Male Pelvis Flashcards
Which of the following is not a component of the spermatic cord?
epididymis
testicular artery
cremaster muscle
lymph nodes
epididymis
What is the most common malignancy of the testicles?
embryonal cell carcinoma
seminoma
choriocarcinoma
spermatocele
seminoma
Secondary varicoceles are most likely associated with all of the following EXCEPT:
left-sided location
right-sided location
hepatomegaly
renal mass
left-sided location
The most common location of BPH is the:
peripheral zone
transitional zone
central zone
verumontanum
transitional zone
During a sonographic examination of the right testis, you visualize multiple small cysts located along the mediastinum testis. What is the most likely diagnosis?
epididymitis
tubular ectasia of the rete testis
multiple spermatoceles
epidermoid cyst
tubular ectasia of the rete testis
Enlargement of the prostate in older men is most often caused by:
prostatitis
prostate cancer
BPH
klinefelter syndrome
BPH
Which of the following is a benign intratesticular mass that typically has a whorled or onion skin sonographic appearance?
seminoma
teratoma
epidermoid cyst
adrenal rest
epidermoid cyst
Which of the following best describes a spermatocele?
the most common malignant neoplasm of the scrotum
a benign intratesticular cyst
a cyst found within the head of the epididymis
a dilated group of veins found within the scrotum
a cyst found within the head of the epididymis
A dilated group of veins found within the scrotum is called a:
varicocele
spermatocele
seminoma
hydrocele
varicocele
Which of the following would likely resemble a solid intratesticular mass and be associated with Cushing syndrome?
choriocarcinoma
epidermoid cyst
intratesticular varicocele
adrenal rest
adrenal rest
Primary varicoceles are associated with all of the following EXCEPT:
left-sided location
retroperitoneal mass
infertility
palpable extratesticular mass
retroperitoneal mass
A common cyst most often seen in the head of the epididymis that contains nonviable sperm is the:
epididymal cyst
tunica albuginea cyst
spermatocele
seminoma
spermatocele
What scrotal abnormality is caused by incompetent valves within the pampiniform plexus?
testicular carcinoma
testicular microlithiasis
testicular torsion
varicocele
varicocele
What lab value can be assessed as a tumor marker to evaluate a patient for testicular malignancy?
serum bilirubin
amylase
AFP
adrenocorticotropic hormone
AFP
The blue dot sign is indicative of:
testicular torsion
epididymitis
orchitis
torsion of the testicular appendage
torsion of the testicular appendage
A 23 year old man presents to the sonography department with a history of infertility. Which of the following is associated with male infertility?
spermatocele
choriocarcinoma
varicocele
hydrocele
varicocele
Which of the following houses the male urethra?
corpus spongiosum
buck fascia
bulbourethral gland
corpus cavernosum
corpus spongiosum
All of the following are sonographic findings consistent with torsion of the testicular appendage EXCEPT:
no intratesticular flow
small hyperechoic mass adjacent to the testis
reactive hydrocele
scrotal wall thickening
no intratesticular flow
What is the most common correctable cause of male infertility?
varicocele
chlamydia
hydrocele
testicular torsion
varicocele
A simple fluid collection surrounding the testis is referred to as a:
hematocele
hydrocele
varicocele
spermatocele
hydrocele
What is the most common malignancy of the penis?
cystadenocarcinoma
adenocarcinoma
follicular carcinoma
squamous cell carcinoma
squamous cell carcinoma
A patient presents to the sonography department for a penile sonogram. He complains of a painful curvature of the penis and impotence. What is the most likely diagnosis?
squamous cell carcinoma
peyronie disease
tinner syndrome
testicular fracture
peyronie disease
The exocrine function of the testicles is to produce:
testosterone
human chorionic gonadotropin
AFP
sperm
sperm
The most common location of a hydrocele is:
superior to the testis
within the scrotal wall
between the two layers of the tunica vaginalis
between the tunica vaginalis and tunica albuginea
between the two layers of the tunica vaginalis
Acute onset of testicular pain at rest is a common clinical finding with:
testicular carcinoma
hydrocele
testicular trauma
testicular torsion
testicular torsion
A 7 year old boy presents to the ER with acute testicular pain localized to the superior pole of his right testis. What is the most likely diagnosis?
