2025/2026
Identify the population most commonly affected by bacterial prostatitis - Correct Answers o
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Acute - Sexually active men 30 to 50 years
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- Chronic bacterial prostatitis common in men older than 50 years old
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- Athletes who run long distance are predisposed
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- Complaints of fever, chills, LBP, malaise, arthralgia, myalgia, frequency, urgency, dysuria,
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nocturia, and bladder outlet obstruction
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o Chronic bacterial prostatitis- men over age 50 years of age. Symptoms often absent , perineal
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pain, lower abdomen pain, scrotal or penile pain, pain with ejaculation, dysuria, irritative voiding
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Il` Discuss the physical exam characteristics of acute bacterial prostatitis - Correct Answers Acute
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Il` bacterial prostatitis- warm, tense, swollen , boggy and very tender prostate.
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Most common pathogen Strep faecalis and staph aureus
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Il` Discuss how the Phren sign can differentiate between testicular torsion and epididymitis -
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Il` Correct Answers Epididymis characteristic is relief of discomfort with elevation of testis. Positive
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Il` Prehn's sign = pain relief. Il` Il` Il` Il` Il`
Testicular torsion elevation of the affected testicle does NOT relieve the pain (Negative Prehn's
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sign = pain is NOT relieved)
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Epididymis Positive Prehn's sign = pain relief. Neg = no pain relief = testicular torsion).
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Il` Discuss common symptoms reported from a patient with BPH - Correct Answers Affects men
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Il` age 40 years and older.
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,Obstructive symptoms include Il` Il`
• Decreased stream • Hesitancy
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• Postvoid dribbling • Sensation of incomplete bladder emptying
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• Overflow incontinence • Inability to voluntarily stop the urine stream
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• Urinary retention • Straining
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Irritative symptoms include Il` Il`
• Nocturia • Urinary frequency
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• Urinary urgency • Dysuria
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Il` Urge incontinence
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Erectile dysfunction should be assessed on patient taking finasteride.
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Il` Discuss the hallmark characteristic of a varicocele - Correct Answers The hallmark characteristic
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Il` of varicocele is the sensation that the testes feel like a "bag of worms."
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Varicocele can be bilateral, but if it is unilateral it is almost always on the left side due to the
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anatomy of the vasculature drainage in the testes.
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Tortuous veins posterior and above testes can be seen with patient sitting upright
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Venous engorgement may increase with Valsalva maneuver; resolves when patient lies down.
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Grade 1 varicocele is one that is palpable only when the patient performs the Valsalva maneuver.
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Grade 2 varicocele is palpable when the patient is standing.
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, Grade 3 varicocele may be assessed with light palpation and visual inspection
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Il` Identify the population most affected by testicular cancer - Correct Answers Males between the
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Il` ages of 15 and 35 Il` Il` Il` Il`
Il` Explain spinal stenosis - Correct Answers Narrowing of the spinal canal w/ compression of nerve
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Il` roots
- Congenital or acquired (age)
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- Most commonly from enlarging osteophytes at the facet joints, hypertrophy of the ligamentum
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flavum and protrusion/buldging of the intervertebral discs
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- May produce symptoms by directly pushing on nerve or interrupting the blood supply to nerve
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Common source of chronic low back pain, seen most with aging. All older people have some
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degree of this
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Il` Discuss common characteristics (subjective findings) of patients with lumbar spinal stenosis -
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Il` Correct Answers - Radicular complaints in calves, buttocks, upper thighs
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- Pain w/ walking or prolonged standing
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o Vascular claudication - pain stops w/ rest
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o Psuedoclaudication - pain doesn't stop immediately at rest
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- Short term relief by leaning forward/stooping
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- Sometimes relief w/ sitting
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- Pain in back/leg when sleeping on back at night
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- Pain w/ walking/standing
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Il` 8. Discuss common characteristics (objective findings) of patients with lumbar spinal stenosis -
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Il` Correct Answers - Muscle weakness Il` Il` Il` Il` Il` Il` Il`
- Impaired proprioception
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