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X Physical Diagnosis Final > Male Exam > Flashcards

Male Exam Flashcards

1
Q

What are the scrotal contents to palpate?

A

Testes, epididymis and spermatic cord (vas deferens)

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2
Q

When is the highest incidence of testicular cancer?

A

15-35 yrs old

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3
Q

Where do you palpate the epididymis?

A

Located superiorly and posterolaterally on testicle

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4
Q

How do you palpate the spermatic cord?

A

Palpate from the epididymis to the inguinal ring using thumb and index finger

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5
Q

How would you know there is hernia in the inguinal canal?

A

When turn head and cough, feel sudden pressure at side or tip of finger

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6
Q

What do your check for when examining the perianal area?

A

Hemorrhoids, fissures, skin tags, other lesions

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7
Q

What do you feel when palpating prostate?

A

Size of a walnut but feels like an almond with 2 lobes, firm like tip of nose or thenar area of palm

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8
Q

What test do you do after removing your finger?

A

Hemoccult/guaiac test

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9
Q

Condyloma acuminata

A

Sexually transmitted (HPV)
Usually multiple, grow together and spread to perineum and anal area
Variable sized soft papule and plaques in anogenital regions

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10
Q

2 types of HSV

A

Type 1: lips, area around mouth

Type 2: genital infections

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11
Q

What is genital herpes?

A

Begins with painful vesicles on an erythematous case, vesicles can ulcerate
Incurable with recurrent outbreaks

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12
Q

What causes syphilitic chancre?

A

Due to spirochete treponema pallidum

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13
Q

What is syphilitic chancre?

A

Primary (acute) phase begins as a painless papule that erodes into a painless ulcer
May become secondarily infected
Usually self-limiting 4-8 wks

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14
Q

What is urethritis?

A

Infection of inflammation of the urethra

Male complains of dysuria and discharge (may have inflamed meatus)

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15
Q

2 types of urethritis

A

Gonococcal (by neisseria gonorrhoeae)

Non-gonococcal (by chlamydia trachomatis and others-usually more clear, less purulent discharge)

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16
Q

Peyronie’s disease

A

Idipathic condition resulting in fibrosis in the tunica albuginea
Firm plaques in penile shaft are palpable
May develop penile curvature, painful erection and occasional ED

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17
Q

What is a carcinoma of the penis?

A

Begins as form nodule or ulcer that doesn’t heal and is usually non tender

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18
Q

When in carcinoma of the penis most common?

A

Avg age is 50

More common in uncircumsized males

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19
Q

Indirect inguinal hernia

A

Above inguinal ligament, near the internal inguinal ring
Often extends into scrotum
Palpable as impulse down inguinal canal

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20
Q

When is a direct inguinal hernia seen?

A

Usually in men over 40

21
Q

Direct inguinal hernia

A

Above the inguinal ligament, rarely into the scrotum

Bulges anteriorly through the abdominal wall

22
Q

When is a femoral hernia most common?

A

In women

23
Q

Femoral hernia

A

Below inguinal ligament and more lateral than an inguinal hernia
May mimic lymph node
Never into scrotum!!

24
Q

Common description of varicocele

A

Soft bag of worms

25
Q

Varicocele

A

Varicose veins of scrotal vessel that develops slowly
May slowly collapse if scrotum elevated while pt supine
Associated with infertility

26
Q

Hydrocele

A

Soft, non-tender hemi-scrotal swelling that transilluminates because full of fluid
Size of swelling may wax and wane (check for concurrent indirect hernia or testicular masses)

27
Q

Spermatocele/epididymal cyst

A

Painless, mobile mass just above the testis

Smaller than hydrocele usually and may transilluminate

28
Q

Acute epididymitis

A

Infection of epididymis via vas deferens
Fever and chills
Acute and unilateral, dull to severe scrotal pain radiating to ipsilateral flank
Hemi-scrotal swelling and tenderness which may progress to erythematous, fluctuant mass

29
Q

What sign is seen in acute epididymitis?

A

Prehn’s sign (elevation of scrotum providing relief)

30
Q

What often occurs after epididymitis?

A

Acute orchitis (also complication of mumps)

31
Q

Acute orchitis

A

Inflammation of infection of the testis
Testicular swelling and tenderness
Similar appearance to epididymitis

32
Q

What is a pt complaint of testicular pain until proven otherwise?

A

Testicular torsion

33
Q

Testicular torsion

A

ACUTE onset of scrotal pain, unilateral with hemi scrotal swelling
Often hrs after vigorous activity/ minor trauma
TTP without relief from elevation
Absent cremasteric reflex

34
Q

When is testicular torsion most common?

A

Neonates and adolescents

35
Q

What deformity is seen with testicular torsion?

A

Bell-clapper

36
Q

Testicular tumors

A

Painless, solid testicular swelling or nodule
Inguinal LAD or para-aortic LAD
May have abdominal pain or pulmonary symptoms of neurologic deficits

37
Q

Internal hemorrhoids

A

Enlargements of normal vascular cushions above pectinate line
Can cause bright red bleeding with defecation
Can prolapse and appear as red, moist mass

38
Q

External hemorrhoids

A

Dilated veins covered with skin
Tender, swollen, bluish mass at anal margin
Asympomatic unless thrombosed

39
Q

Anal fissure

A 
Tear in inside lining of wall of anus
Caused by stretching of anal mucosa
Severe pain with passage of stool and scant bleeding
Pain causes spasm that worsens fissure
Diagnose with history and anoscopy
40
Q

Anorectal abscess

A

Originates from an infected anal crypt gland
Severe pain in anal or rectal area
Fever and malaise common
Perianal erythema and palpable, fluctuant mass
Purulent rectal drainage if abscess begins to drain spontaneously

41
Q

What can an anorectal abscess lead to?

A

Anorectal fistula

42
Q

Rectal polyps

A

Protuberance into lumen above surrounding colonic mucosa
May be pedunculated (stalk) or sessile (at base)
Soft, difficult to feel with finger
Biopsy to rule out malignancy

43
Q

Rectal carcinoma

A

Firm, nodular rolled edge
Often have blood per rectum
Not usually diagnosed with physical exam

44
Q

Acute prostatitis

A

Enlarged, tender prostate gland
UTI symptoms, often with fever and chills
Perineal or abd pain
Examine gently!

45
Q

How do you treat acute prostatitis?

A

Antibiotics

46
Q

How does chronic prostatitis present?

A

With recurrent UTIs
Prostate exam may be normal
Treat with abx for longer

47
Q

When is benign prostatic hypertrophy more common?

A

With increasing age

48
Q

What is benign prostatic hypertrophy?

A

Symmetrical enlargement of the gland

Slowing of urine stream with difficulty starting stream

49
Q

Carcinoma of the prostate

A

Enlarged, firm nodule or area of hardness
Irregular contour and median sulcus is obscured
Usually slow-growing tumor
Metastasizes locally and to bone
May have difficulty voiding

X Physical Diagnosis Final (4 decks)

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