Men's health

Question 1

penile shaft is formed by 3 columns of erectile tissue

Answer 1

corpus spongiosum-underside

two corpus cavernosa-where blood is collected during an erection

Question 2

epididymis

Answer 2

located on the posteriolateral surface of each testes and where sperm is housed to mature and is eventually transported into vas deferens

Question 3

tunica vaginalis

Answer 3

surrounds testes and epididymis; derived from peritoneum during fetal descent of the testes into the scrotum

Question 4

factors needed for normal sexual function

Answer 4

endocrine: normal testosterone levels
vascular: adequate arterial blood supply from the internal iliac arteries
nervous: intact alpha adreneric and cholinergic pathways

Question 5

male GU history questions

Answer 5

are you satisfied with your sex life? (easier to answer on paper)
decreased libido? psychogenic, biological, medication side-effect

Question 6

ejaculatory dysfunction

Answer 6

premature ejaculation: almost always psychogenic

decreased or absent ejaculate may be secondary to medications, surgery, neurological deficit or lack of androgen

Question 7

STD screening

Answer 7

for the pt w/ risk factors or symtoms
pts rarely present with one STD at a time, consider concomitant STIs and screen for them

penile discharge: gonococcal (yellow-The Clap) or non-gonococcal (clear or white)

rashes: painful, clear vesicles on an erythematous base = herpes
painless ulceration = chancres from syphilis

Question 8

top STDs to screen for

Answer 8

chlamydia, gonorrhea, trichomonas, non-specific urethritis

others: syphilis, HPV, Hep B, genital herpes

Question 9

HIV screening for increased risk people include

Answer 9

men with male sex partners
past or present IV drug users
past or present partners of people with HIV infection, bisexual practices, or injection drug use
pts with hx of blood tranfusion btw 1978 and 1985

Question 10

Testicular cancer

Answer 10

etiology: unknown, prior testicular cancer, crytochordism

s/s: MC sx is swelling in part of one testicle, painless, ache in lower abdomen or affected testicle, heaviness in scrotum, collection of fluid in scrotum

dgx: good PE, ultrasound of scrotum and testes can reliably identify masses within the testes
transillumination is not definitive

testicular self exam: all men, especially those between 15 and 35 should check monthly
should see their provider for any of the following:
1. painless lump, swelling, or enlargement of either testicle
2. pain or discomfort in the testicle or scrotum
3. feeling of heaviness or sudden fluid collection in the scrotum
4. dull ache in the lower abd or groin