NURS 5432 University Of Texas -
Arlington -Nurs 5432 module 4: men's
health and STDs Questions With
Complete Solutions
Question #1
What is the cremasteric reflex, and how is it tested?
Correct Answer:
Lightly stroking or pinching the superior medial aspect of the thigh should cause brisk ipsilateral
testicular retraction. This reflex should be assessed after inspection and before palpation of the
testicles.
Rationale:
An intact cremasteric reflex helps rule out testicular torsion; absence is a sensitive
but nonspecific finding for torsion. It can be absent in normal testes, so it should not be used as
the sole diagnostic criterion. This reflex is a rational, non-invasive screening tool in acute scrotal
assessment.
, Question #2
What is Prehn's sign, and what does it suggest?
Correct Answer:
If lifting the affected testicle relieves pain, this is a positive Prehn sign.
Rationale:
A positive Prehn sign typically points to epididymitis rather than testicular torsion. In torsion,
lifting the testicle often worsens the pain. This differential sign is a rational clinical tool to guide
urgent surgical versus medical management.
Question #3
What is the "blue dot sign," and what condition does it indicate?
Correct Answer:
A small blue discoloration visible through the skin at the upper pole of the testicle, accompanied
by tenderness, indicates torsion of the appendix testis (testicular appendage).
Rationale:
This sign is virtually pathognomonic for appendiceal torsion when tenderness is also present. It
helps differentiate this benign condition from testicular torsion, which requires urgent surgery.
This is a rational, visually distinctive clinical marker.
Question #4
What is cryptorchidism, and what are its risks?
Correct Answer:
,Cryptorchidism = undescended testicles. Treatment is orchiopexy, typically performed at ages 6-
18 months.
Rationale:
Undescended testicles carry an increased risk of testicular cancer later in life. Early surgical
intervention (orchiopexy) improves fertility outcomes and allows for easier testicular
surveillance. This rational management approach minimizes long-term malignancy risk.
Question #5
What are the risk factors for testicular cancer?
Correct Answer:
• Cryptorchidism (undescended testicle) — most significant risk factor
• Family history of testicular cancer
• Personal history of testicular cancer
• HIV infection
• Testicular atrophy
• Klinefelter syndrome
• Hypospadias
• Infertility
• Chemical exposure (e.g., Agent Orange)
Rationale:
Cryptorchidism is the single most important risk factor, increasing risk up to 10-fold. Early
detection and treatment of risk factors, especially surgical correction of undescended testicles
before puberty, significantly reduces cancer risk. This rational risk stratification guides screening
and surveillance.
Question #6
What are the signs and symptoms of testicular cancer?
, Correct Answer:
• Painless testicular mass or enlargement (most common)
• Heaviness in the scrotum
• Dull ache in the lower abdomen, back, or groin
• Sudden collection of fluid in the scrotum (hydrocele)
• Breast tenderness or enlargement (gynecomastia)
• Back pain (from retroperitoneal metastasis)
• Shortness of breath (from pulmonary metastasis)
Rationale:
The painless mass is the hallmark presentation. Any painless testicular mass warrants prompt
evaluation including ultrasound and tumor markers (AFP, hCG, LDH). Early detection
dramatically improves prognosis — this rational approach emphasizes self-examination and
prompt medical evaluation.
Question #7
What is a varicocele, and how is it graded?
Correct Answer:
Varicocele = enlarged veins of the spermatic cord.
Grading:
• Grade 1: Palpable only with Valsalva maneuver
• Grade 2: Palpable when standing (not visible)
• Grade 3: Clearly visible through the scrotal skin
Management:
• Grade 1: Reassure
• Grade 2-3, <20% testicular size difference: Reassure + refer to urology if fertility desired
• Grade 2-3, >20% size difference: Refer to urology
• Adjunct: Scrotal support, NSAIDs, semen analysis q2 years
Arlington -Nurs 5432 module 4: men's
health and STDs Questions With
Complete Solutions
Question #1
What is the cremasteric reflex, and how is it tested?
Correct Answer:
Lightly stroking or pinching the superior medial aspect of the thigh should cause brisk ipsilateral
testicular retraction. This reflex should be assessed after inspection and before palpation of the
testicles.
Rationale:
An intact cremasteric reflex helps rule out testicular torsion; absence is a sensitive
but nonspecific finding for torsion. It can be absent in normal testes, so it should not be used as
the sole diagnostic criterion. This reflex is a rational, non-invasive screening tool in acute scrotal
assessment.
, Question #2
What is Prehn's sign, and what does it suggest?
Correct Answer:
If lifting the affected testicle relieves pain, this is a positive Prehn sign.
Rationale:
A positive Prehn sign typically points to epididymitis rather than testicular torsion. In torsion,
lifting the testicle often worsens the pain. This differential sign is a rational clinical tool to guide
urgent surgical versus medical management.
Question #3
What is the "blue dot sign," and what condition does it indicate?
Correct Answer:
A small blue discoloration visible through the skin at the upper pole of the testicle, accompanied
by tenderness, indicates torsion of the appendix testis (testicular appendage).
Rationale:
This sign is virtually pathognomonic for appendiceal torsion when tenderness is also present. It
helps differentiate this benign condition from testicular torsion, which requires urgent surgery.
This is a rational, visually distinctive clinical marker.
Question #4
What is cryptorchidism, and what are its risks?
Correct Answer:
,Cryptorchidism = undescended testicles. Treatment is orchiopexy, typically performed at ages 6-
18 months.
Rationale:
Undescended testicles carry an increased risk of testicular cancer later in life. Early surgical
intervention (orchiopexy) improves fertility outcomes and allows for easier testicular
surveillance. This rational management approach minimizes long-term malignancy risk.
Question #5
What are the risk factors for testicular cancer?
Correct Answer:
• Cryptorchidism (undescended testicle) — most significant risk factor
• Family history of testicular cancer
• Personal history of testicular cancer
• HIV infection
• Testicular atrophy
• Klinefelter syndrome
• Hypospadias
• Infertility
• Chemical exposure (e.g., Agent Orange)
Rationale:
Cryptorchidism is the single most important risk factor, increasing risk up to 10-fold. Early
detection and treatment of risk factors, especially surgical correction of undescended testicles
before puberty, significantly reduces cancer risk. This rational risk stratification guides screening
and surveillance.
Question #6
What are the signs and symptoms of testicular cancer?
, Correct Answer:
• Painless testicular mass or enlargement (most common)
• Heaviness in the scrotum
• Dull ache in the lower abdomen, back, or groin
• Sudden collection of fluid in the scrotum (hydrocele)
• Breast tenderness or enlargement (gynecomastia)
• Back pain (from retroperitoneal metastasis)
• Shortness of breath (from pulmonary metastasis)
Rationale:
The painless mass is the hallmark presentation. Any painless testicular mass warrants prompt
evaluation including ultrasound and tumor markers (AFP, hCG, LDH). Early detection
dramatically improves prognosis — this rational approach emphasizes self-examination and
prompt medical evaluation.
Question #7
What is a varicocele, and how is it graded?
Correct Answer:
Varicocele = enlarged veins of the spermatic cord.
Grading:
• Grade 1: Palpable only with Valsalva maneuver
• Grade 2: Palpable when standing (not visible)
• Grade 3: Clearly visible through the scrotal skin
Management:
• Grade 1: Reassure
• Grade 2-3, <20% testicular size difference: Reassure + refer to urology if fertility desired
• Grade 2-3, >20% size difference: Refer to urology
• Adjunct: Scrotal support, NSAIDs, semen analysis q2 years
