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Presented by The Male Health Exam Practicum David L. Bell, MD, MPH Associate Professor, Dept of Pediatrics and Population and Family Health Medical Director, The Young Men’s Clinic

The Male Health Exam Practicum - events.mphi.org · The Male Health Exam Practicum David L. Bell, MD, MPH Associate Professor, Dept of Pediatrics and Population and Family Health

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Page 1: The Male Health Exam Practicum - events.mphi.org · The Male Health Exam Practicum David L. Bell, MD, MPH Associate Professor, Dept of Pediatrics and Population and Family Health

Presented by

The Male Health Exam Practicum

David L. Bell, MD, MPH

Associate Professor, Dept of Pediatrics and Population and Family Health Medical Director, The Young Men’s Clinic

Page 2: The Male Health Exam Practicum - events.mphi.org · The Male Health Exam Practicum David L. Bell, MD, MPH Associate Professor, Dept of Pediatrics and Population and Family Health

Positive experience, Apprehensions, Fears of the Male GU Exam – Group Share

Page 3: The Male Health Exam Practicum - events.mphi.org · The Male Health Exam Practicum David L. Bell, MD, MPH Associate Professor, Dept of Pediatrics and Population and Family Health

DISCLOSURE STATEMENT

David L Bell, MD, MPH

Commercial Interest Role Status

Nothing to disclose

Page 4: The Male Health Exam Practicum - events.mphi.org · The Male Health Exam Practicum David L. Bell, MD, MPH Associate Professor, Dept of Pediatrics and Population and Family Health

Learning Objectives

Review approach to male exam

Identify common male GU dermatology concerns

Refine your skills performing the male health exam.

Page 5: The Male Health Exam Practicum - events.mphi.org · The Male Health Exam Practicum David L. Bell, MD, MPH Associate Professor, Dept of Pediatrics and Population and Family Health

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Male Anatomy

Page 6: The Male Health Exam Practicum - events.mphi.org · The Male Health Exam Practicum David L. Bell, MD, MPH Associate Professor, Dept of Pediatrics and Population and Family Health

Smegma

Page 7: The Male Health Exam Practicum - events.mphi.org · The Male Health Exam Practicum David L. Bell, MD, MPH Associate Professor, Dept of Pediatrics and Population and Family Health

Benign Pearly Papules

Page 8: The Male Health Exam Practicum - events.mphi.org · The Male Health Exam Practicum David L. Bell, MD, MPH Associate Professor, Dept of Pediatrics and Population and Family Health

Sebaceous Cysts

Page 9: The Male Health Exam Practicum - events.mphi.org · The Male Health Exam Practicum David L. Bell, MD, MPH Associate Professor, Dept of Pediatrics and Population and Family Health

Sebaceous Cysts (Scrotum)

Page 10: The Male Health Exam Practicum - events.mphi.org · The Male Health Exam Practicum David L. Bell, MD, MPH Associate Professor, Dept of Pediatrics and Population and Family Health

Phimosis

Page 11: The Male Health Exam Practicum - events.mphi.org · The Male Health Exam Practicum David L. Bell, MD, MPH Associate Professor, Dept of Pediatrics and Population and Family Health

Paraphimosis

Page 12: The Male Health Exam Practicum - events.mphi.org · The Male Health Exam Practicum David L. Bell, MD, MPH Associate Professor, Dept of Pediatrics and Population and Family Health

Lichen Nitidus

Page 13: The Male Health Exam Practicum - events.mphi.org · The Male Health Exam Practicum David L. Bell, MD, MPH Associate Professor, Dept of Pediatrics and Population and Family Health

Balanitis

Page 14: The Male Health Exam Practicum - events.mphi.org · The Male Health Exam Practicum David L. Bell, MD, MPH Associate Professor, Dept of Pediatrics and Population and Family Health

Balanitis Circinata

Page 15: The Male Health Exam Practicum - events.mphi.org · The Male Health Exam Practicum David L. Bell, MD, MPH Associate Professor, Dept of Pediatrics and Population and Family Health

Lichen Planus

Page 16: The Male Health Exam Practicum - events.mphi.org · The Male Health Exam Practicum David L. Bell, MD, MPH Associate Professor, Dept of Pediatrics and Population and Family Health

Psoriasis

Page 17: The Male Health Exam Practicum - events.mphi.org · The Male Health Exam Practicum David L. Bell, MD, MPH Associate Professor, Dept of Pediatrics and Population and Family Health

