GU Exam Males questions with complete solutions

CVA tenderness related to sudden distension of renal capsule-think pyelonephritis ureteral distention ie kidney stones, results in severe pain; can radiate to groin; patient cannot become comfortable on the table. No PE findings bladder distention Can cause lower abdominal pain and suprapubic pain groin discomfort think spermatic cord, testicular, prostate, lymph disorders, herpes zoster, hernia testicular pain consider epididymitis, orchitis, hydrocele, torsion, tumor, calculi hydrocele nontender fluid filled mass within the tunica vaginalis testicular torsion twisting of testicle on spermatic cord acute pain and swollenn retracts into scrotum becoming tender and swollen NEG phren's sign Phren's Sign relief of pain when elevation of testicle testicular CA No translumination Usually painless nodule Cryptorchidism-testicle never descends into scrotum RISK FOR TESTICULAR CANCER Epididymitis Acutely inflamed epididymis Tender and swollen Co-existing infection usually Positive Phrens sign (relief of pain with elevation of the testicle) Varicocele Varicosities of the pampiniform plexus of the veins form a soft, irregular mass in the scrotum Bag of worms Spermatocele painless movable cystic mass just above testis transilluminates contains sperm acute orchitis Inflammation of one or both testes Usually due to infection, mumps indirect hernia common at all ages Originates above inguinal ligament and often passes into the scrotum through the external ring May touch the examiners finger in the inguinal canal Direct hernia less common than indirect Originates above the inguinal ligament near external inguinal ring and rarely enters scrotum Femoral hernia more common in women Originates below inguinal ligament more lateral than inguinal hernia, never enters scrotum incarcerated hernia ts contents cannot be returned to the abdominal cavity strangulated hernia the blood supply to the entrapped contents is compromised when to suspect strangulation in presence of tenderness, nausea, and vomiting phimosis inability to retract the foreskin over the glans paraphimosis occurs when the foreskin cannot be replaced in its normal position after it is retracted behind the glans Tip the penis may swell after foreskin is retracted hypospadias Congenital displacement of the urethral meatus to the inferior surface of the penis epispadias Developmental anomaly in which the urethral meatus is on the dorsal side of the penis Peyronie's Disease irregular fibrosis of septum or sheath of corpus cavernosum penis, extending into tunica albuginea priapism Erection is sustained by reflex or central nerve stimulation, or by local mechanical causes, such as thrombosis, hemorrhage, neoplasm, injection of vasoactive agents, and inflammation of the penis syphilis painless chancre chancroid h. ducreyi punched out ulcer lymphogranuloma venereum C. trachoatis vesicular papulse nodular HSV painful vesicles Condyloma Acuminate lesion HSV virus