torsion. |
|
|
Term
| What does increased flow on the doppler U/S of the testes indicative of? |
|
Definition
| think inflammation (reliable in first 12 hours). |
|
|
Term
| Pt presents with heaviness in his scrotum and mass. His girlfriend said he should come in, but says he feels this is normal for him. What condition do you suspect? |
|
Definition
|
|
Term
| What condition is described as a collection of fluid between the two layers of tunica vaginalis? |
|
Definition
|
|
Term
|
Definition
| More common in 1st year of life |
|
|
Term
| When is a hydrocele painful? |
|
Definition
| Painful if large or infected |
|
|
Term
| How is the diagnosis of a hydrocele made? |
|
Definition
| made with transillumination |
|
|
Term
| Which type of hydrocele is described as a closure of processus vaginalis traping peritoneal fluid? |
|
Definition
| Non-communicating hydrocele |
|
|
Term
| Which type of hydrocele is described as failure of closure of processus vaginalis? |
|
Definition
|
|
Term
| Which type of hydrocele is described as closure of distal processus, trapping fluid in mid portion of processus vaginalis? |
|
Definition
|
|
Term
| What is the treatment for a hydrocele? |
|
Definition
|
|
Term
| What condition is described as engorgement of the internal spermatic veins above the testis, resulting from incompetence of the venous valves of internal spermatic venous system? |
|
Definition
|
|
Term
| What side is a varicocele MC? |
|
Definition
| MC found on the Left side |
|
|
Term
| Where does the L spermatic vein empty into? |
|
Definition
| empties into L renal vein |
|
|
Term
| Where does the R spermatic vein empty into? |
|
Definition
|
|
Term
| If varicocele presents solely on right side, remains dilated while pt assumes the supine position, or if they occur abruptly or enlarge rapidly, what condition should you suspect? |
|
Definition
| be suspicious of retroperitoneal or renal mass causing obstruction |
|
|
Term
| What kind of lasting effects can occur from a varicocele? |
|
Definition
| May cause atrophy of both testes, may lead to infertility |
|
|
Term
| When is surgery indicated for a varicocele? |
|
Definition
| Surgery indicated if assoc with infertility and/or pain |
|
|
Term
| A 42 y/o male presents to your practice complaining of swelling in his groin. States he noticed the swelling when he went to shower after doing heavy lifting in the garden. What condition do you suspect? |
|
Definition
|
|
Term
| Which type of hernia is usually found within the scrotum? |
|
Definition
|
|
Term
| Which type of hernia is described as coming through the external inguinal ring, so examining fingers cannot get above it within the scrotum? |
|
Definition
|
|
Term
| What is the treatment for a inguinal hernia? |
|
Definition
|
|
Term
| Where is a spermatocele palpable? |
|
Definition
| near upper pole of the testicle |
|
|
Term
| Is a spermatocele painful? |
|
Definition
|
|
Term
| What is the treatment for a spermatocele? |
|
Definition
| watchful waiting or surgery if it becomes symptomatic |
|
|
Term
| What MUST any mass, in any pt, at any time felt to be in the testicle be addressed with? |
|
Definition
| direct contact with a urologist. |
|
|
Term
| Are masses rising from within the testes usually malignant or benign? |
|
Definition
|
|
Term
| When a hydrocele is diagnosed, what must you perform and why? |
|
Definition
| Perform complete testicular exam so don’t miss associated testicular tumor (10% of cases) |
|
|
Term
| If varicocele is on the R side, enlarges quickly or remains dilated while pt is supine, what studies and evaluations must you perform? |
|
Definition
| F/up with careful abdominal exam and appropriate imaging, such as CT scan |
|
|
Term
| When is a surgery indicated for varicocele? |
|
Definition
| needed if infertility or pain |
|
|
Term
| If a pt c/o of heaviness in their testes, what might you suspect? |
|
Definition
| Hydrocele or spermatocele |
|
|
Term
| What condition is described as position of urethral meatus located on dorsal aspect of penis? |