testicular torsion
hydrocele
torsion of the testicular appendage
yolk sac tumor
torsion of the testicular appendage
Zinner syndrome consists of unilateral renal agenesis, ejaculatory duct obstruction, and ___
prostate cancer
seminoma
bulbourethral stones
seminal vesicle cysts
seminal vesicle cysts
Dilated veins of the varicocele will measure:
> 8mm
4mm
< 2mm
2mm
> 2mm
The lack of the normal fixation of the testis to the posterior scrotal wall is referred to as:
Klinefelter syndrome
blue dot sign
bell-clapper deformity
cryptorchidism
bell-clapper deformity
Which of the following techniques is useful for providing sonographic evidence of a varicocele?
valsalva maneuver
sitting position
pulsed Doppler
right lateral decubitus position
valsalva maneuver
The endocrine function of the testicles is to produce:
testosterone
human chorionic gonadotropin
AFP
sperm
testosterone
All of the following are sonographic findings consistent with the diagnosis of testicular torsion EXCEPT:
hyperemic flow within the testis
hypoechoic testis
reactive hydrocele
decreased intratesticular flow
hyperemic flow within the testis
Spermatogenesis occurs within the:
tunica albuginea
rete testis
mediastinum testis
seminiferous tubules
seminiferous tubules
You have been asked to perform a study to rule out cryptorchidism. The term cryptorchidism denotes:
one or both of the testicles have a malignancy
that the testicle has torsed
one or both of the testicles have not descended into the scrotum
the patient has been kicked in the scrotum
one or both of the testicles have not descended into the scrotum
The most common germ cell tumor of the testis is the:
yolk sac tumor
embryonal cell carcinoma
seminoma
teratoma
seminoma
The most common location of a varicocele is:
the right side of the scortum
the left side of the scrotum
the inguinal canal
within the testis
the LEFT side of the scrotum
The most common location of prostatic cancer is the:
peripheral zone
transitional zone
central zone
verumontanum
peripheral zone
Which of the following is consistent with the sonographic features of testicular abscess?
hyperemic flow around the abscess but not within it
onion skin sonographic appearance and hyperemic epididymis
hyperemic flow within an anechoic mass
hyperemic flow within the abscess but not around it
hyperemic flow around the abscess but not within in
What is the most common cancer found in men?
testicular cancer
lung cancer
liver cancer
prostate cancer
prostate cancer
What would be the most likely sonographic appearance of a seminoma?
hyperechoic
anechoic
heterogenous with calcifications
hypoechoic
hypoechoic
The mediastinum testis is identified sonographically as:
A .hypoechoic structure coursing through the midline of the testis
B. pyramid-shaped structure adjacent to the upper pole of the testis
C. prominent echogenic linear echo in the midline of the testis
D. homogenous ovoid structure adjacent to the lower pole of the testis
E. cystic, spherical structure of variable location
C. prominent echogenic linear echo in the midline of the testis
Which of the following conditions would show hyperemic flow on color Doppler?
testicular torsion
spermatocele
orchitis
hydrocele
infarction
orchitis
A large complex hydrocele is most commonly associated with which of the following?
seminoma
epididymal cyst
varicocele
orchitis
infarction
orchitis
You are performing an ultrasound of a patient with a known “bell clapper” deformity. This deformity is associated with which condition?
seminoma
torsion
varicocele
epididymitis
infarction
torsion
The capsular artery of the testis is a branch of what artery?
deferential
abdominal AO
cremasteric
testicular
internal iliac
testicular
The testicular artery is a branch of what artery?
deferential
abdominal AO
internal iliac
external iliac
left renal
abdominal AO
You are performing a Doppler evaluation of the testis. Which of the following describes the waveform you will see within an artery of the testicular parenchyma if the testis is normal?
high resistance
bidirectional
phasic
low resistance
continuous
low resistance
You are performing Doppler analysis of the spermatic cord. Which of the following arteries or structures is found within the spermatic cord?
