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Reproductive Sonography > Scrotal Pathology > Flashcards

Scrotal Pathology Flashcards

1
Q

What are the possible scrotal wall abnormailities

A

Non-inflammatory
Inflammatory
Scrotal wall malignant lesions
Inguinal & scrotal swelling
Abnormalities of spermatic cord
Tumors

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2
Q

What are the non-inflammatory causes of scrotal wall abnormalities

A

Heart failure
Lymphedema
Hypoalbuminemia

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3
Q

What are the inflammatory causes of scrotal wall abnormalities

A

Cellulitis
Fournier gangrene

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4
Q

What are the scrotal wall malignant lesions that can cause scrotal wall abnormalities

A

Metastases from melanoma
Lung or anal carcinoma

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5
Q

What are the inguinal & scrotal swellings that can cause scrotal wall abnormalities

A

Inguinal hernia
Hydrocele
Pyocele

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6
Q

What are the abnormalities of the spermatic cord that can cause scrotal wall abnormalities

A

Varicocele
Encysted hydrocele of cord

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7
Q

What are the possible tumors of the scrotal wall

A

Rhabdomyomas & Sarcomas

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8
Q

This pathology is when there is excess fluid that builds up in the cavities (Tunica vaginalis)

A

Hydrocele

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9
Q

Water/fluid in the scrotum

A

Hydrocele

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10
Q

The scrotal fluid surrounding the testis except for the ___ ___ where the tunica _____ does not cover testis & is attached to ____

A

Except bare area
Tunica vaginalis
Epididymis

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11
Q

Hydrocele is sometimes present at ____ but can also result from ___ & ___

A

Birth
Injury & Inflammation

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12
Q

Hydrocele is most common cause of

A

Painless scrotal swelling

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13
Q

What are the symptoms of hydrocele

A

Scrotal swelling that gets progressively noticeable
Dull ache of scrotum
Heaviness of scrotum