|
Definition
|
|
Term
| What may epispadias be associated with? |
|
Definition
|
|
Term
| Which is more common epispadias or hypospadias? |
|
Definition
|
|
Term
| What can increase the incidence of hypospadias? |
|
Definition
| Estrogens and progestins given during pregnancy |
|
|
Term
| What is hypospadias associated with? |
|
Definition
|
|
Term
| When should hypospadias be surgically corrected? |
|
Definition
| Should be surgically corrected by age 2 |
|
|
Term
| At what gestational week can you determine the sex of the child based on viewable genitalia? |
|
Definition
|
|
Term
| What condition is described as foreskin cannot be retracted behind the glans? |
|
Definition
|
|
Term
| What is the MC cause of phimosis? |
|
Definition
| Chronic infection from poor local hygeine |
|
|
Term
| What type of CA can develop under the foreskin with phimosis? |
|
Definition
|
|
Term
| What condition is an inflammation of the glans penis? |
|
Definition
|
|
Term
| What condition is an inflammation of the foreskin? |
|
Definition
|
|
Term
| What condition is described as the foreskin has been left retracted behind the glans, resulting in painful engorgement and edema of glans? |
|
Definition
|
|
Term
| What are the complications of untreated paraphimosis? |
|
Definition
| may result in glandular ischemia with arterial occlusion and necrosis of the glans |
|
|
Term
| How should paraphimosis be tx initially? |
|
Definition
| Firmly squeeze glans x 5 minutes to reduce tissue edema/decrease size. |
|
|
Term
| What is the definitive treatment for paraphimosis? |
|
Definition
|
|
Term
| What condition is described as palpable dense, fibrous plaque of varying size involving tunica albuginea? |
|
Definition
|
|
Term
| Where is the usual location of the plaque in Peyronie's disease? |
|
Definition
| usually near dorsal midline on the tunica albuginea |
|
|
Term
| What condition has Peyronie's disease been associated with? |
|
Definition
| Dupuytren’s contracture of the tendons of the hand |
|
|
Term
| What is the only proven tx option for peyronie's disease? |
|
Definition
|
|
Term
| In what % of pts does spontaneous remission of Peyronie's disease occur? When did this occur? |
|
Definition
|
|
Term
| What condition is described as Uncommon condition of prolonged painful erection…”greater than 4 hrs”? |
|
Definition
|
|
Term
| What is the MC cause of Priapism? |
|
Definition
|
|
Term
| What other conditions are associated with causing Priapism? |
|
Definition
Leukemia
Sickle Cell Dz
Pelvic Tumors
Pelvic Infections
Penile Trauma
Spinal Cord Trauma
Certain Meds |
|
|
Term
| Is priapism ischemic or non-ischemic? |
|
Definition
| true urologic emergency (ischemic) |
|
|
Term
| Should Hypospadiac males be circumcised? why or Why not? |
|
Definition
| should not be circumcised because skin will later be needed for reconstructive surgery |
|
|
Term
| How do you treat a fungal cause of phimosis? |
|
Definition
|
|
Term
| How do you treat a bacterial cause of phimosis? |
|
Definition
| bacitracin or neomycin-polymyxin B-bacitracin |
|
|
Term
| How do you treat a dermatitis cause of phimosis? |
|
Definition
|
|
Term
| What imaging test would you use to identify the depth of the plaque in peyronie's disease? |
|
Definition
|
|
Term
| What condition has pathophysiology described as The major abnormality is believed to be physiologic obstruction of the venous drainage causing buildup of highly viscous, poorly oxygenated blood within the corpora cavernosa? |
|
Definition
|
|
Term
| What condition is described as is a noncancerous enlargement of the prostate gland that may restrict flow of urine from the bladder? |
|
Definition
|
|
Term
| What diagnosis is a histologic diagnosis that refers to the proliferation of smooth muscles and epithelial cells within the prostatic transition zone? |
|
Definition
|
|
Term
| What is the MC benign tumor in men? |
|
Definition
|
|
Term
| What is the medical management treatment for BPH symptoms? |
