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B1
Benign Prostatic Hyperplasia (BPH) Disease
Mechanism and Characteristics
DHT-induced Growth Factors
Common in Men > 50 Years Old
Smooth, Symmetric, Firm Enlargement
Affects Lateral and Middle (Periurethral) Gland
Urethra Compression
Symptoms and Complications
Increased Urinary Frequency
Nocturia
Dysuria
Urinary Tract Infection
Hydronephrosis
1 min
Benign Prostatic Hyperplasia (BPH) Diagnosis and Treatment
Diagnosis
Digital Rectal Exam
Urinalysis to Detect Infection or Blood
Treatment
Alpha-1 Antagonists
Tamsulosin
5 Alpha Reductase Inhibitors
Finasteride
TURP (Transurethral Resection of Prostate)
1 min
Varicocele
Pathophysiology
Dilation of Pampiniform Plexus Veins
Signs and Symptoms
Soft Left-Sided Scrotal Mass
Bag of Worms
Increased Size with Standing or Valsalva
Decreased Size while Supine
Testicular Atrophy
Subfertility
Diagnosis
Ultrasound
Retrograde Venous Flow
Treatment
Surgical Gonadal Vein Ligation
Scrotal Support
3 mins
Hydrocele
Mechanism
Impaired Lymphatic Drainage
Signs and Symptoms
Large Scrotum
Painless
Considerations
Needle Aspiration or Surgery
Scrotal Support
Monitor for Bleeding and Infection
1 min
Prostate Cancer Assessment
Most Common Cancer in Men
Assessment
Mimics BPH
Metastasis to Back
Low Back Pain
Fatigue
Considerations
Prostate Specific Antigen (PSA)
Digital Rectal Examination (DRE)
Transrectal Ultrasound (TRUS)
Biopsy
2 mins
Testicular Carcinoma Assessment
Cause/Mechanism
Seminoma Germ Cells
Non-Seminoma Germ Cells
Assessment
Painless Scrotal Mass
Testicular Swelling
Acute Pain Rare
Elevated Serum Tumor Markers
Considerations
Males Between 15-35 Years Old
Cryptorchidism
Testicular Self Exam
2 mins
Prostatitis
Chronic Bacterial Prostatitis
Acute Bacterial Prostatitis
Types
Sexually Transmitted Organisms
E. Coli Infection
Assessment
Flu-Like Symptoms
Perineal Pain
Dysuria
Sexual Dysfunction
Recurrent UTIs
Urinalysis
Tender Boggy Prostate
Management
Antibiotics
Considerations
Chronic Prostatitis
3 mins
Gonorrhea
Mechanism
Neisseria gonorrhoeae
Assessment
Dysuria
Yellowish-Green Discharge
Increased Urinary Frequency
Women Often Asymptomatic
Interventions
Ceftriaxone (IM)
Chlamydia
Doxycycline
Azithromycin
Considerations
Treat Partners
2 mins
Chlamydia
Mechanism
Chlamydia trachomatis
Assessment
May Be Asymptomatic
Dysuria
Epididymitis
Discharge
Dyspareunia
Interventions
Doxycycline
Azithromycin
No Intercourse for 1 Week
Treat Partners
2 mins
Genital Herpes
Mechanism
Herpes Simplex Virus 1 and 2 (HSV)
Assessment
May Be Asymptomatic
Oral or Genital Lesions
Vesicles in Clusters
Pain
Flu-like Symptoms
Antiviral Medications
Acyclovir
Valacyclovir
Famciclovir
Considerations
Infectious During Recurrences
2 mins
Syphilis
Characteristics
Treponema pallidum
Spirochete with characteristic motility
Signs and Symptoms
Painless chancre
Condylomata lata
Generalized lymphadenopathy
Rash on palms and soles
Aortitis
Gummas
Neurosyphilis
Argyll Robertson pupils
Vasa vasorum
Tabes dorsalis
Treatment
Penicillin
Jarisch-Herxheimer reaction
2 mins
Genital Warts - Condylomata Acuminata
Mechanism
Human Papillomavirus (HPV)
Assessment
Papillary Cauliflower Like Growths
Bleeding
Vaginal Discharge
Interventions
Wart Removal
Trichloroacetic acid (TCA)
Podophyllin resin
Cryotherapy
Considerations
HPV Vaccine
Cervical Cancer
2 mins
Pelvic Inflammatory Disease (PID)
Mechanism
Neisseria gonorrhoeae
Chlamydia Trachomatis
Symptoms
Cervical Motion Tenderness
Chandelier Sign
Salpingitis
Tubo-ovarian abscess
Hydrosalpinx
Complications
Ectopic Pregnancy
Infertility
Adhesions
Fitz-Hugh-Curtis Syndrome
2 mins
Pelvic Inflammatory Disease (PID) Interventions
Antibiotics
No Intercourse for 3 Weeks
Semi-Fowler's Position
Analgesics
Monitor Temperature
Treat Partners
2 mins
Endometriosis Characteristics
Endometrial Tissue Outside of Uterus
Glands and Stroma
Most Common in Ovary, Pelvis, Peritoneum and Bowels
"Chocolate Cyst" in Ovary
Adenomyosis
Theories
Retrograde Flow
Metaplastic Transformation
Mullerianosis
2 mins
Endometriosis Symptoms and Treatment
Symptoms
Dysmenorrhea
Cyclic Pelvic Pain
Dyschezia
Dysuria
Dyspareunia
30-40% are Infertile
Treatment
Surgery
NSAIDs
OCPs
Progesterone (Progestins)
GnRH Agonists
1 min
Menopause Symptoms
Symptoms
HAVOCS Mnemonic
Hot Flashes
Atrophy of Vagina
Osteoporosis
Coronary Artery Disease (CAD)
Sleep disturbances
50 secs
Cervical Cancer Screening
Women Aged 21-65 Years
Pap Smear Every 3 Years
Women Aged 30-65 Years
Can Opt for Co-testing (Pap Smear + HPV Testing) Every 5 Years
Identify Lesions
High grade lesions
Cryotherapy
Loop Excision
Cold Knife Conization
2 mins
Cervical Cancer Assessment
Cause/Mechanism
Human Papillomavirus (HPV)
Assessment
Metrorrhagia
Leukorrhea
Pain
Abnormal Pap Test
May Be Asymptomatic
Considerations
HPV Vaccine
2 mins
Dysfunctional Uterine Bleeding
Assessment
Bimodal Age Distribution
Painless Vaginal Bleeding
Amenorrhea
Menorrhagia (Heavy Menstrual Bleeding)
Metrorrhagia (Bleeding Between Menses)
Interventions
Balloon Thermotherapy
Hormone Medications
Dilation and Curettage (DandC)
Considerations
Monitor for Anemia
3 mins
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