Uro practice (quizlet)

What type of urinary incontinence is most likely to be seen in a male s/p TURP?

A) Urge incontinence

B) Stress incontinence

C) Overflow incontinence

D) Functional incontinence

B) Stress incontinence

Pt is a 76 y/o male with PMH of urinary incontinence. He is not sure what type of incontinence he has, but he states he was told by his PCP that it is caused by "overactive bladder". Which of the following medications would be best to treat his incontinence?

A) Pharmacologic therapy is not used to treat this type of incontinence

B) Finasteride (Proscar)

C) Solifenacin (Vesicare)

D) Furosemide (Lasix)

C) Solifenacin (Vesicare)

Overactive bladder = urge

What type of urinary incontinence is most likely to be seen in a male s/p TURP?

A) Urge incontinence

B) Stress incontinence

C) Overflow incontinence

D) Functional incontinence

B) Stress incontinence

Pt is a 76 y/o male with PMH of urinary incontinence. He is not sure what type of incontinence he has, but he states he was told by his PCP that it is caused by "overactive bladder". Which of the following medications would be best to treat his incontinence?

A) Pharmacologic therapy is not used to treat this type of incontinence

B) Finasteride (Proscar)

C) Solifenacin (Vesicare)

D) Furosemide (Lasix)

C) Solifenacin (Vesicare)

Overactive bladder = urge

What type of incontinence can be treated with botox injections if refractory to other treatments?

A) Urge incontinence

B) Stress incontinence

C) Overflow incontinence

D) Functional incontinence

A) Urge incontinence

A 68 y/o male patient with PMH of mixed urinary incontinence is undergoing Uroflow/electromyography to determine how well his bladder is emptying. What post-void residual would be indicative of detrusor weakness?

A) 50 mL

B) 100 mL

C) 150 mL

D) 200 mL

D) 200 mL

Pt is a 4-month old male who is brought in by mom. She is concerned about swelling in his scrotum that seems to be smaller in the morning, but grow throughout the day. After physical exam, you suspect a hydrocele and note that it is reducible. If this condition were to persist, what surgical intervention is appropriate?

A)

B) Hydrocelectomy with scrotal incision

C) Hydrocelectomy with inguinal incision

D) Hydrocelectomy with abdominal incisoin

C) Hydrocelectomy with inguinal incision

Which of the following is most characteristic of a non-communicating hydrocele?

A) Usually congenital and self-limiting

B) Silk glove sign

C) Size does not usually change

D) Hydrocelectomy with inguinal incision can be used to treat

C) Size does not usually change

Pt is a 19 y/o M who presents with swelling of his left testicle. He states that it is not painful and he notices that it is more prominent when he is standing up. Upon inspection, you cannot see any swelling, but you are able to palpate what feels like a "bag of worms" before you even ask him to bear down. What grade varicocele does the pt have?

A) Grade I

B) Grade II

C) Grade III

D) Grade IV

B) Grade II

Which of the following is correct regarding Hesselbach's triangle?

A) This is usually where indirect inguinal hernias occur

B) The lateral border is the rectus muscle

C) The inferior border is the inferior epigastric vessels

D) The inferior border is the inguinal ligament

D) The inferior border is the inguinal ligament

What type of hernia is felt in the scrotum and increases with valsalva?

A) Direct inguinal hernia

B) Indirect inguinal hernia

C) Spigelian hernia

D) Epigastric hernia

B) Indirect inguinal hernia

Pt is a 17 y/o M who presents with acute pain and scrotal swelling, as well as N/V. PE findings are significant for Bell clapper's deformity. Which of the following would support the suspected diagnosis?

A) Intact cremasteric reflex

B) TUS demonstrating lack of blood flow

C) Silk glove sign

D)

B) TUS demonstrating lack of blood flow

Pt is a 16 y/o M who presents with scrotal pain, mostly on the posterior aspect of his right testicle, that has slowly been worsening over the last 6-7 days. He is sexually active and reports he has noticed urethral discharge that is thick and creamy. Urinalysis is significant for leukocytes and a culture has been ordered. What is the next best step for this pt?

A) Aspiration and surgical referral

B) Encourage hydration and frequent voiding

C) Manual detorsion

D) NSAIDs, appropriate abx, scrotal support

D) NSAIDs, appropriate abx, scrotal support

(Epididymitis)

Which of the following is most likely associated with blunt trauma to the testicle?

A) Epididymitis

B) Communicating hydrocele

C) Spermatocele

D) Testicular rupture

D) Testicular rupture

Which of the following is an infection of the glans and foreskin?

A) Balanitis

B) Balanoposthitis

C) Epididymitis

D) Paraphimosis

B) Balanoposthitis

Which of the following is considered a medical emergency?

A) Balanitis

B) Balanoposthitis

C) Phimosis

D) Paraphimosis

D) Paraphimosis

38 y/o M comes to your clinic with concern over a lump found on his testicle. It is hard, painless. What labs would you order for this patient and why?

AFP, LDH, BHCG

Distinguish seminoma vs non seminoma

57 year old female with no significant PMHx joined orange theory and noticed when she increases her running intensity she uncontrollable wet her pants. This is very frustrating. What type of incontinence does she have?