|
Definition
| Alpha-blocker Therapy decreases tone of the Prostate which decreases resistance |
|
|
Term
| What are the irritative voiding c/o BPH due to? |
|
Definition
| result from the secondary response of the bladder to the increased outlet resistance |
|
|
Term
| What are the 3 storage "irritative" symptoms of BPH? |
|
Definition
1- frequency,
2 - nocturia,
3 - urgency |
|
|
Term
| What are the four voiding symptoms of BPH? |
|
Definition
1 - feeling of incomplete emptying,
2- intermittency,
3 - straining,
4 - weak stream |
|
|
Term
| What is the most important tool in evaluate BPH? |
|
Definition
| AUASI (BPH screening tool) |
|
|
Term
| On DRE you find the prostate is smooth, firm, elastic with enlargement noted. What does this finding suggest? If induration was present, what would you do? |
|
Definition
| BPH; with induration r/o CA |
|
|
Term
| What procedure is Not recommended to determine the need for tx in BPH but may assist in determining the surgical approach in pts opting for invasive therapy? |
|
Definition
|
|
Term
| What tx should pts with mild sx of BPH receive? |
|
Definition
| Watchful Waiting; recommend annual f/u |
|
|
Term
| What tx should pts with moderate sx of BPH receive? |
|
Definition
| Start medical therapy - Alpha Blockers |
|
|
Term
| What tx should pts with severe s/s of obstructive uropathy and fluid/electrolyte abnormalities receive? |
|
Definition
|
|
Term
| What are the absolute surgical indications for BPH? |
|
Definition
refractory urinary retention,
large bladder diverticula
Recurrent UTI
Recurrent gross hematuria
Bladder stones
Renal insufficiency |
|
|
Term
| Which drugs are alpha blockers? |
|
Definition
Tamsulosin (Flomax)
Alfuzosin (Uroxatral)
Doxazosin (Cardura)
Terazosin (Hytrin)
Silodosin (Rapaflo) |
|
|
Term
| What are the side effects of Alpha Blockers? |
|
Definition
Orthostatic hypotension
Ejaculation changes
Nasal congestion
Weakness |
|
|
Term
| What medical therapy is best for pts with larger prostates (>40gm)? |
|
Definition
| 5 alpha-reductase inhibitors |
|
|
Term
| What med works by blocking the conversion of testosterone to dihydrotestosterone? |
|
Definition
| 5 alpha-reductase inhibitors |
|
|
Term
| Which drugs are 5 alpha-reductase inhibitors? |
|
Definition
Finasteride (Proscar)
Dutasteride (Avodart) |
|
|
Term
| What are the SE of the 5 alpha-reductase inhibitors? |
|
Definition
Decreased libido
Ejaculation changes
Erectile dysfunction |
|
|
Term
| What meds act by decreasing acetylcholine effects on the smooth muscles of the bladder? |
|
Definition
|
|
Term
| What are the Antimuscarinics? What drugs are they used in combo with? |
|
Definition
| tolterodine, Detrol (esp. in combination with alpha blockers) |
|
|
Term
| What minimally invasive procedure is described as 2 curved needles (which extend just beyond cystoscope) deliver RF energy into prostate? How long can the irritative voiding last after the procedure? |
|
Definition
| TUNA (Transurethral Needle Ablation); can last several weeks after procedure |
|
|
Term
| What procedure for treating BPH is described as Microwaves heat prostate and create thermal necrosis? How long can irritative voiding last after the procedure? |
|
Definition
| TUMT (Transurethral Microwave Thermotherapy); irritative voiding can last for a few weeks after the procedure |
|
|
Term
| Out of the minimally invasive procedures for treating BPH is the most superior when comparing symptom scores and flow rate improvement ? |
|
Definition
| Transurethral resection of the prostate (TURP) |
|
|
Term
| What is the alternative to TURP that comes closest to matching its results in both terms of symptom relief and improvement in flow rates? |
|
Definition
| Transurethral Incision of the Prostate (TUIP) |
|
|
Term
| When is an open simple prostatectomy used instead of a TURP? |
|
Definition
| When prostate is too large to remove endoscopically (> 100 g in size) |
|
|
Term
At the following ages, what is their risk for BPH?
