Male GU exam (King- 10 questions)

Question 1

what does the male genitalia examination consist of

Answer 1

inspection
palpation
look for hernias
rectum and prostate exam

Question 2

do vascular structures, blood, hernias, and normal testicles transluminate?

Answer 2

NO

Question 3

what is a hydrocele

Answer 3

abnormal collection of fluid in the tunica vaginalis

non tender

mass is contained within the scrotum

can be transilluminated

may be present at birth or in pediatric population

fingers can get above mass

Question 4

what is a spermatocele

Answer 4

pea sized, non-tender mass that contains spermatozoa, usually attached to the upper pole of the epididymis

Question 5

where does the prostate gland lie in relation to the rectum

Answer 5

anterior to the wall of the rectum

Question 6

cancer of prostate feels like what

Answer 6

hard, irregular nodules, asymmetric gland

Question 7

BPH feels like what

Answer 7

symmetrically enlarged prostate
soft gland
may bulge into the rectal lumen

Question 8

what does prostatitis feel like

Answer 8

tender
boggy
fluctuant gland

chapman’s reflex on the lateral thigh

Question 9

Peyronies disease

Answer 9

fibrous tissue in one corpus cavernosum

when they have an erection –> marked curvature towards affected side

Question 10

what does stripping of the urethra mean?

Answer 10

if they have discharge, thumb and finger at the base of the penis and squeeze secretions downward

Question 11

carcinoma of the testes

Answer 11

men age 20-30
very aggressive
non tender

Question 12

hydrocele of testes

Answer 12

remnants of processus vaginalis patent

young people

Question 13

what are some causes of testicular tenderness

Answer 13

orchitis
torsion
epididymitis
tumor
hernia

Question 14

what scrotal masses will transluminat

Answer 14

hydrocele

sometimes epididymal cyst

Question 15

inguinal hernia

Answer 15

non tender

mass extends into the inguinal canal

usually unilateral

may or may not be able to transluminate

may be present at birth or in peds pop

Question 16

epididymitis

Answer 16

tender!

may have dysuria

hard to tell apart from orchitis

does NOT transilluminate

gradual onset

Question 17

testicular torsion on exam

Answer 17

usually early to mid teens

abrupt onset

very severe pain

affected teste is usually elevated in scrotum

very rapid onset
diagnosis should be made ASAP or else testicular necrosis will occur within few hours

Question 18

varicocele on exam

Answer 18

painless

very gradual onset
bag of worms palpation
does NOt transilluminate
may be bialteral

Question 19

testicular cancer of exam

Answer 19

painless

gradual onset

testicle may feel very hard and enlarged

does NOT transilluminate

Question 20

indirect inguinal hernia

Answer 20

the hernia sac exits through the internal inguinal ring

may pass with the cord toward and sometimes into the scrotum

most common hernia all ages and both sexes

can be seen in new borns

Question 21

direct inguinal hernia

Answer 21

less common than indirect

usually found in men older than 40, rare in women

the hernia sac exits through a tear in the floor of the canal (transversalis fascia)

may be found in the scrotum but rarely

generally caused by straining

Question 22

femoral hernia

Answer 22

exits inferior to the inguinal ligament and into the femoral triangle

more common in women than men

NOT the most common hernia in women (that would be the indirect inguinal hernia)

highest rate of incarceration

Question 23

what are skin tags of the rectum

Answer 23

very common - completely benign

overgrowth of anal epithelium

painless

pale color

benign

Question 24

in what pt’s are anorectal fistula’s commonly found

Answer 24

pt’s with crohn’s disease

almost always caused by an abscess

Question 25

vesicles that ulcerate

pruitis and painful

Answer 25

herpes

Question 26

overgrowth of tissue in a chancrous shape

painless and usually asymptomatic

flat condyloma

Answer 26

secondary syphilis

Question 27

what is the normal size of the prostate

Answer 27

normal gland is 4 cm in diameter

protrudes 1 cm into the rectum

if it has an increase in size it is most likely benign prostatic hypertrophy or cancer

Question 28

rubbery prostate

Answer 28

benign prostatic hypertrophy

Question 29

fluctuant or tender prostate

Answer 29

prostatitis

Question 30

rigid prostate

Answer 30

carcinoma

Question 31

if there is a inflammatory or possibly malignant lesion of the penis or scrotum, where should you look

Answer 31

assess the inguinal lymph nodes

Question 32

incarcerated hernia

Answer 32

when its contents cannot be returned to the abdominal cavity

Question 33

strangulated hernia

Answer 33

when the blood supply to the entrapped contents is compromised

suspect this in the presence of tenderness, nausea, vomiting