Male Genitouterine Exam

Question 1

Nocturia

Answer 1

Waking up at night with the urge to urinate

Question 2

Urinary Incontinence

Answer 2

involuntary leakage of urine

Question 3

Dysuria

Answer 3

pain with urination

Question 4

Hematuria

Answer 4

blood in the urine

Question 5

Renal Calculi

Answer 5

Kidney Stones

Question 6

Circumcision

Answer 6

Removal of Foreskin from Penis

Question 7

Consistency of Testicle should feel like what?

Answer 7

A hard boiled egg

Question 8

Where is the epididymis located and What does it feel like?

Answer 8

Located on top of testicle and posterolateral

Feels nodular and cordlike

Question 9

What do Spermatic Cords feel like?

Answer 9

The inside of a BIC pen

Question 10

Genital Herpes

Answer 10

• Caused by Herpes Simplex 2 virus (Usually HSV 2)
• Begins with painful vesicles that become ulcerated
• Often recurrent

Question 11

Molluscum Contagiosum

Answer 11

• Umbilicated vesicular-like lesions
• Contagious, usually painless
• Benign viral condition; self-limited (6-12 months)

Question 12

Primary Syphilitic Chancre

Answer 12

A small red macule enlarges and develops through a papular stage, becoming eroded to form a typical round, painless ulcer. If untreated, the ulcer usually heals after 4-8 weeks.

Question 13

Gonorrhoeae

Answer 13

The typical purulent urethral discharge can often be demonstrated during examination by “milking” the urethra. The patient alse has associated meatitis.

Question 14

Chlamydia Trach-matis

Answer 14

Most common cause of Gonorrhoea: Non gonococcal urethritis with mucopurulent discharge. Although the discharge is often more watery than gonorrhoea, gonorrhoea must always be excluded by gram stain and culture.

Question 15

Peyronie’s Disease

Answer 15

• Idiopathic condition resulting in fibrosis in the corpora cavernosa
• Palpable, nontender plaques just beneath the skin, along the dorsum of the shaft of the penis
• may result in penile curvature, painful erections, occasionally erectile dysfunction

Question 16

Carcinoma of Penis

Answer 16

• Begins as a firm nodule or ulcer that does not heal
• Usually nontender
• More common in uncircumsized males

Question 17

Indirect Inguinal Hernia

Answer 17

• Goes through the inguinal canal: above inguinal ligament, near its midpoint (the internal inguinal ring)
• often into the scrotum
• The hernia comes down the inguinal canal and touches the fingertip.
• Most common, all ages, both sexes
• Often in children, may be in adults

Question 18

Direct Inguinal Hernia

Answer 18

• Does not go through the inguinal canal, simply protrudes through the superficial ring
• Less common
• Occurs in men over age 40, rare in women
• Above inguinal ligament, close to the pubic tubercle (near the external inguinal ring)
• Rarely into the scrotum
• The hernia bulges anteriorly and pushes the side of the finger forward

Question 19

Femoral Hernia

Answer 19

• Least Common
• More common in women thatn men
• Below the inguinal ligament: appears more lateral than an inguinal hernia and may be hard to differentiate from lymph nodes
• Never into the scrotum
• Inguinal canal is empty

Question 20

Variocele

Answer 20

Varicose veins of scrotal vessels
Usually on the left
Feels like a soft “bag of worms”
May slowly collapse if scrotum elevated while patient supine
May be assoc. with infertility

Question 21

Hydrocele

Answer 21

Benign, nontender, fluid-filled mass within the tunica vaginalis
Transilluminates - red glow

Question 22

Spermatocele

Answer 22

Painless, mobile mass just above the testis
Usu. smaller than a hydrocele
Contains sperm
May transilluminate

Question 23

Acute Epididymitis

Answer 23

Infection of the epididymis
Local pain & swelling
Primarily in adults
Often assoc. with UTI or prostate infection

Question 24

Acute Orchitis

Answer 24

Inflammation or infection of the testis
Testicular swelling & tenderness
Similar in appearance to epididymitis
Complication of mumps & other viral infections

Question 25

Testicular Torsion

Answer 25

``` Due to twisting of the spermatic cord Intense pain Red, swollen, tender scrotum Testis may be pulled upwards Surgical emergency! ```

Question 26

Testicular Tumors

Answer 26

Firm, painless testicular nodule | Does not transillum-inate

Question 27

Internal Hemorrhoids

Answer 27

painless

Question 28

External Hemorrhoids

Answer 28

painful

Question 29

Internal hemorrhoid prolapse

Answer 29

protrudes from anus

Question 30

External hemorrhoid thrombosis

Answer 30

develops blood clot, painful

Question 31

Anal Fissure

Answer 31

Anal fissure is a tear in the inside lining of the wall of the anus May be caused by the passage of very hard stools Symptoms – severe pain as stool passes Also, itching, burning, bleeding & wet discharge Diagnosed by history & anoscopy

Question 32

Perirectal Abscess

Answer 32

swelling and erythema of buttocks

Question 33

Perianal Condylomata

Answer 33

HPV – human papillomavirus infection | Usually sexually transmitted

Question 34

Rectal Carcinoma

Answer 34

Not always within reach of finger during Rectal Exam

Question 35

Prostatitis- Acute and Chronic

Answer 35

``` Enlarged, tender prostate gland Much more tender during acute infection, often with fever & chills Examine carefully Avoid spread of infection Treat with antibiotics ```

Question 36

Benign Prostatic Hypertrophy (hyperplasia)

Answer 36

BPH more common with increasing age Symmetrical enlargement of gland Slowing of urine stream with difficulty starting stream

Question 37

Carcinoma of Prostate

Answer 37

Enlarged, firm nodule or area of hardness Irregular contour, median sulcus obscured Usually a slow-growing tumor Metastasizes locally and to bone