Chapter 26: Alterations of the Male Reproductive System

Question 1

In the 95% of those with delayed puberty, the problem is caused by which condition?

a. Disruption in the hypothalamus
c. Deficit in estrogen or testosterone
b. Disruption of the pituitary d. Physiologic hormonal delays

Answer 1

ANS: D
In 95% of cases, delayed puberty is a physiologic delay; that is, hormonal levels are
normal and the hypothalamic-pituitary-gonadal (HPG) axis is intact, but maturation is
happening slowly. This selection is the only option that accurately describes 95% of those
with delayed puberty.
PTS: 1 REF: Page 886

Question 2

What is the first sign of puberty in boys?

a. Thickening of the scrotal skin
c. Enlargement of the testes
b. Growth of pubic hair
d. Change in voice

Answer 2

ANS: C
The first sign of puberty in boys is an enlargement of the testes and a thinning of the
scrotal skin.
PTS: 1 REF: Page 886

Question 3

Which type of precocious puberty causes the child to develop some secondary sex
characteristics of the opposite sex?
a. Mixed 
c. Isosexual
b. Incomplete 
d. Homosexual

Answer 3

ANS: A
Mixed precocious puberty (i.e., virilization of a girl or feminization of a boy) causes the
child to develop some secondary sex characteristics of the opposite sex. This selection is
the only option that accurately identifies the type of precocious puberty described.
PTS: 1 REF: Page 887

Question 4

What term is used to identify a condition in which the foreskin cannot be retracted over the
glans penis?
a. Paraphimosis 
c. Prephimosis
b. Priapism 
d. Phimosis

Answer 4

ANS: D
Phimosis is the only term used to identify the condition in which the foreskin cannot be
retracted back over the glans.
PTS: 1 REF: Page 888

Question 5

What term is used to identify a fibrotic condition that causes lateral curvature of the penis
during erection, which is associated with a local vasculitis-like inflammatory reaction and
decreased tissue oxygenation?
a. Phimosis
c. Lateral paraphimosis
b. Lateral phimosis
d. Peyronie disease

Answer 5

ANS: D
Peyronie disease (bent nail syndrome) is a fibrotic condition of the tunica albuginea of the
penis, resulting in varying degrees of curvature and sexual dysfunction (see Figure 25-2).
Although the exact cause is unknown, a local vasculitis-like inflammatory reaction occurs
and decreased tissue oxygenation results in fibrosis and calcification. Peyronie disease is
the only term used to identify the pathophysiologic condition described.
PTS: 1 REF: Pages 889-890

Question 6

What term is used to identify an inflammation of the glans penis?

a. Glanitis
c. Priapism
b. Balanitis
d. Hydrocelitis

Answer 6

ANS: B
Balanitis is the only term used to identify an inflammation of the glans penis (see Figure
25-4).
PTS: 1 REF: Page 890

Question 7

. Cryptorchidism can be defined as which of the following?

a. Normal developmental state of the testes
b. Abnormal state in which the testes are overdeveloped
c. Lack of scrotum
d. Testicular maldescent

Answer 7

ANS: D
Cryptorchidism is a condition of testicular maldescent, the only option that accurately
defines cryptorchidism.
PTS: 1 REF: Page 892

Question 8

What is the most common infectious cause of orchitis and one that usually affects
postpubertal boys?
a. Herpes 
c. Mumps
b. Escherichia coli 
d. Cytomegalovirus

Answer 8

ANS: C
Of the options available, mumps is the most common infectious cause of orchitis and
usually affects postpubertal boys.
PTS: 1 REF: Pages 894-895

Question 9

The risk of which cancer is greater if the man has a history of cryptorchidism?

a. Penile
c. Prostate
b. Testicular
d. Epididymal

Answer 9

ANS: B
The risk of testicular cancer is 35 to 50 times greater in men with cryptorchidism or in
those with a history of cryptorchidism than it is for the general male population. This is not
true of the other options.
PTS: 1 REF: Pages 893-894

Question 10

What are the clinical manifestations of testicular cancer?

a. Firm, nontender testicular mass
c. Painful fluid-filled testicular mass
b. Painful, mobile, firm testicular mass
d. Soft, nontender testicular mass

Answer 10

ANS: A
Of the options available, a firm, painless testicular enlargement is commonly identified as
the first sign of testicular cancer.
PTS: 1 REF: Pages 895-896

Question 11

How does the epididymis become infected?
a. The pathogenic microorganisms ascend the vasa deferentia from an already
infected urethra or bladder.
b. The pathogenic microorganisms are attached to sperm that travel through the
genital tract.
c. The pathogenic microorganisms from the tunica vaginalis are transported to the
epididymis.
d. The pathogenic microorganisms from the prostate fluid ascend to the epididymis

Answer 11

ANS: A
The pathogenic microorganisms usually reach the epididymis by ascending the vasa
deferentia from an already infected urethra or bladder. Of the selections available, this is
the only option that accurately describes how the epididymis becomes infected.
PTS: 1 REF: Page 897

Question 12

Symptoms of benign prostatic hyperplasia (BPH) are a result of which pathophysiologic
condition?
a. Infection of the prostate
c. Ischemia of the urethra
b. Obstruction of the urethra d. Compression of the urethra