41 - 50 y/o?
51 - 60 y/o?
> 80 y/o? |
|
Definition
41-50 yrs = 20%
51-60 yrs = 50%
>80 yrs = >90% |
|
|
Term
| What score on the AUASI indicates Mild, Moderate and Severe BPH symptoms? |
|
Definition
1-7, Mild
8-19, Moderate
20-35, Severe |
|
|
Term
| What are the forms of Phytotherapy? |
|
Definition
Saw palmetto
African plum
Rye pollen
Pumpkin seeds |
|
|
Term
| What neurotransmitters initiate an erection? |
|
Definition
| nitric oxide, acetylcholine, prostaglandins |
|
|
Term
| What are some organic causes of ED? |
|
Definition
|
|
Term
| What are some endocrine causes of ED? |
|
Definition
hypogonadism
hyperthyroidism
Elevated PRL |
|
|
Term
| What are some neurologic causes of ED? |
|
Definition
spinal cord lesions
MS
autonomic neuropathy |
|
|
Term
| What are some pelvic surgery causes of ED? |
|
Definition
bladder neck
TURP (Prostate) |
|
|
Term
| What drugs can induce ED? |
|
Definition
Antihypertensives (beta-blockers and diuretics),
digoxin,
major tranquilizers,
alcohol,
estrogen,
antidepressants,
cimetidine,
steroids |
|
|
Term
| What are the risk factor's for ED? |
|
Definition
Age > 40y/o
DM, Dyslipidemia, HTN
Neurogenic Dz
Psychological Dz
Renal Failure
Hormonal D/o
Previous Prostate CA tx
Previous Trauma
Drug Use, Smokers, Alcoholics
Obesity, Sedentary Lifestyle |
|
|
Term
| Which meds can lead to ED? |
|
Definition
Anti-HTN (BB, Thiazide Diuretics, Spirinolacton, Clonidine)
Prostate Agents (Alpha Blockers- Doxyzosin, Terazosin, 5-alpha reductase inhibitors)
Anti-Depressants - Cimetidine, Ketaconazole |
|
|
Term
| What is Nocturnal penile tumescence testing used for? |
|
Definition
| To differentiate between organic and psychological cause |
|
|
Term
| What will men who do not have organic dysfunction causing their ED probably benefit from? |
|
Definition
| behaviorally oriented sex therapy |
|
|
Term
| Before giving hormone replacement therapy for documented androgen deficiency, what must you r/o first? |
|
Definition
|
|
Term
| What class of meds is used in vasoactive therapy for the treatment of ED? |
|
Definition
| prostaglandins (Papaverine, Phentolamine, Alprostadil) |
|
|
Term
| What med is used for tranurethral therapy? |
|
Definition
| Alprostadil (MUSE) - Prostaglandin |
|
|
Term
| What med stimulates adenyl cyclase to increase intracellular levels of cAMP causing smooth-muscle relaxation and vasodilation? |
|
Definition
| Alprostadil (Prostaglandin E1) |
|
|
Term
| How does Sildenafil (Viagra) work? |
|
Definition
| inhibits phosphodiesterase 5 (an inhibitor of erection) and allows cGMP to function unopposed |
|
|
Term
| When is sildenafil (viagra) contraindicated? |
|
Definition
| Concomitant organic nitrates or nitric oxide donors (eg, sodium nitroprusside) |
|
|
Term
| What can coconmittant use of alpha-blockers (eg doxyzosin) and Sildenafil lead to? |
|
Definition
| may lead to symptomatic hypotension. |
|
|
Term
| How many viagra (sildenafil) do you take per day? |
|
Definition
|
|
Term
| How long does sildenafil (viagra) last? |
|
Definition
|
|
Term
| How long does Vardenafil (Levitra) last? |
|
Definition
|
|
Term
| How often do you take Cialis (Tadalafil)? |
|
Definition
|
|
Term
| What is the rate of onset with Cialis? How long does it last? |
|
Definition
| Onset within 30 - 60 min; Lasts 36hrs |
|
|
Term
| What is the max amount of time for use for Yohimbine? |
|
Definition
|
|
Term
| What are the adverse effects of PDE-5 Inhibitor? |
|
Definition
Hypotension
Temporary color vision disturbances
Mild HA
Facial flushing
Priapism |
|
|
Term
| What are the contraindications of PDE-5 Inhibitor? |
|
Definition
| Men using nitrates, men on alpha-blockers |
|
|
Term
| Which alpha-blocker is ok to use with PDE-5 Inhibitor? |
|
Definition
| Flomax (tamsulosin) with Cialis |
|
|
Term
| What are the relative contraindications for PDE-5 Inhibitors? |
|
Definition
Active coronary ischemia in men not on nitrates
CHF
Borderline hypotension, or on mult. HTN agents
P450 - 3A4 inhibitors (E-mycin, cimetidine, Ketaconazole, Itraconazole) |
|
|
Term
| What lifestyle changes may help improve ED? |
|
Definition
Regular exercise
Healthy diet
Smoking cessation
Decrease alcohol intake
Limit long-distance cycling…or change seat |
|
|
Term
| In what pts is urinary incontinence MC? |
|
Definition
|
|
Term
| Is the bladder neck muscle smooth or skeletal? Voluntary or Involuntary? |
|
Definition
| Bladder Neck = smooth and involuntary |
|
|
Term
| Is the external sphincter muscle smooth or skeletal? Voluntary or Involuntary? |
|
Definition
| External Sphincter = skeletal and Voluntary |
|
|
Term
| What test can be used to dx a bladder fistula? |
|
Definition
|
|
Term
| What test can be used to diagnose bladder neck descent problems? |
|
Definition
|
|
Term
| What test is used to evaluate bladder capacity, accommodation, sensation, voluntary control, contractility, and response to pharmacologic intervention? |
|
Definition
|
|
Term
| What condition is described as Pts lose urine at all times and in all positions? |
|
Definition
|
|
Term
| What is the cause of total urinary incontinence? |
|
Definition
| anatomic abnormalities, either congenital or acquired |
|
|
Term
| What is the treatment for total urinary incontinence? |
|
Definition
|
|
Term
| What condition is described as loss of urine associated with activities that result in an increase in intra-abdominal pressure? |
|
Definition
|
|
Term
| What is the cause of stress incontinence? |
|
Definition
