Intern Year: Tintinalli- Section 10-Ch 96-Male Gu Problems

Front 1

How can you reduce edema to the glans penis? What is this used for?

Back 1

Wrapping it with a two inch elastic bandage for five minutes

Tx for para phimosis to prevent gangrene

Front 2

Maldevelopment of this structure leads to increased risk for torsion

Back 2

Scrotal ligament

(Gubernaculum)

Front 3

Hydroceles can form in this potential space in the testis

Back 3

Tunica vaginalis

Front 4

Testicular nodules should be assumed to be what?

Back 4

Carcinoma

Until proven otherwise

Front 5

What is Fournier Gangrene

Back 5

Polymicrobial, synergistic, infective necrotizing fasciitis of the perineal, genital, or perianal anatomy

Front 6

2 comorbidities commonly associated with fourniers gangrene

Back 6

Diabetes
Etoh

Front 7

What is balanoposthitis? What can it be the sole symptom of?

Back 7

Inflammation of the glans and the foreskin

Diabetes

Consider candida gardnerella, and anaerobes as potential causes

Front 8

Tx for phimosis

Back 8

Definitive: circumcision

Topical steroid (betamethasone 0.05% to 0.1) once a day for 4-6 weeks is 70-90% effective

Front 9

What is a paraphimosis? Which is a true urologic emergency, phimosis or para?

Back 9

Para: true urologic emergency, inability to reduce the proximal erythematous foreskin dismally over the glans penis into its natural position

Front 10

Pt presents after intercourse with a non erect swollen do colored and tender penis. What do you need to be concerned for as a result of the diagnosis

Back 10

This is a fractured penis

Look for urethral rupture with retrograde urerthrogram

Front 11

Give some causes for priapism

Back 11

Injection of vasoactive substances (PGE)
Hydralazine, ccbs
Chlorpromazin, Trazodone (mental disorder)
Sickle cell

Front 12

No matter the cause of priapism, initial therapy includes what?

Back 12

Terbutaline (b2 agonist .25-.5mg SC in deltoid q 30 min

Narcotic analgesia

Corporal aspiration followed by irrigation

Front 13

Diff for acute scrotal pain

Back 13

Torsion
Epididymitis
Incarcerated hernia
Vasculitis

Front 14

Most sensitive finding (99%) in testicular torsion is?

Back 14

Unilateral absence of cremaster reflex

Other: firm, tender, higher in position, horizontal in lie

Front 15

What is Prehn Sign

Back 15

Relief of pain with elevation of effected testis

Usually a positive sign for epididymis but cannot rule out torsion

Front 16

How quickly do you need to diagnose torsion to have good salvage of the testis

Back 16

<6 hours from sx

Front 17

If ultrasound is equivocal for torsion, what can be used

Back 17

Scintigraphy

Front 18

How do you attempt to do manual detorsion

Back 18

Similar to opening a book
Medial to lateral
If standing at pt feet rotate right testis clockwise, left counter

Try one and a half rotations

Front 19

What diagnosis must be considered in any male presenting with abdominal pain

Back 19

Torsion

Front 20

What is the "blue dot sign" seen in

Back 20

Appendage all torsin

Seen on upper pole of testis or epididymis,is

Front 21

Tx for suspected epididymitis in Pt under 40

Back 21

Treat for gonorrhea and chlamydia

Ceftriaxone 250mg IV
PLUS
Doxycycline 100mg PO bid for ten days

Front 22

Tx for suspected epididymitis in Pt over 40

Back 22

Treat for gram negative bacilli

Cipro 500mg PO bid for 10-14d
Levofloxacin 250mg po everyday for 10-14d

Front 23

Initial treatment for acute prostatitis?

Back 23

FQs for 30 days

E. coli is working diagnosis

Front 24

What signifies abnormal residual urine volume

Back 24

150-200mL