Male Exam

Question 1

What is classic presentation of a testicular torsion?

Answer 1

Young male with acute onset of unilateral scrotal pain.

Question 2

What does PE show for testicular torsion and what is usually not present?

Answer 2

Scrotal edema and redness. Testicle is firm, tender and usually retracted. Abdominal pain.
Cremaster reflex is absent

Question 3

What is the treatment for testicular torsion and what 2 things usually diagnose it?

Answer 3

Bilateral orchiplexy (if done within 6 hours blood flow can be restored and usually can save the testicle).

Question 4

What is balanitis?

Answer 4

Inflammation of the penis head under the foreskin

Question 5

3 presenting signs of epididymitis?

Answer 5

Gradual onset of posterior scrotal pain with fever
Urethral discharge
Urinary symptoms

Question 6

3 presenting signs of acute orchitis?

Answer 6

Sudden onset of testicular pain and high fever
N
V

Question 7

Scrotal abscesses can involve what 3 things?

Exam typically shows what 3 things and rarely is associated with what?

Answer 7

Epi, testicle, or urethra.
Edema, induration and redness.
NV

Question 8

What is the most common cause of epididymitis in boys less than 14? What is the most common cause of epi in sexually active males 14-35? What is the treatment of choice for epi in this group of patients?

Answer 8

Reflux of urine into the ejaculatory ducts
Gonorrhea and chlamydia

Single IM dose of ceftriaxone with 10 days of oral doxycycline

Question 9

What pathogen is also likely to cause epi in gay men and what is the treatment of choice for them?

Answer 9

E. coli

Ceftriaxone with 10 days of oral Levofloxacin or ofloxacin

Question 10

3 presenting signs of urethritis and what two pathogens most commonly cause it? What is the most common of all STIs?

Answer 10

Urethral discharge, penile itching and burning when peeing
Chlamydia and gonorrhea
HPV

Question 11

When a male presents with urethral symptoms, what should be examined? What is advised to be examined? What is considered?

Answer 11

Inguinal LAD, ulcers and urethral discharge
Check for epididymitis or orchitis
Digital rectal examination of the prostate

Question 12

How do we diagnose urethritis, what 3 things?

Answer 12

Presence of urethral discharge, positive leukocyte esterase test in the first void, or at least two white blood cells per high power field in urine.
Check for 2 pathogens with this.

Question 13

What is the level B screening recommendation for sexually active teens and adults?

Answer 13

Intensive behavioral counseling who are at increased risk for STI

Question 14

What are the two level A screening recommendations for syphilis?

Answer 14

Persons at increased risk

All pregnant women

Question 15

What is the level B recommendation for Gonorrhea/chlamydia screening?

Answer 15

Screen sexually active women 24 years and younger and old women at risk

Question 16

Explain what Fournier gangrene is and what causes it? What is it secondary to sometimes or associated with?

Answer 16

Necrotizing fasciitis of the perineum and genital region due to synergistic poly microbial infection.
Epididymitis

Question 17

2 common presenting signs of prostatitis and and what 3 others can also be present?

Answer 17

Acute onset of irritation or obstructive voiding symptoms

Painful ejaculation, hematospermia, and painful defecation

Question 18

4 symptoms of cystitis?

Answer 18

Voiding symptoms, cloudy and strong smelling urine, hematuria, pelvic pain/pressure

Question 19

Top 3 causes of genital ulcers in the US?

Answer 19

HSV 1 and 2, syphilis, and chancroid

Question 20

Ulcer presentation to remember for the following conditions?

HSV, Syphilis, Chancroid, LGV?

Answer 20

Multiple vesicular lesions and rupture and become painful, shallow
Single, painless well demarcated
Nonindurated painful
Small, shallow, painless genital or rectal papule or ulcer.

Question 21

What to remember about LGV?

Answer 21

Rare and men who have sex with men get it

Question 22

What is the level A screening recommendation for HIV?

Answer 22

Screen for HIV in teens and adults 15-65

Question 23

What type or organism is gonorrhea? Chlamydia? Syphilis?

Answer 23

Gram negative diplococci
Gram negative
Spirochete

Question 24

What test to use for syphilis?

Answer 24

Dark field microscopy

Question 25

What med to use to treat genital herpes?

Answer 25

Acyclovir

Question 26

How do we describe Peyronie’s disease? What usually causes it?

Answer 26

Fibrous scar tissue inside the penis called plaque that causes curved, painful erections.
Trauma

Question 27

What is the most common male birth defect?

Answer 27

Cryptorchidism

Undescended testicle

Question 28

What’s goin on with an inguinal hernia?

Answer 28

Abdominal fat or small intestine enters the inguinal canal and might even enter the scrotum

Question 29

What level of recommendation is it for a sports physical?

Answer 29

C