| Associated with pelvic floor laxity and poor support of the vesicourethral sphincteric unit |
|
|
Term
| Which urinary incontinence does not have pts becoming incontinent in the supine position? |
|
Definition
|
|
Term
| What are the findings of stress incontinence on a lateral stress cystogram? |
|
Definition
| Bladder neck will descend below the midportion of the pubic symphysis |
|
|
Term
| What treatment offers the best results and highest cure rates for stress incontinence? |
|
Definition
|
|
Term
| What condition is described as uncontrolled loss of urine that is preceded by a strong, unexpected urge to void? |
|
Definition
|
|
Term
| Which type of incontinence is unrelated to position or activity? |
|
Definition
|
|
Term
| What condition is associated with detrusor hyperreflexia or sphincteric dysfunction? |
|
Definition
|
|
Term
| What conditions are commonly associated with urge incontinence? |
|
Definition
| Inflammatory conditions or neurogenic bladder d/o |
|
|
Term
| What is the treatment for urge incontinence? |
|
Definition
Toilet Re-Training
Anticholinergic meds (antispasmotics)
- Oxybutinin (Ditropan)
- Tolterodine (Detrol)
Tricylic antidepressants
- Imipramine (Tofranil) |
|
|
Term
| What incontinence can result from chronic urinary retention? |
|
Definition
|
|
Term
| What is the tx for overflow incontinence? |
|
Definition
| catheterization and tx of underlying condition (cause of retention) |
|
|
Term
| What percentage of men > 65y/o are affected by ED? |
|
Definition
|
|
Term
| What nervous stimulation is responsible for an erection? |
|
Definition
| autonomic and somatic nerve supply |
|
|
Term
| Which arteries supply blood to get an erection? |
|
Definition
|
|
Term
| What does an erection with injection of vasoactive substances mean? |
|
Definition
| vascular system is intact |
|
|
Term
| In pts who fail to achieve erection with injection of vasoactive substances on serial attempts using increasing doses or combination of drugs, what is indicated? |
|
Definition
| Additional vascular testing and vascular reconstructive surgery in an attempt to correct their ED |
|
|
Term
| What is considered infertility? |
|
Definition
| Failure to conceive after 1 yr of trying |
|
|
Term
| How many couples are affected by infertility? |
|
Definition
|
|
Term
| What are the "cornerstones" to lab eval of infertility after H&P? |
|
Definition
| Endocrinologic profiles and detailed semen analysis |
|
|
Term
| What is the term describing Presence of < 20 million sperm/ml in the ejaculate? |
|
Definition
|
|
Term
| What term describes Complete absence of sperm? |
|
Definition
|
|
Term
| If there is a complete absence of sperm, what condition might you first suspect? How would you dx it? |
|
Definition
| retrograde ejaculation; UA |
|
|
Term
| How long does spermatogenesis take? |
|
Definition
|
|
Term
| What prior testicular insults can lead to infertility? |
|
Definition
| testicular torsion, cryptorchidism, trauma, groin surgery |
|
|
Term
| What infections can lead to infertility? |
|
Definition
| Mumps orchitis, epididymitis |
|
|
Term
| What meds can lead to infertility? |
|
Definition
Cimetidine,
spironolactone,
nitrofurantoin,
sulfasalazine,
alpha-blockers (Cimetidine) |
|
|
Term
| What are the risk factors for infertility? |
|
Definition
Sexual habits
Previous fertility (pt and partner)
Partner age (>35?)
Endocrine d/o
Systemic dz (renal failure, cirrhosis, sickle cell)
Other dz (CF, Klinefelter’s)
Poor dietary intake |
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Term
| What may be a finding in s/p viral orchitis causing infertility? |
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Definition
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Term
| How many hours must a pt getting a semen analysis abstain from sex prior to the test? |
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Definition
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Term
| What is the normal sperm count? |
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Definition
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Term
| Within what timeframe of collection should the semen be analyzed? |
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Definition
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Term
| What is the normal volume of semen? |
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Definition
| Normal volume = 1.5 – 5 ml |
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Term
| What is the normal motility of sperm? |
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Definition
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Term
| What is the normal morphology? |
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Definition
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Term
| What is the best predictor of fertility in semen? |
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Definition
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Term
| If sperm counts are low, what further eval is indicated? |
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Definition
| Endocrinologic eval including serum FSH, LH, and testosterone |
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Term
| If the sperm count is zero, what f/u should be done? |
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Definition
| Serum FSH, fructose, testicular biopsy and U/A |
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Term
| If there is an abnormal sperm count, what is the f/u? |
