Male health starred slides

Question 2

Anatomical structures and their pathologies:
1) What is a pathology of the urethral meatus?
2) What is a pathology of the urethra?
3) What is a pathology of the glans?
4) What is a pathology of the corona/ prepuse?

Answer 2

1) Hypospadias
2) Cystitis
3) Balanitis
4) Paraphimosis

Question 3

1) What is the significance of the corpus cavernosum?
2) What structure do vasectomies involve?
3) What pathology can occur at the epididymis/testicle?
4) What very common pathology can occur involving the Tunica Vaginalis?

Answer 3

1) Erection
2) Vas deferens
3) Epididymitis/orchitis
4) Testicular torsion

Question 4

1) Hydroceles and varicoceles both involve what structure?
2) BPH can occur where?

Answer 4

1) Scrotum
2) Prostate

Question 5

1) Define paraphimosis
2) Is it an emergency? Why or why not?

Answer 5

1) Retracted fοreѕkiո in an uncircumcised mаlе that cannot be returned to normal position
2) Emergency; can cause ischemia to the glans/penis

Question 6

When loops of bowel force their way through weak areas of the inguinal canal, what type of groin hernia is this?

Answer 6

Inguinal

Question 7

1) What type of hernias arise at internal inguinal ring?
2) What type of hernias arise more medially through floor of inguinal canal (Hesselbach’s triangle)?

Answer 7

1) Indirect inguinal
2) Direct inguinal

Question 8

What are the boundaries of Hesselbach’s Triangle medially, laterally, and inferiorly?

Answer 8

1) Medially: Rectus abdominis m.
2) Laterally: Inferior epigastric vessels
3) Inferiorly: Inguinal ligament

Question 9

1) What is the most common malignancy in adult males 15-35 years old?
2) Is it curable? Explain.
3) How does it often present as?

Answer 9

1) Testicular cancer
2) Highly curable if detected early; do not delay evaluation
3) Painless testicular mass

Question 10

1) In any male with a solid, firm mass within the testis, __________________ must be the considered diagnosis until proven otherwise
2) How could it be proven otherwise?

Answer 10

1) testicular cancer
2) Scrotal ultrasound followed by other diagnostic work-up as necessary

Question 11

1) Who are indirect inguinal hernias most common in?
2) What abt direct hernias?
3) What abt femoral hernias?
Of these, which hernia is most common?

Answer 11

1) All ages, both sexes. Often in children, may be in adults. Most common.
2) Usually in men >40 and rare in women. Less common.
3) Least common. More common in women.
-Indirect inguinal most common

Question 12

What is the point of origin of:
1) Indirect inguinal hernias?
2) Direct inguinal hernias?
3) Femoral hernias?
-Of these, which can be hard to differentiate from lymph nodes?

Answer 12

1) Above inguinal ligament near midpoint (internal inguinal ring)
2) Above inguinal ligament close to pubic tubercle (near external inguinal ring)
3) Below inguinal ligament, more lateral than an inguinal hernia.
-Femoral hernias can be hard to differentiate from lymph nodes

Question 13

How do
1) Indirect inguinal hernias
2) Direct inguinal hernias
3) Femoral hernias
relate to the scrotum, and to examining w. a finger in the inguinal canal?

Answer 13

1) Often into scrotum; the hernia comes down inguinal canal & touches the fingertip.
2) Rarely in the scrotum; hernia bulges anteriorly and pushes the side of the finger forward.
3) Never in the scrotum; inguinal canal is empty
slide 29

Question 14

1) What demarcates the anal canal from the rectum?
2) What is the boundary between somatic (anal canal) and visceral (rectum) nerve supplies?

Answer 14

1) A serrated line
2) The anorectal junction (often called the pectinate or dentate line)

Question 15

1) In the male, the prostate gland lies against what?
2) What does a normal prostate gland feel and look like? important
3) True or false: You can only palpate part of the prostate (right and left lateral lobes) on DRE.

Answer 15

1) The anterior rectal wall
2) Rounded, heart-shaped, 2.5 cm long, smooth, rubbery, non-tender, not fixed to surrounding tissues
3) True

Question 16

What are 6 common or concerning Sx of the male anus, rectum, and prostate?

Answer 16

1) Change in bowel habits
2) Blood in the stool (hematochezia & melena)
3) Pain with defecation; rectal bleeding or tenderness
4) Anal warts or fissures
5) Weak stream of urine
6) Burning upon urination (dysuria)

Question 17

What men’s health Health Promotion and Counseling should be done? (3 things)

Answer 17

1) Discuss prostate cancer screening
2) Screen for colorectal cancer and premalignant polyps/lesions (USPSTF)
3) Provide counseling about sexually transmitted infections (STIs)

Question 18

1) Prostate cancer is the leading cancer diagnosed in men in the United States, and the ________ leading cause of death
2) What are the primary risk factors? What else may be a risk factor?
3) Are screening recommendations universal?

Answer 18

1) third
2) Advanced age, ethnicity (black), and family history
-intake of dietary fat
3) Screening recommendations vary depending on source (American Urological Association, American Cancer Society, USPSTF, etc.) and are controversial

Question 19

1) Why should you engage in shared decision making regarding prostate cancer screenings?
2) For average risk males, initiate discussion of screening at age ___ years (as early as age ____ for higher risk)

Answer 19

1) Screening may offer a small potential benefit, but there are risks of harm (false positives, etc.)
2) 50; 40

Question 20

1) What prostate cancer screening method is recommended? How often and in what age group?
2) Frequency of ________ testing and age to initiate and stop screening varies depending on the source

Answer 20

1) Prostate-specific Antigen (PSA) testing every 1-2 years up to age 69-75
2) PSA

Question 21

1) What type of GI cancer and polyps should you screen for in both males and females?
2) At what age should screening start for all adults of avg risk? (in both sexes)
3) What age group is there selective screening?
4) How often are colonoscopies done?

Answer 21

1) Colorectal cancer and premalignant polyps/lesions (USPSTF)
2) 45
3)76-85 years
4) Every 10 years (other testing options exist if pt is not amenable to colonoscopy)

Question 22

When you provide counseling about sexually transmitted infections (STIs), what else should you suggest?

Answer 22

Partners to be tested