Lecture Notes: Reproductive, Urinary, and Breast Health

SECTION 1: BREAST HEALTH

Benign Breast Conditions

• Cysts: Fluid-filled sacs common in childbearing age; enlarge premenstrually.
  • Simple cysts: Anechoic on ultrasound; no treatment needed unless painful.
  • Complicated cysts: May contain debris; require aspiration or repeat imaging.
  • Complex cysts: Mixed solid/fluid; require biopsy due to 23-31% malignancy risk.

Mastalgia (Breast Pain)

• Most common complaint; 75% is cyclic and hormone-related.
• Cyclic mastalgia worsens in luteal phase, improves post-menses.

Breast Cancer Risk Factors

• Gender: AFAB.
• Age: Increasing age.
• Genetics: BRCA1/2 mutations, family/personal history.
• Hormonal: Early menarche (<12), late menopause (>55), nulliparity, late first pregnancy.
• Lifestyle: Obesity, alcohol use, radiation exposure, Ashkenazi Jewish heritage.

Signs of Breast Cancer

• Hard, fixed, painless lump with irregular edges, usually in upper outer quadrant (Tail of Spence).

Post-Mastectomy Arm Care (ALND)

• Avoid BP/injections on affected side.
• Protect skin from trauma, sun, insect bites.
• Use gloves, avoid tight clothes/jewelry.
• Immediate care for any skin break.

Male Breast Cancer

• Evaluate all male breast lumps.
• Regular screening for BRCA carriers.
• Treatment same as females.

SECTION 2: URINARY TRACT & RENAL

UTI Diagnostics

• Urine culture + sensitivity for confirmation.
• Dipstick: +Leukocyte esterase indicates pyuria; +Nitrites indicates bacteria.

Who Needs a Culture?

• Males, diabetics, immunocompromised, recurrent UTIs, pregnant/postmenopausal women, catheterized patients, LTC residents.

Common UTI Symptoms

• Dysuria, urgency, frequency, nocturia, suprapubic pain, hematuria.

Pyelonephritis

• Acute: Fever, chills, CVA tenderness, flank pain, N/V, pyuria.
• Chronic: Fatigue, polyuria, weight loss, leads to scarring/kidney failure.
• Diagnostics: UA, culture, CT/MRI, BUN/Cr.

Voiding Dysfunction

• Causes: Neurogenic (MS, stroke, Parkinson's) or non-neurogenic (OAB, post-op).
• Treatments: Timed voiding, pelvic floor exercises, anticholinergics, catheterization.

Triple-Lumen Catheters

• Used post-TURP or for continuous bladder irrigation (CBI) in hematuria.

BPH Surgical Options

• Options: UroLift, Rezum, GreenLight, TUIP, TURP, HoLEP.
• Depends on gland size, age, comorbidities.

SECTION 3: MALE REPRODUCTIVE CONDITIONS

Epididymitis & Orchitis

• Inflammation often due to infection.
• Causes: Chlamydia, gonorrhea, UTI, prostatitis.
• Treatment: Rest, scrotal elevation, ice, antibiotics, NSAIDs.

HPV (Types 6 & 11)

• Causes genital warts (condylomata); soft, flesh-colored, verrucous.
• Found on genitals/oral mucosa.
• Vaccine prevents types 6, 11, 16, 18.

PID (Pelvic Inflammatory Disease)

• Ascending infection from cervix to uterus/tubes/ovaries.
• Causes: Gonorrhea, Chlamydia.
• Types: Acute, chronic, localized or widespread.
• Symptoms: Pelvic pain, discharge, fever.
• Complications: Infertility, ectopic pregnancy.

STI-Related Enteritis

• Chlamydia may mimic proctitis.
• Enteric infections: E. histolytica, Giardia, Shigella, Campylobacter.
• Diagnostics: Sigmoidoscopy, rectal swabs, cultures.
• Treatment: Depends on organism (antibiotics, antivirals, anti-parasitics).

Syphilis

• Primary: Painless chancre at infection site.
• Secondary: Rash on palms/soles, fever, lymphadenopathy.
• Latent phase follows secondary stage; may relapse.

This guide is essential for test prep, clinical care, and patient education in topics related to breast, urinary, and reproductive health. Consider using charts, flashcards, or NCLEX-style questions for deeper review.