scrotal pain swelling and masses Flashcards

1
Q

what is concerning for scrotum cancer?

A

non painful mass that does not transluminate

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2
Q

masses that arise from w/in the testes are usually malignant T/F?

A

true

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3
Q

if you are unsure if an image is solid what imaging is preferred?

A

ultrasound

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4
Q

what are some causes of hydrocele?

A

patent processus vaginalus

epididymitis

trauma/testicular torsion

testicular cancer

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5
Q

what is assoicated w/ hydrocele?

A

testicular tumors

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6
Q

patient presents w/ heaviness in testicles that transilluminates?

A

hyrdrocele

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7
Q

what is the treatment for hydrocele?

A

watchful waiting w/ regular follow ups, surgery

DO NOT ASPIRATE

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8
Q

patient presents w/ mass <2cm that’s distinct from the testical and located on the top. DX trx

A

epididymal cyst

benign: watchful waiting

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9
Q

patient presents w/ >2 cm lesion that arises from head of epididymis, non tender. DX TRX

A

maybe us US

spermatocele

watchful waiting, painful then surgery

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10
Q

pt. presents / hx of infertility. Complaining of dull ache. Sx worse w/ activity and a bag of worms that increases w/ valsalva. DX TX

A

varicocele

watchful waiting, scrotal support, activity mod. NSAIDS prn

if infertility and/or pain: surgery (ligartion of the gonadal vein

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11
Q

what varicocele requires further evaluation w/ CT and abdominal exam?

A

unilateral R side pain

lesion remains dilated w/ supination

occur abruptly or enlarge rapidly

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12
Q

what is the causeof indirect hernia?

A

patent process vaginalis

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13
Q

what is the cuase of a direct hernia?

A

weakness of the posterial waal of inguinal canal (acquired)

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14
Q

what is the treatment for hernia?

A

refer to general surgery for repair

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15
Q

what should you do if you are unsure if a mass is comig from w/in the testicle or not?

A

scrotal US and urologic consultation

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16
Q

what is necessary for diagnosis of testicular cacner?

A

orchiectomy

17
Q

what is an important risk factor for testicular cancer?

A

cryptorchidism (r-side)

18
Q

what is used for staging of testicular cacner?

19
Q

labs for teticular cancer?

A
inc HCG
inc alpha fetoprotein
inc. lactate dehydrogenase
CBC for anemia
LFT (liver)
20
Q

what is the MC secondary testicular tumor metastases?

21
Q

what does the USPSTF recommend for testicular self exam?

A

grade D (don’t)

22
Q

who is testicualr torsion MC in?

A

neonates and post pubertal boys

23
Q

what is predisposes someone to testicular torsion?

A

bell clapper deformity

24
Q

what is the most sensitive finding for torsion?

A

absent cremasteric reflex

25
what is a negative prehn sign?
elevation of scrotum fails to relive pain: testicular torsion
26
what is the test of choice for testicular torsion?
color doppler, but lack of U/S should not delay surgery
27
what are signs of manual detorsion success?
relief of pain lower testicle no longer transverse, more longitudinal blood flow on doppler U/S
28
what is the MC cause of scrotal pain in adults?
epididymitis and epidiymo-orchitis
29
what are the two types of epidiymitis and epdydmo-orchitis?
sexually transmitted (Gonorrhea, chlamydia) nonsexually transmitted
30
what are sexually transmitted epidydimites associated w/?
urethritis in men <40
31
what are non sexually transmitted epididymitis associated w/?
old men w/ UTIs and prostatitis
32
what is the treatment for sexually transmitted epididymitis?
ceftriaxone and doxycycline (+sexual partner) bed rest, scrotal elevation
33
what is the treatment for non-sexually transmitted epididymitis?
ciprofloxacin or levofloxacin bed rest, scrotal elevation
34
scrotal skin reveals a blue dot?
torsion of appendix testis
35
causes of referred pain?
stones, UTI, pyelonephritis, low back pain, AAA, post surgical (herniorrhaphy)
36
fever and partotitis preceding orchitis?
mumps
37
nec fasc of perinemu and scrotal skin in diabetics?
fournier's gangrene; urgent surgery