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GU > scrotal pain swelling and masses > Flashcards

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?

A

CT/PET

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?

A

lymphoma

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
Q

what is a negative prehn sign?

A

elevation of scrotum fails to relive pain: testicular torsion

26
Q

what is the test of choice for testicular torsion?

A

color doppler, but lack of U/S should not delay surgery

27
Q

what are signs of manual detorsion success?

A

relief of pain
lower testicle
no longer transverse, more longitudinal
blood flow on doppler U/S

28
Q

what is the MC cause of scrotal pain in adults?

A

epididymitis and epidiymo-orchitis

29
Q

what are the two types of epidiymitis and epdydmo-orchitis?

A

sexually transmitted (Gonorrhea, chlamydia)

nonsexually transmitted

30
Q

what are sexually transmitted epidydimites associated w/?

A

urethritis in men <40

31
Q

what are non sexually transmitted epididymitis associated w/?

A

old men w/ UTIs and prostatitis

32
Q

what is the treatment for sexually transmitted epididymitis?

A

ceftriaxone and doxycycline (+sexual partner)

bed rest, scrotal elevation

33
Q

what is the treatment for non-sexually transmitted epididymitis?

A

ciprofloxacin or levofloxacin

bed rest, scrotal elevation

34
Q

scrotal skin reveals a blue dot?

A

torsion of appendix testis

35
Q

causes of referred pain?

A

stones, UTI, pyelonephritis, low back pain, AAA, post surgical (herniorrhaphy)

36
Q

fever and partotitis preceding orchitis?

A

mumps

37
Q

nec fasc of perinemu and scrotal skin in diabetics?

A

fournier’s gangrene; urgent surgery

GU (19 decks)

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