Psoriasis

Page 18: The Male Health Exam Practicum - events.mphi.org · The Male Health Exam Practicum David L. Bell, MD, MPH Associate Professor, Dept of Pediatrics and Population and Family Health

The celes

Page 19: The Male Health Exam Practicum - events.mphi.org · The Male Health Exam Practicum David L. Bell, MD, MPH Associate Professor, Dept of Pediatrics and Population and Family Health

Hydroceles

Page 20: The Male Health Exam Practicum - events.mphi.org · The Male Health Exam Practicum David L. Bell, MD, MPH Associate Professor, Dept of Pediatrics and Population and Family Health

Spermatoceles (Epidydimal Cysts)

Page 21: The Male Health Exam Practicum - events.mphi.org · The Male Health Exam Practicum David L. Bell, MD, MPH Associate Professor, Dept of Pediatrics and Population and Family Health

Varicocele

Page 22: The Male Health Exam Practicum - events.mphi.org · The Male Health Exam Practicum David L. Bell, MD, MPH Associate Professor, Dept of Pediatrics and Population and Family Health

Hernia

Page 23: The Male Health Exam Practicum - events.mphi.org · The Male Health Exam Practicum David L. Bell, MD, MPH Associate Professor, Dept of Pediatrics and Population and Family Health

Scabies

Page 24: The Male Health Exam Practicum - events.mphi.org · The Male Health Exam Practicum David L. Bell, MD, MPH Associate Professor, Dept of Pediatrics and Population and Family Health
Page 25: The Male Health Exam Practicum - events.mphi.org · The Male Health Exam Practicum David L. Bell, MD, MPH Associate Professor, Dept of Pediatrics and Population and Family Health

Hypospadius (Malformation)

Page 26: The Male Health Exam Practicum - events.mphi.org · The Male Health Exam Practicum David L. Bell, MD, MPH Associate Professor, Dept of Pediatrics and Population and Family Health

Gonorrhea

Page 27: The Male Health Exam Practicum - events.mphi.org · The Male Health Exam Practicum David L. Bell, MD, MPH Associate Professor, Dept of Pediatrics and Population and Family Health

Chlamydia

Page 28: The Male Health Exam Practicum - events.mphi.org · The Male Health Exam Practicum David L. Bell, MD, MPH Associate Professor, Dept of Pediatrics and Population and Family Health

Syphilis

Page 29: The Male Health Exam Practicum - events.mphi.org · The Male Health Exam Practicum David L. Bell, MD, MPH Associate Professor, Dept of Pediatrics and Population and Family Health

HPV-Condyloma

Page 30: The Male Health Exam Practicum - events.mphi.org · The Male Health Exam Practicum David L. Bell, MD, MPH Associate Professor, Dept of Pediatrics and Population and Family Health

HPV Vaccine – New Recommendation

– After the October 2016 ACIP meeting, CDC now recommends that 11 or 12 year olds receive 2 doses of HPV vaccine instead of 3.

Page 31: The Male Health Exam Practicum - events.mphi.org · The Male Health Exam Practicum David L. Bell, MD, MPH Associate Professor, Dept of Pediatrics and Population and Family Health

Herpes

Page 32: The Male Health Exam Practicum - events.mphi.org · The Male Health Exam Practicum David L. Bell, MD, MPH Associate Professor, Dept of Pediatrics and Population and Family Health

Herpes Serologic Testing

HerpesSelect

– Glycoprotein

Not routine

– Previous diagnosis without testing without recurrent symptoms

– Recurrent symptoms

– Exposure to HSV + partner

Page 33: The Male Health Exam Practicum - events.mphi.org · The Male Health Exam Practicum David L. Bell, MD, MPH Associate Professor, Dept of Pediatrics and Population and Family Health

HIV PREVENTION PRIMER

Page 34: The Male Health Exam Practicum - events.mphi.org · The Male Health Exam Practicum David L. Bell, MD, MPH Associate Professor, Dept of Pediatrics and Population and Family Health

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Page 35: The Male Health Exam Practicum - events.mphi.org · The Male Health Exam Practicum David L. Bell, MD, MPH Associate Professor, Dept of Pediatrics and Population and Family Health

Decreasing Incidence of HIV

Recognizing Acute HIV

Testing

Early Treatment

Post-Exposure Prophylaxis (PEP)

Pre-Exposure Prophylaxis (PrEP)

35

Condoms Sexual

Education

Testing Testing

Modalities

Early Treatment

Page 36: The Male Health Exam Practicum - events.mphi.org · The Male Health Exam Practicum David L. Bell, MD, MPH Associate Professor, Dept of Pediatrics and Population and Family Health

Recognizing Acute HIV is important!