vas deferens
testicular artery
cremasteric artery
deferential artery
all of the abobve
all of the above
The intratesticular arteries that arise from the capsular artery are known as:
deferential arteries
cremasteric arteries
vas deferens
centripetal arteries
pampiniform plexus
centripetal arteries
The left testicular vein drains into what vein?
left renal vein
inferior vena cava
epigastric vein
internal iliac vein
external iliac vein
left renal vein
You are performing an ultrasound exam on an adolescent male to rule out testicular torsion. How should you adjust the system color Doppler parameters to achieve the greatest sensitivity to slow flow?
high PRF, low filter, high gain, high packet size
low PRF, low filter, high gain, low packet size
high PRF, high filter, high gain, high packet size
low PRF, low filter, high gain, high packet size
low PRF, low filter, low gain, low packet size
low PRF, low filter, high gain, high packet size
You are performing an ultrasound study on a 27 year old male with scrotal pain to rule out epididymo-orchitis vs torsion. Which finding below is most consistent with epididymitis?
absence of flow by color Doppler
increased flow by color Doppler
small cyst in the epididymal head
small calcification in the epididymal head
multiple tiny calcifications throughout the testis
increased flow by color Doppler
A 33 year old male has been referred for a scrotal ultrasound as a part of an infertility work up. You will tailor your exam to include an evaluation for which of the following?
epididymal cyst
torsion of the appendix testis
varicocele
testicular artery aneurysm
testicular cyst
varicocele
Which of the following arteries shows a low-resistance waveform?
testicular artery
deferential artery
cremasteric artery
external iliac artery
all of the above
testicular artery
Which of the following arteries courses within the testicular parenchyma?
testicular artery
deferential artery
cremasteric artery
centripetal artery
all of above
centripetal artery
You detect a mass within the left testis on a 43 year old male. Which of the following is a sign indicative of malignancy?
A. irregular shape of the testis
B. intratesticular location of mass
C. presence of a large hydrocele
D. all of the above
E. A and B only
A and B only
In performing scrotal sonography, you should tailor your exam to include color Doppler analysis in which of the following conditions?
A. epididymitis
B. torsion
C. testicular microlithiasis
D. A and B only
E. all of the above
A and B only
You have detected an intratesticular mass in a patient with mild scrotal swelling. Which of the following is an ultrasound feature of seminoma you should look for?
hyperechoic intratesticular lesions
ill-defined tumor borders
large hydrocele
all of the above
none of the above
none of the above
You are imaging a patient presenting with trauma, pain, and scrotal swelling. You detect a large hydrocele with prominent internal echoes. This most likely represents:
pyocele
simple hydrocele
varicocele
hematocele
hernia
hematocele
most likely associated with trauma
You have detected a transtesticular artery during scrotal sonography. Which of the following is TRUE regarding this finding?
it is a common anatomic variant
it courses in the opposite direction if the centripetal arteries
it enters the testicular parenchyma at the mediastinum testis
a large vein frequently accompanied it
all of the above
all of the above
Which of the following would NOT be associated with orchitis?
hypoechoic testis
hyperemic testicular flow
enlargement of testis
thickened scrotal wall
microlithiasis
microlithiasis
You are performing a scrotal ultrasound on a 21 year old male with acute scrotal pain. You do NOT detect flow with color Doppler in the painful testis. This finding is most consistent with which of the following?
torsion
orchitis
microlithiasis
seminoma
none of the above
torsion
Which structure would you image posterior to the prostate gland?
urinary bladder
pubic bones
levator ani muscles
rectum
urethra
rectum
You have been asked to identify the seminal vesicles. What is their anatomic relation to the prostate gland?
posterior and inferior
anterior and inferior
anterior and superior
posterior and superior
medial
posterior and superior
Which of the following describes the most common patient positioning for performance of a transrectal prostate ultrasound?
supine
left lateral decubitus
right oblique
supine reverse Trendelenberg position
standing
left lateral decubitus
What lab test is most helpful in screening patients for prostate cancer?
prostate specific antigen
serum alpha-fetoprotein
serum bilirubin
prostate cancer detection factor
prostate temperature
prostate specific antigen (PSA)
What are the most common patient symptoms of prostatism?
