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FINALS RENAL + UROLOGY > scrotum + testicles > Flashcards

scrotum + testicles Flashcards

1
Q

what is the tunica vaginalis

A

serous membrane pouch that covers testes

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2
Q

what is hydrocele

A

fluid within tunica vaginalis

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3
Q

what is communicating hydrocele

A

allows peritoneal fluid to drain to scrotum

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4
Q

who commonly gets communicating hydrocele

A

male nweborns and resolve in a few months

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5
Q

what is non-communicating hydrocele

A

excess fluid production within tunic vaginalis

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6
Q

causes hydrocele

A

epididymo-orchitis // testicular torsion // testicular tumour

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7
Q

o/e hydrocele

A

soft, nontender swelling // confined to scrotum // transilluminates // testes difficult to palpate

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8
Q

diagnosis hyrocele

A

usually clinical but can be USS

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9
Q

mx hydrocelle

A

conservative –> USS to check for tumour

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10
Q

what is varicocele

A

enlarged testicular veins

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11
Q

features varicocele

A

subfertile // left sided // ‘bag of worms’

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12
Q

invx + mx varicole

A

USS // conservative, maybe surgery if painful

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13
Q

what is a worrying cause of varicocele

A

renal cancer

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14
Q

what is testicular torsion

A

torsion of spermatic cord –> ischaemia + necrosis

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15
Q

who gets testicular torsion

A

males 10-30 (usually kids) //during exercise

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16
Q

symptoms testicular torsion

A

severe + sudden pain // lower abdo pain // N+V

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17
Q

o/e testicular torsion (4)

A

swollen // tender testis retracted // no cremasteric reflex (stroke thigh teste retracts) // elevation of testis does not relieve pain (prehn’s)

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18
Q

mx testicular torsion

A

(USS) // urgent surgical exploration // fixation of both testis

19
Q

what is the most common cause of scrotal swelling in primary care

A

epidiymal cysts

20
Q

o/e epidiymal cysts

A

painless // usually over 40yrs // separate from body of testis // posterior

21
Q

symptoms (3)

A

PKD, CF, von hippel-landeua

22
Q

invx epidiymal cysts

A

USS

23
Q

what is Epididymo-orchitis

A

infection of epididymis +/- testes

24
Q

causes Epididymo-orchitis

A

young men = chlamydia or gonorrhea // older = E.Coli

25
Q

symptoms Epididymo-orchitis

A

unilateral pain and swelling // maybe urethral discharge // dysuria

26
Q

important differential Epididymo-orchitis

A

torsion

27
Q

invx Epididymo-orchitis

A

young = STI // older = mid urine stream for microscopy and culture

28
Q

mx Epididymo-orchitis

A

STI = ceftriaxome IM 500 mg + doxy 100mg BD 10 days // E.coli = quinilone eg oflocaxin 2 weeks

29
Q

what drug can cause Epididymo-orchitis

A

amiodarone

30
Q

symptoms inguinal hernia

A

superior and medial to pubic tubercle // ache // may reduce with cough

31
Q

what age group get testicular cancer

A

20-30

32
Q

testicular tumour types

A

germ cell (95%) seminomas or non-seminomas // leydig // sarcoma

33
Q

RF testicular cancer

A

infertility // cyrpotochordism // FH // klinefelters // mumps

34
Q

symptoms testicular cancer

A

painless lump // hydrocele // gynaecomastia

35
Q

what ratio is raised to cause gynaecomastia in testicular cancer

A

increased oestrogen:androgen

36
Q

how does gynaecomastia develop in testicular cancer

A

germ cells –> hCG –> increase oestrodiol (+ testosterone) // Leydig –> secrete more oestradiol

37
Q

tumour markers for germ cell tumours

A

seminomas hCG in // non-seminoma AFP +/- hCG // both = LDH

38
Q

invx testicular cancer

A

USS // (CT staging)

39
Q

mx testicular cancer

A

orchidectomy, chemo, radio (good prognosis)

40
Q

non-seminatous germ cell tumours

A

teratoma, yolk sac, choriocarcinoma, mexed

41
Q

what is Cryptorchidism

A

congenital undescended testes at 3 montrhs of age

42
Q

differentials Cryptorchidism

A

intersex conditions

43
Q

assoc conditions Cryptorchidism

A

infertile, testicular cancer, torsion

44
Q

o/e Cryptorchidism

A

soap test // retracts quickly to inguinal canal –> surgery

FINALS RENAL + UROLOGY (16 decks)

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