Answer 12

ANS: D
BPH becomes problematic as prostatic tissue compresses the urethra, where it passes
through the prostate. Of the selections available, only this option accurately describes the
pathophysiologic condition behind the symptoms of BPH.
PTS: 1 REF: Pages 897-899

Question 13

Which infection has clinical manifestations that include the sudden onset of malaise, low
back pain, and perineal pain with high fever and chills, dysuria, nocturia, and urinary
retention?
a. Orchitis
c. Epididymitis
b. Balanitis
d. Bacterial prostatitis

Answer 13

ANS: D
Bacterial prostatitis can exhibit common manifestations that include a sudden onset of
malaise, low back and perineal pain, high fever (up to 40° C [104° F]), and chills, as well
as dysuria, inability to empty the bladder, nocturia, and urinary retention. Myalgia and
arthralgia also may occur. This selection is the only option that exhibits the symptoms
described.
PTS: 1 REF: Pages 899-900

Question 14

Priapism has been associated with the abuse of what substance?

a. Marijuana
c. Cocaine
b. Alcohol
d. Heroin

Answer 14

ANS: C
Of the options available, priapism has been associated with cocaine use.
PTS: 1 REF: Page 890

Question 15

Which age group should be targeted for testicular cancer education and screening?

a. 15 to 35 year olds
c. 30 to 55 year olds
b. 20 to 45 year olds
d. 45 to 70 year olds

Answer 15

ANS: A
Overall, testicular cancers are rare, yet they are the most common form of cancer in young
men between the ages of 15 and 35 years.
PTS: 1 REF: Page 895

Question 16

What is the reason breast cancer in men has such a poor prognosis?

a. Breast cancer is extremely aggressive in men.
b. Treatment is usually delayed as a result of late detection.
c. Chemotherapies are not as effective in men.
d. Breast tumors tend to be small and hard to isolate.

Answer 16

ANS: B
Breast cancer is relatively uncommon in men, but it has a poor prognosis because men
tend to delay seeking treatment until the disease is advanced. This selection is the only
option that accurately identifies the reason breast cancer in men has a poor prognosis.
PTS: 1 REF: Page 914

Question 17

Which are clinical manifestations of male breast cancer? (Select all that apply.)

a. Ulceration present on the breast
b. Retraction of breast tissue
c. Nipple discharge
d. Palpable mass midline of the nipple
e. Unilateral solid mass

Answer 17

ANS: A, B, C, E
The malignant male breast lesion is usually a unilateral solid mass located near the nipple.
Because the nipple is commonly involved, crusting and nipple discharge are typical
clinical manifestations. Other findings include skin retraction, ulceration of the skin over
the tumor, and axillary node involvement.
PTS: 1 REF: Page 914

Question 18

Which statements are true regarding urethritis? (Select all that apply.)

a. A purulent drainage may be present.
b. A clear mucus-like discharge may be present.
c. Symptoms include urethral tingling and itching or burning on urination.
d. A 24-hour urine test is required to diagnose the disorder.
e. Treatment includes appropriate antibiotic therapy.

Answer 18

ANS: A, B, C, E
Symptoms of urethritis include urethral tingling and itching or a burning sensation on
urination (dysuria), frequency, and urgency. The individual may note a purulent or clear
mucus-like discharge from the urethra. Nucleic acid detection amplification tests allow
easy detection of Neisseria gonorrhoeae and Chlamydia trachomatis in first-void urine.
Treatment consists of appropriate antibiotic therapy for infectious urethritis and an
avoidance of future chemical or mechanical irritation.
PTS: 1 REF: Page 888

Question 19

Which statements are true regarding prostate cancer? (Select all that apply.)

a. It ranks second to lung cancer as being most common among American men.
b. A familial history of prostate cancer is a risk factor.
c. Dietary habits seem to play a role in its development.
d. African-American men have an increased risk for its development.
e. Being over 65 years of age increases the risk for developing prostate cancer.

Answer 19

ANS: B, C, D, E
Prostate cancer is the most commonly diagnosed non–skin cancer in American men, and
the incidence varies greatly worldwide. Possible causes include a genetic predisposition,
environmental and dietary factors, inflammation, and alterations in levels of hormones
(e.g., testosterone, dihydrotestosterone, estradiol) and growth factors. Incidence is greatest
among northwestern European and North American men (particularly African Americans)
older than 65 years of age.
PTS: 1 REF: Pages 900-910

Question 20

Match the description with the disorder.
______ A. Painless diverticulum of the epididymis located between the head of the
epididymis and the testis
______ B. Collection of fluid in the tunica vaginalis
______ C. Rotation of a testis, which twists blood vessels of the spermatic cord
______ D. Abnormal dilation of the vein within the spermatic cord
20. Varicocele
21. Hydrocele
22. Testicular torsion
23. Spermatocele

Answer 20

20. ANS: D PTS: 1 REF: Page 891
    MSC: A varicocele is an abnormal dilation of a vein within the spermatic cord and is classically
    described as a bag of worms
21. ANS: B PTS: 1 REF: Page 892
    MSC: A hydrocele is a collection of fluid within the tunica vaginalis
22. ANS: C PTS: 1 REF: Page 894
    MSC: Torsion of the testis is rotation of a testis, which twists blood vessels in the spermatic cord.
23. ANS: A PTS: 1 REF: Page 892
    MSC: A spermatocele is a painless diverticulum of the epididymis located between the head of the
    epididymis and the testis.