Stress incontinence

What are some causes of stress incontinence?

Postpartum females, post-pelvic surgery, prostate surgery

What type of incontinence is caused by laxity in the pelvic floor and poor support of the vesicourethral sphincter?

Stress incontinence

Non-surgical tx for stress incontinence

Kegals, pelvic floor therapy

Surgical tx options for stress incontinence

Bladder sling, bladder neck suspension, transurethral bulking agents, artificial sphincter

48 year old male with PMHx of GAD and depression currently on antidepressants started noticing that his boxers are wet. What type of urinary incontinence does he have?

Overflow incontinence

Does overflow incontinence affect more men or women?

Men

What type of urinary incontinence occurs when the bladder doesn't fully empty, leading to frequent dribbling?

Overflow incontinence

Causes of overflow incontinence due to blocked badder

BPH, strictures, bladder stones, prostate CA

Causes of overflow incontinence due to poor bladder compliance

Chronic retention, neurogenic bladder

Causes of overflow incontinence due to medications

Psychotropic, antidepressants

28 year old female with non significant PMHx is concerned over new onset of urinary frequency. She states she has the intense urge to void and occasionally looses control and has some accidents. She denies history of UTI, DM, or Neurogenic bladder. What kind of urinary incontinence does she have?

Urge incontinence

28 year old female with non significant PMHx is concerned over new onset of urinary frequency. She states she has the intense urge to void and occasionally looses control and has some accidents. She denies history of UTI, DM, or Neurogenic bladder. What are some non-pharmacologic treatment options for her current condition?

Diet changes, manage constipation, behavior urotherapy

28 year old female with non significant PMHx is concerned over new onset of urinary frequency. She states she has the intense urge to void and occasionally looses control and has some accidents. She denies history of UTI, DM, or Neurogenic bladder. What are some medications that can be used to treat her current condition?

Anticholinergics, alpha blockers, mirabegron

28 year old female with non significant PMHx is concerned over new onset of urinary frequency. She states she has the intense urge to void and occasionally looses control and has some accidents. She denies history of UTI, DM, or Neurogenic bladder. What are some surgical treatment options for her current condition?

Nerve stimulator implantation, botox

Risk factors that are associated with bladder include which of the following except:

A) Smoking

B) Diabetes

C) Industrial dye or solvent exposure

D) 7th decade of life

B) Diabetes

67 year old male present to your office with one week history of gross painless hematuria, he has a long history of smoking. What diagnosis do you suspect?

Bladder cancer

67 year old male present to your office with one week history of gross painless hematuria, he has a long history of smoking. What labs are you ordering?

CBC, BMP/LFTs, UA/UCx, voided cytology

S/sx of bladder cancer?

Dysuria, frequency, urgency, pelvic pain and LE in advanced disease, or asymptomatic

Which is the most common type of bladder Ca?

A) Adenocarcinoma

B) Squamous Cell Carcinoma

C) Transitional Cell Carcinoma

C) Transitional Cell Carcinoma

67 year old male present to your office with one week history of gross painless hematuria, he has a long history of smoking. He is found to have T3 bladder CA with multiple lesions. What is the tx of choice for this pt?

Radical cystectomy

What is removed in a radical cystectomy?

• Bladder

• Prostate

• Seminal vesicles

• Surrounding fat

• Peritoneal attachments

• Bilateral pelvic LN

Partial cystectomy is indicated for patients with what type of bladder ca?

Muscle invasive CA (T2-T4) solitary lesions

Other than the T2-T4 stage CA, which other classification would get a radical cystectomy?

CIS or T1

Non-invasive tx for CIS or T1 bladder CA

Transurethral resection of bladder tumor, intravesical chemo

Invasive tx for CIS or T1 bladder CA

Radical cystectomy

What is the most common neoplasm in men age 20-35 and considered an uncommon malignancy?

Testicular cancer

What subtype of cancers comprise most testicular cancers? What side?

Seminoma, right side

Right-sided testicular cancer being more common parallels the increased incidence with ______ on the right side

Cryptorchidism

All of the following are risk factors for testicular cancer except:

A) UDT

B) Klinefelter syndrome

C) Erectile dysfunction

D) Family history

C) Erectile dysfunction

RFs for testicular CA

Cryptorchidism, prior testicular CA, testicular trauma, genetics, chemical exposure, family hx

S/sx of testicular CA

Painless swelling/nodule, sensation of heaviness, may have hydrocele, gynecomastia

Seminoma or non-seminoma:

Normal AFP

Seminoma

Seminoma or non-seminoma:

Increase in AFP

Non-seminoma

Surgical tx for testicular CA

Inguinal orchiectomy

75 year old uncircumcised male who presents to your office with a lesion on his glans penis. He thought he scratched the head of the penis, but the wound seems not to heal. What is your diagnosis?

Penile CA

RFs for penile CA

Poor hygiene, HPV, uncircumcised, smoking, penile trauma

MC type of penile CA? Where is it commonly seen?

SCC, on glans

Bx needs to be ordered for penile CA to r/o what other conditions?

Syphilis, chancroid, HPV

What should be ordered when diagnosing penile CA to r/o syphilis, chancroid, and HPV?

Bx