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Definition
| repeat semen analysis …repeat semen analysis |
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Term
| How much time between repeat semen analysis? |
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Definition
| separated by at least 60 days |
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Term
| What imaging can be done during an infertility eval to r/o subclinical varicocele? |
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Definition
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Term
| What imaging study may be required in pts with suspected ductal obstruction? |
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Definition
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Term
| What is the “gold standard” procedure for diagnosing pelvic, inguinal, scrotal, and vasal obstruction? |
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Definition
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Term
| What is vasography being replaced by? |
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Definition
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Term
| What is the MC neoplasm in men aged 20-35? |
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Definition
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Term
| What is the 'typical' presentation of testicular CA? |
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Definition
| pt-identified painless mass |
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Term
| What is necessary for dx of testicular CA? |
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Definition
| Orchiectomy necessary for dx |
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Term
| What type of tumors are 90-95% of all primary testicular tumors? |
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Definition
| germ cell tumors - arising from spermatogenic cells within seminiferous tubules |
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Term
| Which testes is MC affected by testicular CA? Why? |
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Definition
| right side, which parallels increased incidence of cryptorchidism on the right side |
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Term
| What are the risk factors for testicular CA? |
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Definition
Cryptorchidism
Testicular trauma, torsion
Infection-related testicular atrophy
Chemical exposures/pollutants |
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Term
| Which imaging study can readily determine whether mass is intra or extratesticular in origin? |
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Definition
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Term
| What biochemical markers can be pos in testicular CA? |
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Definition
Human chorionic gonadotropin (hCG)
Alpha-fetoprotein
Lactate dehydrogenase (LDH) |
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Term
| Once dx of testicular cancer has been established by inguinal orchiectomy, how is clinical staging of the dz is accomplished? |
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Definition
| accomplished by chest, abdominal, and pelvic CT scanning |
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Term
| What is the MC testis tumor in pts > 50 y/o? |
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Definition
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Term
| What is the MC primary site of CA with secondary metastasis to testes? |
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Definition
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Term
| What are the essentials of diagnosis in bladder CA? |
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Definition
Irritative Voiding Symptoms
Hematuria
Pos Cytology
Filing defect within bladder |
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Term
| What is the 2nd MC GU CA? |
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Definition
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Term
| Is bladder CA more common in men or women? |
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Definition
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Term
| What is the mean age of pts when diagnosed with bladder CA? |
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Definition
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Term
| What is a risk factor for bladder CA? |
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Definition
#1 - Smoking
Chronic cystitis |
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Term
| What is the MC presenting symptom in bladder CA? |
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Definition
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Term
| What is the FDA approved screening test for bladder CA used in high risk pts? |
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Definition
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Term
| How is bladder CA confirmed? |
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Definition
| cystoscopy with bx (after obtaining urinary cytology) |
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Term
| What is the initial form of tx for all bladder CA that is diagnostic, allows for staging, and will control superficial cancers? |
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Definition
