27 - 17 yo M with groin pain

Question 1

what is the blue dot sign? of what condition is it indicative?

Answer 1

• bluish discoloration seen through the skin at the upper pole of the testis
• pathognomonic for appendiceal torsion with tenderness is also present

Question 2

what sign is pathognomonic for for appendiceal torsion with tenderness is also present?

Answer 2

blue dot sign

Question 3

what is the prehn sign? what is it used for?

Answer 3

• pain relieved by lifting of the testis

- helps distinguish epididymitis from testicular torsion: in epididymitis the pain is relieved by lifting the testis

Question 4

the pain from which testicular condition is relieved by lifting the testis? what is this maneuver called?

Answer 4

• epididymitis

- prehn sign

Question 5

what is a bell clapper deformity?

Answer 5

testis freely mobile within tunica vaginalis due to failure of normal posterior anchoring of gubernaculum

Question 6

for adolescent diabetes prevention, fasting plasma glucose should be checked every ____ years in high risk children and adolescents, beginning at age ____

Answer 6

• 2 years

- 10

Question 7

germ cell tumors are broken up into what two subtypes?

Answer 7

• seminomatous

- non-seminomatous

Question 8

what are the most common prepubertal germ cell tumors in males?

Answer 8

yolk sac tumors

Question 9

what is the most lethal germ cell tumor in males?

Answer 9

choriocarcinoma (rarest - 1%)

Question 10

what are the non-germ cell tumors in males?

Answer 10

• leydig cell tumors

- sertoli cell tumors

Question 11

what chromosomal syndrome is associated with an increased incidence of germ cell tumors?

Answer 11

Klinefelter (47xxy)

Question 12

scrotal pain is caused by which 3 somatic nerves?

Answer 12

• genitofemoral
• ilioinguinal
• posterior scrotal

Question 13

what is the appendix testis?

Answer 13

small vestigial structure (embryonic remnant of Mullerian duct) located on the anterosuperior aspect of the testis