nausea, painful urination, and pressure sensation on the urinary bladder
weight loss, nocturia, hematuria, and small stream
difficult initiation of voiding, nocturia, and small stream
hematuria, dysuria, and nocturia
swelling, lethargy, dysuria, and nocturia
difficult initiation of voiding, nocturia, and small stream
Which of the following is an indication for transrectal ultrasound of the prostate?
abnormal digital rectal exam
abnormal lab test results indicative of prostate cancer
guidance for directed sonographic biopsy
monitor response to treatment of prostate cancer
all of the above
all of the above
What is the role of color Doppler during transrectal prostate sonography?
color Doppler has not been shown to be helpful during prostate sonography
color Doppler allows improved perception of pathological vessels associated with cancer
increased color Doppler signals are diagnostic of chronic prostatitis
absence of flow with color Doppler is indicative of benign prostatic hypertrophy
increased color Doppler signals in the seminal vesicles indicate the presence of seminal vesicles cysts
color Doppler allows improved perception of pathological vessels associated with cancer
What is the sonographic appearance of prostate cancer?
hypoechoic lesions
isoechoic lesions
hyperechoic lesions
only A and B
all of the above
all of the above
You are aiding a physician in a transrectal biopsy of the prostate. What patient preparation is required?
no prep is required
a cleansing enema immediately prior to the procedure
antibiotics are administered prior to and following the exam
nothing to eat or drink 12hrs prior to the procedure
B and C only
B and C only
Which anatomic classification is most commonly used to describe the prostate during sonographic evaluation?
lobar anatomy
microscopic anatomy
zonal anatomy
topographic anatomy
all of the above
zonal anatomy
The prostaticovesical arteries that supply the prostate are branches from which artery?
abdominal AO
internal iliac
external iliac
inferior mesenteric
superior mesenteric
internal iliac
Which of the following describes the most widely used conventional display of the prostate using transrectal sonography?
the anterior abdominal wall is shown at the bottom of the screen
the rectum is shown at the bottom of the screen
the rectum is shown to the right of the screen in a SAG view
the left side of the patient is shown on the left side of the image in a TRV plane
the head of the patient is on the right side of the image in a SAG plane
the rectum is shown at the bottom of the screen
You are performing a transrectal prostate ultrasound in a SAG plane. The most lateral images of the gland show which tissue?
transitional zone
central zone
periurethral area
peripheral zone
fibromuscular stromatolites
peripheral zone
You have been asked to perform a transrectal prostate ultrasound exam. What frequency transducer is best suited for this study?
2-3 MHz
3-4 MHz
4-5 MHz
5-6 MHz
7-8 MHz
7-8 MHz
Which of the following describes the most common appearance of the seminal vesicles by transrectal prostate sonography?
hyperechoic, symmetrical, irregularly shaped structures
hypoechoic, symmetrical, irregularly shaped structures
hyperechoic, asymmetrical, smooth structures
hyperechoic, asymmetrical, irregular shaped structures
hypoechoic, asymmetrical, smooth structures
hypoechoic, symmetrical, irregularly shaped structure
You have been requested to perform a transrectal ultrasound of the prostate in a patient with suspected BPH. What is the ultrasound appearance of this condition?
small, shrunken prostate gland with numerous calcifications
small prostate gland with increased vascularity and hypoechoic nodules
enlarged prostate gland which may be diffuse or focal
enlargement of the peripheral zone with sparing of the inner gland
all of the above
enlarged prostate gland which may be diffuse or focal
You are performing a prostate ultrasound on a patient having infertility work-up. Which cyst may be associated with infertility?
müllerian duct cyst
prostatic utricle cyst
retention cyst
ejaculatory duct cyst
seminal vesicular cyst
ejaculatory duct cyst
You are performing a transrectal ultrasound in a patient with acute prostatitis. An anechoic mass is seen within the prostate. This most likely represents:
prostate utricle cyst
abscess
hematoma
lymphocele
seroma
abscess
You have been asked to perform a transrectal ultrasound of the prostate in a patient with metastasis of unknown origin. What are you looking for?
BPH
ejaculatory duct cyst
prostatic abscess
prostate cancer
prostatitis
prostate cancer