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Page 37: The Male Health Exam Practicum - events.mphi.org · The Male Health Exam Practicum David L. Bell, MD, MPH Associate Professor, Dept of Pediatrics and Population and Family Health

Recognizing Acute HIV is important!

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Page 38: The Male Health Exam Practicum - events.mphi.org · The Male Health Exam Practicum David L. Bell, MD, MPH Associate Professor, Dept of Pediatrics and Population and Family Health

Five Generations of HIV Tests

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Page 39: The Male Health Exam Practicum - events.mphi.org · The Male Health Exam Practicum David L. Bell, MD, MPH Associate Professor, Dept of Pediatrics and Population and Family Health

Generations of HIV testing

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Page 40: The Male Health Exam Practicum - events.mphi.org · The Male Health Exam Practicum David L. Bell, MD, MPH Associate Professor, Dept of Pediatrics and Population and Family Health

New Testing Algorithms

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Page 41: The Male Health Exam Practicum - events.mphi.org · The Male Health Exam Practicum David L. Bell, MD, MPH Associate Professor, Dept of Pediatrics and Population and Family Health

Decreasing Incidence of HIV

Recognizing Acute HIV

Testing

Early Treatment

Post-Exposure Prophylaxis (PEP)

Pre-Exposure Prophylaxis (PrEP)

41

Condoms Sexual

Education

Testing Testing

Modalities

Early Treatment

Page 42: The Male Health Exam Practicum - events.mphi.org · The Male Health Exam Practicum David L. Bell, MD, MPH Associate Professor, Dept of Pediatrics and Population and Family Health

Decreasing Incidence of HIV

Recognizing Acute HIV

Testing

Early Treatment

Post-Exposure Prophylaxis (PEP)

Pre-Exposure Prophylaxis (PrEP)

42

Condoms Sexual

Education

Testing Testing

Modalities

Early Treatment

Page 43: The Male Health Exam Practicum - events.mphi.org · The Male Health Exam Practicum David L. Bell, MD, MPH Associate Professor, Dept of Pediatrics and Population and Family Health

Take Away Points

43

Condoms Sexual

Education

Testing Testing

Modalities

Early Treatment

Early Diagnosis – Acute HIV

PEP PrEP

Page 44: The Male Health Exam Practicum - events.mphi.org · The Male Health Exam Practicum David L. Bell, MD, MPH Associate Professor, Dept of Pediatrics and Population and Family Health

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Page 45: The Male Health Exam Practicum - events.mphi.org · The Male Health Exam Practicum David L. Bell, MD, MPH Associate Professor, Dept of Pediatrics and Population and Family Health

Acknowledgements

Photos courtesy of:

Dermatology Image Atlas

Centers for Disease Control & Prevention

Page 46: The Male Health Exam Practicum - events.mphi.org · The Male Health Exam Practicum David L. Bell, MD, MPH Associate Professor, Dept of Pediatrics and Population and Family Health

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Page 47: The Male Health Exam Practicum - events.mphi.org · The Male Health Exam Practicum David L. Bell, MD, MPH Associate Professor, Dept of Pediatrics and Population and Family Health

Approach to the Male GU Exam

Materials/Room Set-up

Stool or Chair

Sit upright

Word Choice

The Exam

Page 48: The Male Health Exam Practicum - events.mphi.org · The Male Health Exam Practicum David L. Bell, MD, MPH Associate Professor, Dept of Pediatrics and Population and Family Health

Overview of the Male GU Exam

Outside/In

Assess Pubertal Status (<18yo)

Inspect Pubic Area generally

Palpate for Lymph Nodes

Examine Testicles and Scrotum

Assess for hernias

Inspect Penis, including urethral stripping when necessary.

Page 49: The Male Health Exam Practicum - events.mphi.org · The Male Health Exam Practicum David L. Bell, MD, MPH Associate Professor, Dept of Pediatrics and Population and Family Health

MALE PRACTICUM