Family Medicine EOR: Urology/Renal (Smarty PANCE) Exam Questions and Answers 100% Correct | Graded A+

Family Medicine EOR: Urology/Renal (Smarty PANCE) Exam Questions and Answers 100% Correct | Graded A+ What is balanitis? Inflammation of the glans penis (head of the penis). It is fairly common and affects approximately 3-11% of males during their lifetime. What is the most common cause of balanitis? The most common cause of balanitis is related to inadequate personal hygiene in uncircumcised males. Fungal infections are the most common identifiable etiology, with the majority of infections being caused by Candida albicans What are the symptoms of balanitis? Symptoms include redness, swelling, pain, itching, discharge, and white, shiny skin on the penis What is the diagnosis of balanitis? Diagnosis is often clinical based on symptoms and physical examination. Supporting tests may include swabs for culture or PCR to identify infections, blood glucose tests for underlying diabetes, and biopsy in persistent or suspicious cases. What is the treatment of balanitis? Proper hygiene with frequent washing and drying off the prepuce is an essential preventive measure. Topical antifungals, usually for one to three weeks is the treatment of choice for most patients What is another name for benign prostatic hyperplasia? BPH What is BPH? Disease of elderly men (average age is 60 to 65 years); prostate gradually enlarges, creating symptoms of urinary outflow obstruction What is the size of a normal prostate? 20 to 25 gm Where does BPH occur? Periurethrally (the tissue surround the urethra) (Note: prostate cancer occurs in the periphery of the gland) What are the symptoms? Obstructive-type symptoms: hesitancy, weak stream, nocturia, intermittency, UTI, urinary retention How is the diagnosis of BPH made? Diagnosis is based primarily on digital rectal examination (DRE) and symptoms; cystoscopy, transrectal ultrasonography, urodynamics, or other imaging studies may also be needed. What lab tests should be performed in the diagnosis of BPH? Urinalysis, PSA, BUN, CR What is the differential diagnosis of BPH? ● Prostate cancer (e.g., nodular)—biopsy ● Neurogenic bladder—history of neurologic disease ● Acute prostatitis—hot, tender gland ● Urethral stricture—RUG, history of STD ● Stone ● UTI What are the treatment options? ● Alpha-adrenergic blockers - cause urethral relaxation and rapid symptom relief (eg, terazosin, doxazosin, tamsulosin, alfuzosin, silodosin) ● 5 alpha-reductase inhibitors reduce the size of the prostate (finasteride, dutasteride), ● Phosphodiesterase type 5 inhibitor (PDE5 inhibitor) tadalafil, especially if there is concomitant erectile dysfunction ● Surgical— TURP, TUIP, open prostate resection ● Transurethral balloon dilation ● Avoidance of anticholinergics, sympathomimetics, and opioids Why do α-adrenergic blockers work? α-adrenergic blockers work and α-adrenergic blockers work - cause urethral relaxation and rapid symptom relief What is Proscar®? Finasteride: 5-α reductase inhibitors - blocks transformation of testosterone to dihydrotestosterone; may shrink and slow progression of BPH What is Hytrin®? Terazosin: α-blocker; may increase urine outflow by relaxing prostatic smooth muscles What are the indications for surgery in BPH? Surgery is done when patients do not respond to drug therapy or develop complications such as recurrent urinary tract infection, urinary calculi, severe bladder dysfunction, or upper tract dilation What is TURP? TransUrethral Resection of Prostate: resection of prostate tissue via a scope - removes excess prostate tissue to relieve obstruction What is TUIP? Transurethral incision of the prostate (TUIP) - electric current to make incisions in prostate - no tissue is removed (less side effects) What percentage of tissue removed for BPH will have malignant tissue on histology? Up to 10%! What are the possible complications of TURP? Some possible complications of TURP may include: ● Bladder injury ● Bleeding ● Blood in the urine after surgery ● Electrolyte abnormalities ● Infection ● Loss of erections ● Painful or difficult urination ● Retrograde ejaculation (when ejaculate goes into the bladder and not out the penis) What is the hallmark symptom of cystitis? The hallmark symptom of cystitis is dysuria In addition to dysuria, what are some clinical comp