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Term
| What treatment is described as Immuno or chemotherapeutic agents delivered directly into bladder by a urethral catheter? |
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Definition
| Intravesical chemotherapy |
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Term
| What is used to treat metastatic bladder CA? |
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Definition
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Term
| What is the "classic triad" of symptoms in renal cell carcinoma? |
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Definition
| flank mass, hematuria, and pain |
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Term
| What is the origination of renal cell carcinoma? |
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Definition
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Term
| What is the peak age of incidence for renal cell carcinoma? |
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Definition
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Term
| What percentage of pts already have metastasis with initial presentation of renal cell carcinoma? |
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Definition
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Term
| What is a major RF for renal cell carcinoma? What are some other RF? |
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Definition
| Cigarette Smoking;FHx, horseshoe kidney, acquired renal cystic dz, obesity |
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Term
| What is the MC presentation of renal cell carcinoma? |
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Definition
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Term
| What is the most valuable imaging test for renal cell carcinoma? |
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Definition
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Term
| What is the primary treatment for localized renal cell carcinoma? |
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Definition
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Term
| What is the 5-yr dz-free survival of Tumors confined to renal capsule? |
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Definition
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Term
| What is the 5-yr dz-free survival of Tumors extending beyond the renal capsule? |
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Definition
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Term
| What is the 5-yr dz-free survival of node-positive tumors? |
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Definition
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Term
| What is the MC solid renal tumor of childhood? |
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Definition
| Wilms tumor or nephroblastoma |
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Term
| With Wilm's tumor, what is the peak age of onset? |
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Definition
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Term
| What condition is described as unilateral generally large, multilobulated, kidney tumor that is gray or tan in color with focal areas of hemorrhage and necrosis? |
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Definition
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Term
| What are the #1 and #2 sites of metastasis of a Wilms Tumor? |
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Definition
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Term
| What is the MC presentation of Wilms tumor? |
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Definition
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Term
| What is the tx for Wilms tumor? |
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Definition
| Multimodal approach to tx, incorporating surgery, radiation therapy, and chemotherapy |
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Term
| What is the second leading cause of CA related death? |
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Definition
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Term
| What are the RF for prostate CA? |
|
Definition
Aging
African American
FHx positive for prostate cancer
High fat intake (primarily a dz of the overfed)
Toxic exposures (smoking, welding, agent orange) |
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Term
| Where does CA of the prostate metastasize to? |
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Definition
| Bone, bladder and less commonly the testes |
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Term
| What is found on DRE in prostate CA? |
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Definition
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Term
| What complication may locally advanced dz of the prostate with bulky regional LAD lead to? |
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Definition
| lymphedema of lower extremities |
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Term
| What marker is a glycoprotein produced only in the cytoplasm of benign and malignant prostate cells? |
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Definition
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Term
| What PSA level are most organ-confined cancers are assoc with? |
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Definition
