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25 Cards in this Set
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types of symptoms of BPH (2)
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1.Obstructive (define)
2.Irritative (define) |
1.bladder outlet : urinary hesitancy, decreased force, dribbling
2.Decreased bladder capacity/infection: frequency, urgency, nocturia |
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Incidence of BPH
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>50% of men 60
80% men 70yrs prevelance increases with age |
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Risk Factors of BPH
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-elevated PSA
-Increased physical activities -Increased age |
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Assessment findings of BPH
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weak urinary stream
hesitancy and post void dribble incomplete emptying of bladder frequency and urgency nocturia incontinence urinary retention hematuria: gross of microscopic Firm, smooth, symmetrically enlarged prostate |
size of prostate does not correlate with symptoms
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BPH differential diagnosis
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prostatitis
prostate CA urethral stricture neurogenic bladder effect of medications urinary tract infection bladder cancer |
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American urological association symptoms index score BPH
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0-7 mild symptoms
8-19 moderate symptoms 20-35 severe symptoms |
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BPH diagnostic tests
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-u/a
-cr -psa <10ng/mL -U/S prostate -Needle bx -IVP,CT, MRI |
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4 types of Prostatitis
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I acute bacterial
II chronic bacterial III Chronic Prostatitis/ Pelvic Pain syndrome (2 types) IV Asymptomatic Inflammatory prostatitis |
IIIa Inflamatory
IIIb non-inflammatory (most common) |
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Spread of bacteria in prostatitis
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-bloodstream
-ascending urethral infection -rectal bacterial via lymphatic vessels -infected urine refluxing into prostate ducts |
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Signs and Symptoms of
acute prostatitis |
malaise
myalgia arthralgia sudden fever chills pelvic area fullness urinary frequency and urgency uretral discharge nocturia prostate is TENDER, HARD, SWOLLEN AND WARM dysuria cloudy urine obstruction of urine |
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Signs and symptoms of
chronic prostatitis (bactierial) |
starts acute
r/t chronic uti antibiotics don't help less sever than acute prostatitis low back pain intermittent dysuria intermittent obstructive ut sx |
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Signs & Symptoms
chronic non inflammatory prostatitis |
u/a negative
normal leukocyte count reflux r/t obstruction of bladder unknown cause |
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Assessment findings in prostatitis
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hx of onset severity precipitating faxtors
-urine - cloudy -prostate soft scattered area boggy -tender swollen warm (acute) -normal (chronic) -palpable seminal vesicle |
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PROSTATITIS DIFFERENTIAL DIAGNOSIS
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PROSTATE CANCER
BPH UTI IBD BACK PAIN UROLITHIASIS CYSTITIS |
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DIAGNOSTIC TESTS
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X RAY (R/O CALCULI)
CT (R/O ABCESS/TRAUMA) TR U/S (R/O ABCESS) UA - ID BACTERIA CBC (NORMAL OR ELEVATED) BMP -ID OBSTRUCTION KIDNEY |
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UNIVERSAL TESTING FOR HIV
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CDC URGES UNIVERSAL TESTING FROM AGES 18-64, REGARDLESS OF RISK
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INDIRECT INGUINAL HERNIA
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BOTH SEXES, ALL AGES, MOST COMMEN.
OFTEN IN THE SCROTUM CONES DOWN THE INGUINAL CANAL |
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DIRECT INGUINAL HERNIA
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LESS COMMON, MEN OLDER THAN 40.
HERNIA BULGES ANTERIORLY AND PUSHES FINGER ON EXAM |
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TESTICULAR CANCER CLASSIFICATIONS (2)
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1. SEMINOMAS
2. NONSEMINOMAS |
1. CLASSIC, ANAPLASTIC, SPERMATOCYTIC
2. CHORIACARINOMA, EMBRONAL, TERATOMA, YOLK AND SAC TUMOR |
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TESTICULAR CANCER ASSESSMENT FINDINGS
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PAINLESS LUMP
PAIN/DISCOMFORT IN TESTICLES ENLARGEMENT OF TESTE FEELING OF HEAVINESS DULL ACHE IN LOWER ABD, BACK OR GROIN SUDDEN COLLECTION OF FLUID IN SCROTUM |
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DIFFERENTIAL DIAGNOSIS OF TESTICULAR CANCER
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TESTICULAR TORSION
INGUINAL HERNIA EPIDIYMITIS HEMATOCELE VARICOCELE |
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DIAGNOSITC TESTS FOR TESTICULAR CANCER
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ULTRASOUND
BIOPSY LABS: TUMOR MARKERS -AFP (alfa-fetoprotein) -Beta-human chorionic gonadotropin -lactate dehydrogenase (LDH) |
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Erectile Dysfunction classification (3)
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1. Mild
2. Moderate 3. Complete |
1. age 40; 40% 70; 70%
2. age 40:17% 70;34% 3. age 40:5% age 70;15% |
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Factors that Influence ED
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-Heart disease, Respiratory Disease
-HTN, DM, Hyperlipidemia -Cigarette smoking -Depression -Hormonal, Neurological or hematologic disorder -Pelvic irradiation |
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ED Diagnostic Test
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Labs: testosterone and prolactin levels
Screen: lipid panel, general chemistry, diabetes screening |
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