Reproductive

Question 1

What is the difference between a communicating and non-communicating hydrocele?

Answer 1

Whether there is a connection to the peritoneal cavity or not

Question 2

What causes a communicating hydrocele?

Answer 2

Failed closure of the processus vaginalis during development

May also result in an indirect inguinal hernia

Question 3

Which type of hydrocele increases with size with the Valsalva manoeuvre and is reducible?

Answer 3

Communicating

Question 4

What is the most common congenital anomaly of the male genitourinary tract?

Answer 4

Cryptochoridism

Question 5

What type of inguinal hernia may be congenital?

Answer 5

Indirect

Question 6

When is the peak incidence of testicular torsion?

Answer 6

First 30 days of life or during puberty

Question 7

What is Prehn’s sign?

Answer 7

Relief of pain during elevation of the testes and suggests epididymitis rather than torsion

Question 8

What is the definition of precocious puberty?

Answer 8

< 8 for girls

< 9 for boys

Question 9

What is the definition of a cryptorchid/undescended testes?

Answer 9

An undescended (or absent) testes by three months (CGA)

Question 10

How are undescended testes managed?

Answer 10

Surgical referral if still present after 3 months

No investigations other than examination are required prior

Question 11

What are the risks associated with an undescended testicle?

Answer 11

Testicular cancer

Infertility

Testicular torsion

Inguinal hernia

Question 12

What is the most common location of an undescended testicle?

Answer 12

Suprascrotal

Question 13

What is the first sign of puberty in males?

Answer 13

Testicular enlargement

Question 14

What is the first sign of puberty in females?

Answer 14

Breast development

Question 15

What is the normal order of chages in female puberty?

Answer 15

1. Adrenarche (increased adrenal androgen production)
2. Gonadarche (ovarian growth)
3. Thelarche (breast development)
4. Growth spurt
5. Pubarche (pubic hair)
6. Menarche

Question 16

What is the normal order of changes in male puberty?

Answer 16

1. Adrenarche (increased adrenal androgens)
2. Gonadarhe (increased testicular size)
3. Pubarche (pubic hair)
4. Growth spurt
5. Androgenic hair growth (axillary, periareolar, upper lip, pre-auricular, beard)

Question 17

What is paraphimosis?

Answer 17

Retracted foreskin becomes stuck → swelling

Question 18

What is phimosis?

Answer 18

Normal inability of the foreskin to retract over the glans penis

The foreskin becomes more retractable with time

Near 100% unretractable at birth and 1% at age 17

Question 19

What are 3 benefits of circumcision?

Answer 19

1. Lower rates of UTI
2. Lower rates of penile cancer
3. Lower rates of STIs
4. Lower rates of dermatoses (skin disorders)

Question 20

What are the Tanner stages of pubarche?

Answer 20

1. None
2. Sparse, lightly pigmented hair
3. Dark, coarse, curly hair over the pubic symphysis
4. Adult hair that does not extend into the inner thighs
5. Adult hair extending into the inner thighs
   (6. Hair growth along the linea alba)

Question 21

What are the Tanner stages of thelarche?

Answer 21

1. None
2. Breast bud
3. Enlargement of areola and breasts
4. Secondary mound, projecting above breast tissue
5. Adult breast