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14
Q

What are the types of hydrocele

A

Congenital
Infantile
Primary
Secondary

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15
Q

How does acute hydrocele appear sonographically

A

Anechoic fluid surrounding anterolateral aspect of testis

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16
Q

Sonographically in hydrocele usually the testis is

A

Displaced posteromedially

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17
Q

How does chronic hydrocele appear sonographically

A

Low-level
Mobile echoes

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18
Q

What are the 2 types (by location) of hydrocele

A

Noncommunicating
Communicating

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19
Q

When does noncommunicating hydrocele occur

A

When sac closes, but body doesn’t absorb fluid

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20
Q

In noncommunicating hydrocele the remaining fluid is typically

A

Reabsorbed into the body within a year time

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21
Q

Communicating hydrocele usually occurs when

A

Sac surrounding testicle doesn’t close all the way

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22
Q

Communicating hydrocele allows the fluid to

A

Flow in and out

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23
Q

What are the differentials of hydrocele

A

Pyocele
Scrotal hernia
Complex echogenic fluid in tunica vaginalis

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24
Q

How does a scrotal henia appear sonographically

A

Bowel or echogenic omentum seen within scrotum
Peristalsis

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25
Complex echogenic fluid in tunica vaginalis is usually associated with
Trauma Torsion Infarct
26
Define epididymitis
Infection or inflammation of epididymis
27
Epididymitis is usually a result of
STI (Chlamydia or Gonorrhea)
28
What are the symptoms of epididymitis
Scortal/Testicular pain or tenderness Warmness/redness in scrotum Painful urination Fever
29
Depending on the type of infection in epididymitis they may need to take
Antibiotics or antiviral meds
30
What are the lab values of epididymitis
Negative tumor markers Positive urinalysis for WBC Elevated WBC
31
What are the sonographic findings of epididymitis
Isoechoic/slightly hypoechoic Hypervascularity of epididymis
32
What are the differentials of epididymitis
Malignant testicular tumor Torsion
33
If a mass is palpable then they are likely to be _____ (Benign or Malignant)
Malignant
34
Define orchitis
Inflammation of testicles
35
Define primary orchitis
Isolated orchitis due to bacterial or viral infection
36
Orchitis usually develops _-__ days after ___ begin
4-10 days, mumps
37
What is mumps
Swollen parotid salivary glands (Parotitis)
38
T or F: Mumps is very common
False Very rare
39
What is secondary orchitis
Infection spreas from adjacent organs
40
What is the term for inflammation of the testicles & the epididymis
Epididymoorchitis
41
What are the clinical findings of orchitis
Fever Groin pain Dyspareunia Dysorgasmia Dysuria Scrotal swelling Tender/swollen groin area Heavy feeling in testicle Pain made worse by bowel movement
42
What are the risk factors for STI caused orchitis
High-risk sexual behaviors Multiple partners Personal history of gonorrhea or another STD Sexual partner with STD
43
What are the risk factors for orchitis not due to STD
>45 years Long-term Foley catheter No mumps vaccine Congenital problem of UT Frequent UTI's Surgery of UT
44
What are the lab tests that are done for orchitis
CBC (Complete blood count) Urethral smear Urine culture
45
What are the sonographic findings of orchitis
Focal areas of decreased echoes (Unless chronic) Hyperemia evident with increased color flow Differentials same as epididymitis
46
Twisting of the spermatic cord causes
Reduced or absent vascular circulation to the testicle
47
What are the clinical findings of testicular torsion
Swollen erythematous Acute acrotal/inguinal pain
48
What are the signs and symptoms of testicular torsion
Sudden sever pain in scrotum Swelling of scrotum Abdominal pain Fever Frequent urination
49
What happens if a young boy gets testicular torsion
Typically wake up due to scrotal pain in middle or night or early in morning
50
Testicular torsion can result in
Complete infarction of the testicle if it lasts longer than a few hours
51
Name the salvage rate of the number of hours with testicular torsion: <6 hours 6-12 hours 12-24 hours >24 hours
80-100% 76% 20% 0%
52
What is the sonographic appearance of testicular torsion
"Spiral" twist of spermatic cord "Torsion knot" or "Whirlpool" Enlarged testis & epididymis with heterogenous texture Edema of scrotal wall
53
What is the sonographic appearance of testicular torsion for 24 hours
Changes like congestion, hemorrhage and infarction can be visualized
54
What are the differentials of testicular torsion
Testicular trauma Abscess Tumor
55
What is the sonographic appearance of testicular trauma
Hematocele Irregular contours Heterogenous
56
What is the sonographic appearance of an abscess
Thick walled Hypoechoic Low-level internal echoes Thickened tunica albuginea Enlarged hypoechoic epididymis with increased blood flow on color Doppler
57
What is the sonographic appearance of a tumor
Focal hypoechoic mass with heterogenous areas Abnormal vascularity within mass
58
Name the color Doppler flow in acute scrotal conditions in the following (Intratesticular flow & peritesticular flow) Acute torsion Missed torsion Orchitis Epididymitis
AT - (I) Absent & (P) Normal MT - (I) Absent & (P) Increased O - (I) Increased & (P) Normal E - (I) Normal & (P) Increased
59
What is cryptorchidism
Undescended testicle
60
In an undescended testicle 1/3 of the cases are ____ (Bilateral or Unilateral)
Bilateral
61
T or F: Spontaneous decent doesn't occur after age 1
True
62
What are the associations of cryptorchidism
Inguinal hernia Hypospadias
63
With cryptorchidism there is a higher incidence of
Testicular torsion Infertility Cancer in cryptochid testis
64
How does cryptochidism appear sonographically
Difficult to differetiate from lymph nodes Hypoechoic/anechoic
65
What are the differentials of cryptorchidism
Anorchia
66
What is anorchia
Absent testicle

Reproductive Sonography (9 decks)

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