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PCM 4 midterm > Male GU Exam > Flashcards

Male GU Exam Flashcards

1
Q

Inspection of the penis

A
  • Hair pattern
  • Circumcision status
  • Foreskin-retractable and reducible
  • Glans- note lesions or inflammation
  • Urethal meatus- not the position and look for discharge
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2
Q

Medical indication for circumcision

A

Congenital phymosis- opening of the foreskin is very narrowed, can’t be retracted

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3
Q

Most reasons for circumcision

A

Parent preference

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4
Q

Balanitis

A

Inflammation of the glans, usually due to yeast

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5
Q

Hypospadius

A

Urethral opening on the underside of the penis.

Can occur anywhere along the shaft of the penis

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6
Q

Epispadius

A

urethra ends in an opening on the upper aspect (the dorsum) of the penis

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7
Q

What presents with purulent discharge

A

Gonorrhea

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8
Q

How to confirm for syphilis

A

Look for spirochettes
Dark field microscopy
Serology RPR
VRDL

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9
Q

Palpation of the penis

A
  • Tenderness
  • Induration (swelling and inflammation)
  • nodularity
  • Fibrous tissue
  • Strip the urethra if the pt has had a discharge
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10
Q

Peyronie’s disease

A

Fibrous plaque that forms on the tunica albicans (buck’s fascia) on corpus cavernosum

  • Associated with people on beta blockers
  • Also get Duprytin’s contracture
  • Can be debilitating, will cause the penis to bend- will make intercourse impossible
  • Does not affect voiding
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11
Q

Inspection of the scrotum

A
  • Inspect for rashes or ulceration
  • Visible masses or asymmetry- may indicate scrotal mass or atrophy of a testicle
  • Rugal pattern and median raphe
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12
Q

Palpation of scrotal contents

A
  • Presence of 2 testicles
  • Testicular size-shape, consistency
  • Presence of extra-testicular masses
  • Epididymis-size and tenderness
  • vas deferens-swelling and tenderness
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13
Q

Testicular masses

A

Carcinoma

Hydrocele

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14
Q

Testicular tenderness

A

Orchitis
Torsion
Epididymitis
Tumor Hernia

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15
Q

Extratesticular masses

A

hernia
varicocele
epididymal cyst

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16
Q

What masses will transilluminate with light?

A

Hydrocele

Epididymal cyst

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17
Q

What should you look for if there is an absent vas deferens?

A

Need to do a b/l renal ultrasound

Could show an ipsilateral missing kidney

18
Q

If you hear bowel sounds in the scrotum that indicates?

A

Hernia

19
Q

What side is a varicocele most common?

A

Left

20
Q

Hydrocele presentation

A

Non tender, mass contained within the scrotum

  • Can be transilluminated
  • May be present at birth or in the pediatric population
21
Q

Inguinal hernia presentation

A

Nontender, mass that extends into the inguinal canal. Entire loop of bowel in there

  • Usually u/l
  • May or may not be able to transilluminate

Inspect the inguinal canal and femoral triangle for bulging

  • Have pt perform a valsalva maneuver
  • Unless the hernia is quite large, it is unlikely that you will detect it on inspection
22
Q

Epididymitis presentation

A
  • Exquisitely tender
  • May have a history or dysuria
    GRADUAL onset
  • Does not transilluinate
  • Difficult to destinguish from orchitis
23
Q

Testicular torsion presentation

A
  • ABRUPT onset
  • Usually early to mid teens, very severe pain
  • Affect testicle is usually elevated in scrotum
    Rapid diagnosis is essential –> testis will undergo necrosis within a few hours
24
Q

varicocele presentation

A

Feels like a bag of worms on palpation

  • Painless
  • Very gradual onset
  • Does not transilluminate
  • May be b/l
25
Q

Testicular cancer presentation

A

Painless, gradual onset

  • Testicle may feel very hard and enlarged
  • Does not transilluminate
26
Q

Indirect inguinal hernia

A

Most common

  • Hernia sac exits through the internal inguinal ring
  • May pass with the cord toward and sometimes into the scrotum
27
Q

Direct inguinal hernia

A

The hernia sac exits through a tear in the floor of the canal (transversalis fascia)
- Generally caused by straining

28
Q

Femoral hernia

A

Hernia sac exits inferior to the inguinal ligament and into the femoral triangle
- More common in women than men but not the most common hernia in women

29
Q

Inspection of the perianal area

A
  • Fissures
  • Fistulae
  • External hemorrhoids
  • Prolapsed internal hemorrhoids
  • STDs
  • Rectal prolapse
  • Skin tags
30
Q

External hemorrhoid

A

Sensory innervated- thrombosis causes pain

- May account for rectal bleeding

31
Q

Internal hemorrhoid

A

No sensory nerve endings so they are painless

- Bleed more often than external and may bleed more profusely

32
Q

Skin tags

A

Overgrowth of anal epithelium
- Very common, painless
Pale color differentiates them from hemorrhoids

33
Q

Anal fissure

A

Tear in the anal mucosa
- Very painful
Common in people who are chronically constipated and strain moving bowels

34
Q

Anarectal fistula

A

An abnormal tract between the rectum and perianal region

- Almost always caused by an abscess such as those found in Crohn’s disease

35
Q

Cauliflower appearance

A

HPV

36
Q

Appearance of HSV

A

Vesicles that ulcerate

- Usually causes pruritis and pain

37
Q

Appearance of secondary syphilis

A

PAINLESS, usually asymptomatic

- Usually overgrowth of tissue in a chancrous shape

38
Q

Appearance of anal cancer

A
  • Squamous cell
  • Generally painless until the surface becomes ulcerated
  • Usually presents with bleeding so it is often ignored in people with hemmorrhoids
39
Q

Rectal prolapse

A

Weakening of the floor of the pelvis usually secondary to multiple childbirths or age
- Rectum can prolapse through the anus

40
Q

Size of prostate

A

4 cm in diameter and protrudes 1 cm into the rectum

PCM 4 midterm (6 decks)

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