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Term
| What PSA level are more advanced dz including seminal vesicle invasion, lymph node involvement, or occult distant mets associated with? |
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Definition
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Term
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Definition
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Term
| What imaging study has been used largely in staging prostate CA? |
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Definition
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Term
What is the normal PSA value for white males ages:
40 - 49?
50 - 59?
60 - 69?
70 - 79? |
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Definition
40 - 49 = <2.5
50 - 59 = <3.5
60 - 69 = <4.5
70 - 79 = <6.5 |
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Term
What is the normal PSA value for AA males ages:
40 - 49?
50 - 59?
60 - 69?
70 - 79? |
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Definition
40 - 49 = <2
50 - 59 = <4
60 - 69 = <4.5
70 -79 = <5.5 |
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Term
| What rate of change in PSA is linked to an increased likelihood of CA? |
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Definition
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Term
| What type of CA are the majority of prostate CA? |
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Definition
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Term
| What grading system is used with prostate CA? |
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Definition
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Term
| What is the tx for prostate CA? |
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Definition
| radiation and radical prostatectomy |
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Term
| What continents are most affected by penile CA? |
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Definition
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Term
| What are the RF for penile CA? |
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Definition
Poor Hygeine
Uncircumcised |
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Term
| At what age is penile CA MC? |
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Definition
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Term
| What may penile CA begin as? |
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Definition
| Leukoplakia or condylomata lesion |
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Term
| If velvety red lesion on penis, what condition do you suspect? |
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Definition
| Bowen dz (carcinoma in situ) |
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Term
| What is the MC site of penile CA? |
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Definition
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Term
| What is the MC type of penile CA? |
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Definition
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Term
| What is mandatory in the treatment of penile CA? |
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Definition
| biopsy to r/o benign conditions (syphilis, condylomata or chancroid) |
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Term
| What is the treatment for a primary lesion in penile CA? |
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Definition
| Fluorouracil (Effudex) cream 5% or laser tx |
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Term
| What is the treatment for a invasive penile CA? |
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Definition
Complete excision with adequate margins
Complete penectomy if involves shaft |
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|
Term
| Where does penile CA primarily spread? |
|
Definition
| Spreads primarily to inguinal lymph nodes |
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|
Term
| What is the tx for inoperable penila CA and bulky inguinal mets? |
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Definition
|
|
Term
| What is the 5 yr survival rate for penile CA for pts with node negative dz? |
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Definition
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|
Term
| What is the 5 yr survival rate for penile CA for pts with pos inguinal nodes? |
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Definition
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|
Term
| What muscle is part of the spermatic cord? |
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Definition
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Term
| Where is the hydrocele located? |
|
Definition
| between the two layers of tunica vaginalis |
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|
Term
| What side is a varicocele MC found on? |
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Definition
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|
Term
| What side of the penis is a hypospadias on? |
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Definition
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|
Term
| What side of the penis is a epispadias on? |
|
Definition
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|
Term
| What side of the penis is a epispadias on? |
|
Definition
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