Male Exam

Question 1

what are the characteristics of varicocele

Answer 1

MC scrotal mass
15-20% of males
maybe asymptomatic
LEFT sided

Question 2

what are the characteristics of hydroceles

Answer 2

congenital
10% of male infants
ages 2-5 –> result from orchitis and epididymitis
older men > 40 –> result from infection, trauma, cancer
transilluminates

Question 3

what are the characteristics of orchitis

Answer 3

sudden onset of pain
swelling and tenderness
nausea and vomiting

genitourinary infections
granulomatous - gonorrhea, syphilis, tb
viral - mumps (20-35%)

proteinuria and hematuria

Question 4

what are the characteristics of epididymitis

Answer 4

caused by ascending infection, urethritis, prostatis

gradual onset of pain
fever
urethral discharge

very painful and swelling
testes enlarged
scrotum may be red

scrotum elevation decreases pain

Question 5

what condition has pyruia present

Answer 5

epididymitis

Question 6

what are the characteristics of testicular torsion

Answer 6

sudden onset of severe unilateral scortal pain, vomiting/nausea, abdominal pain, fever, urinary frequency

young males - 13-17 years

occurs during activity, trauma, sleep

50% have had a previous episode

loss of cremasteric reflex

one testicle is higher than the other

Question 7

any young male with acute scrotal pain should be considered to have what until proven otherwise

Answer 7

testicular torsion

Question 8

inguinal hernias occur most often in who

Answer 8

males 9:1

Question 9

femoral hernias occur most often

Answer 9

females 3:1

Question 10

what is the congenital or oblique hernia

Answer 10

indirect hernia

Question 11

what is the acquired hernia

Answer 11

direct hernia

Question 12

what is the most common hernia in both sexes

Answer 12

indirect

Question 13

which hernia is felt on the tip of the finger

Answer 13

indirect

Question 14

which hernia is felt on the pad or side of the finger

Answer 14

direct

Question 15

which hernia is more symptomatic

Answer 15

indirect - most symptomatic due to incarceration and strangulation

direct is less symptomatic

Question 16

which hernia occurs in the hesselbach triange

Answer 16

direct

medially - rectus ab.
inferiorly - inguinal lig
laterally - inferior epigastric vessels

Question 17

what hernia has the intestines come through the canal and maybe in the scrotum

Answer 17

indirect

Question 18

what are the characteristics of BPH

Answer 18

weak urine flow 
frequent urination 
nocturia - night urination 
hesitation - trouble starting and stopping 
cant completely empty bladder 
pushing or straining 
urgency - sudden urge 
pain or burning during urination 
dribbling with urination

Question 19

what are the more serious complications of BPH

Answer 19

blood in urine
recurrent UTIs
backup urine to kidney
acute urinary retention

Question 20

what are the characteristics of prostatitis

Answer 20

fever
urgency 
dysuria - pain/burning 
hesitancy
pain in low back, perineal area, lower abs, groin 
pain is worse with bowel movement

Question 21

what are signs of prostatitis

Answer 21

tender 
enlarged 
median furrow may disappear 
boggy 
hot

Question 22

which condition will you see hematuria

Answer 22

prostatitis
and
prostate cancer

(orchitis will have hematuria but also proteinuria)

Question 23

what are the characteristics of prostatic cancer

Answer 23

early - no signs or symptoms

metastatic - with or without symptoms

dull pain in lower pelvis 
lower back pain 
upper thigh pain 
bone pain 
loss of appetite/wt loss 
frequency, dysuria, pain/burning, weak flow, and painful ejaculation

Question 24

what are the benefits of PSA

Answer 24

detects CA long before symptoms

early detection before it has spread outside the gland makes treatment easier

Question 25

what are the drawbacks of PSA

Answer 25

false negatives - 20% of cases have cancer

sensitive but not specific
CA, BPH, prostatitis

Question 26

what percent or fraction of those with elevated PSA do NOT have cancer

Answer 26

2/3

Question 27

what people do not benefit from PSA testing

Answer 27

men over 75

treating prostate cancer over 75 is less likely to lengthen life span