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PNP1 Exam 3 > GU- Cryptochidism > Flashcards

GU- Cryptochidism Flashcards

1
Q

Types of cryptochordidm

A

absent

undescended

ectopic

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2
Q

Result of

A

chromosomal abnormalities

hormonal

anatomic factors

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3
Q

Palpable

A

Majority (80%) are undescended testes or ectopic testes

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4
Q

Retractile testes

A

also palpable, sometimes misdiagnosed as undescended

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5
Q

nonpalpable

A

(20%) can be intra-abdominal, inguinal, or absent testes

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6
Q

most common male anomaly

affects ___% term infants and

____% preterm infants

A

3-5% term

30% premies

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7
Q

Bilateral in ___ % of cases

A

30%

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8
Q

if bilateral nonpalpable testes or cryptorchid associated with hypospadeous at birth should be evaluated for

A

life-threatning intersex conditions such as congenital adrenal hyperplasia

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9
Q

differenciating retractile testes

A

may be noted in scrotum intermittantly especially after a wam bath

associated with an overactive cremasteric reflex

can be placed in scrotum on examination and will remain there for short time after release

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10
Q

if tests retract immediately after palpation they should be considered

A

undescended

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11
Q

if one testicle is absent

A

the other testicle may be larger than expected

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12
Q

position for exam

A

cross leg for child

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13
Q

nonpalpable testes may be atopic, found in

A

femoral or perineal region

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14
Q

scrotum presentation

A

flat or underdeveloped on affected side

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15
Q

what do you think of one larger than expeted testicle?

A

may represent absent or nonfunctioning testicle on opposite side.

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16
Q

testing for unilater or bilateral palpable testes

A

none

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17
Q

testing for bilateral or unilateral nonpalpable with associated phallic abnormality

A

karyotype

endocrine testing

radiographic studies

18
Q

imaging

A

usually not necessary unless child is very obese

19
Q

Which test differentiates between anorchia and undescended testes?

A

Human chorionic gonadotropin (hCG) stimulation test

20
Q

How does the HCG stimulation test work?

A

By stimulating testosterone production in funcitioning testes, can also result in testicular descent

21
Q

At what age is intervention considered?

A

6 months-1 year undescended

if you cannot feel testes anywhere in inguinal canal or is unilateral after 6 MONTHS REFER, the teste not in the scrotum can deteriorate

surgery can be done at 6 months old

22
Q

Reasons for treatment

A

reduced fertility

risk of tumors

trauma, torsion, hernia

psych factors of body image

repair of associated defects such as ing hernia

23
Q

risk of cancer

A

Repair does not decrease risk but allows for screening, testes when corrected can be palpated for exam and detection

in cryptorchid male 1 in 2000

highes in ages 17-25 years

40% in those with undiscended testicle

24
Q

Orchiopexy

A

open surgery fixes testes in scrotum and may repair hernia

Can also be performed laproscopically

25
Q

laproscopy

A

can be used to locate nonplapable testes or blending vessles

26
Q

Hormonal treatment

A

not as effective, good for high rish patients

patients with testes high in scrotum or at external inguinal ring

27
Q

When do we follow up after surgery?

A

incision exam at 2-4 weeks

then

4-6 months postop

28
Q

follow up after HRT

A

1 month and 6 months post treatment

higher risk of reascension

29
Q

routine exams

A

yearly and teach self exam at puberty

30
Q

monitoring of retractile testes

A

rarely problematic, yearly monitoring for ascension increased risk to patients with CNS anomalies

31
Q

Red flag for further eval

A

asymetric testes

32
Q

Complications

A

testicular atrophy

33
Q

Education - frequency and timing of self exam?

A

teach all males self exam at puberty to be done monthly

34
Q

exam prior to puberty

A

annually

35
Q

what is undiscended testes are discovered after 1 year old?

A

immediately see peds urology or surgeon

36
Q

located at edge of inguinal ring

A

prescrotal

37
Q

located between external and internal rings

A

canalicular high or low

most common tyoe

38
Q

superficial inguinal, femoral or perineal

A

ectopic

39
Q

above inguinal ring

not palpable

A

intrabdominal

less than 15%

40
Q

indirect inguinal hernia

A

?

41
Q

participation in sports is discouraged why?

A

risk of trauma to one viable testicle

PNP1 Exam 3 (17 decks)

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