Testicular and Scrotal Disease Flashcards
painless lump in scrotum ddx?
Cancer
varicocele
epidydimal - orchitis
hydrocele
what viruses can cause orchitis?
mumps
ask re: parotids
what’s worse with coughing?
hernia, varicocele, communicating hydrocele
big risk factor specific to testicular cancer
crypto-orchidism
2 ways to get orchitis?
STI
UTI
key differentiating factor to see if a lump is arising in scrotum or from abdo?
reducible? can you get above it?
how to examine for varicocele?
get them to stand up to see if it gets worse
and valsalva
what transilluminates?
simple fluids, low protein,
cancer feels how?
hard
hydrocele feels how?
soft but depends on the tension, can’t feel the testicle
investigations for testicular lumps?
- Urine dipstick
- Bloods
- u/S
testicular tumours markers?
Alpha foetal proteins
beta HcG
LDH
when you want to get initial urine/urethral swab?
test for STIs
M/C/S
what’s most common intrascrotal for men over age 50?
lymphoma
testicular cancer usually present locally or advanced?
local
where does testicular cancer mets to?
lymph nodes
bone
lungs
chest
which lymph nodes does testicular cancer mets to?
retroperitoneal
approach to remove testicular cancer ?
inguinal canal approach, (don’t want to contaminate the scrotal basin)
what testicular cancer produces tumour markers?
non-seminomas
don’t forget what if someone is going to get testicular cancer ?
CXR to check for mets
double time for testicular cancer ?
could be DAYS
in males, are teratomas benign or malignant?
malignant
what types of things can torsion?
torted appendix on top pole of testicle (blue dot sign)
testicle itself
Ix for testicular torsion
ultrasound with doppler
classic sign of testicular torsion?
loss of cremasteric reflex
BCG used how in urology?
to clean up bladder cancers
Types of germ cell tumours?
seminal
non-seminal
