1 Thehuman papillomavirus (HPV) can cause genital warts in males
and females as well as cervical cancer in females. Vaccination
against HPV is available and should be offered to males between
what ages?
Time Spent - 00:00:08
Your Response:9–21 years
Rationale:The current recommendation for HPV vaccination for males starts at age 9 years and
continues until age 26 years when males are most likely to be exposed to the virus. HPV can
cause genital warts in both males and females, cervical cancer in females, and has also been
linked to other types of cancers such as oropharyngeal cancers. Current literature suggests that
age groups other than 9–21 years do not have any significant benefit or need for the HPV
vaccination.
Remediation:
Bickley, Lynn S. Bates' Guide to Physical Examination and History Taking, 13th ed.,
Philadelphia: Wolters Kluwer, Chapter 20: Male Genitalia.
2 A 29-year-old graduate student states that he is able to achieve an
erection and ejaculate during sexual intercourse; however, he does
not experience any pleasurable sensation of orgasm. He is otherwise
healthy and is not on any medications. What is the most likely cause
of his problem?
Time Spent - 00:00:07
Your Response:Psychogenic
Rationale:Lack of orgasm with ejaculation is usually not a physiological or structural issue,
rather psychogenic in nature. It is fairly uncommon but does occur, and clinicians should be
aware of the problem and take a thorough history to ascertain the roots of this disorder.
Androgen insufficiency is incorrect as it is more likely to cause a decrease in libido and problems
with erectile dysfunction (ED) rather than lack of orgasm. Endocrine dysfunction is incorrect as
it may also cause ED and decreased libido as well as reduced or absent ejaculation among others;
however, it should not cause the symptoms described above. Peyronie disease is incorrect as it is
the development of fibrous scar tissue within the penis that causes disfigured and painful
erections. STI is incorrect. STIs can cause a constellation of symptoms such as urethral
discharge, fever, and pain to name a few; however, they should not cause the symptoms
described above.
Remediation:
Bickley, Lynn S. Bates' Guide to Physical Examination and History Taking, 13th
ed., Philadelphia: Wolters Kluwer, Chapter 20: Male Genitalia.
3 While performing a physical examination on male patients, it is
possible to palpate multiple structures in relation to the inguinal
canal and related hernias. Which of the following is not palpable
during an external examination of the abdominal wall or inguinal
region?
Time Spent - 00:00:21
Your Response:External inguinal ring
Correct Response:Internal inguinal ring
Rationale:The internal inguinal ring is typically not palpable through the abdominal wall. The
internal inguinal ring is the opening through which the spermatic cord passes from the abdominal
cavity into the inguinal canal. It is sometimes palpable if the external inguinal ring is large
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, enough and may be found by invaginating the scrotum, angling toward the inguinal canal. The
external inguinal ring is incorrect as it is usually palpable through the abdominal wall; however,
it is better evaluated from a transscrotal approach. The pubic tubercle is incorrect as it is easily
palpable in most circumstances from an external approach. Anterior superior iliac spine is
incorrect as it is also palpable externally and is the location for the proximal attachment of the
inguinal ligament. Direct inguinal hernias is incorrect. It typically presents as a bulge near the
external inguinal ring and may be palpable from an external approach.
Remediation:
Bickley, Lynn S. Bates' Guide to Physical Examination and History Taking, 13th ed.,
Philadelphia: Wolters Kluwer, Chapter 20: Male Genitalia.
4 A 32-year-old male complains of a painless, cystic mass just above
his left testicle. During the physical examination, a strong flashlight
is placed behind the scrotum through the area in question and
transillumination is noted. What is the most likely diagnosis?
Time Spent - 00:00:21
Your Response:Spermatocele
Rationale:A spermatocele is a benign, typically painless, movable cystic mass just above the
testis that will typically transilluminate with a strong light source. Direct hernia and indirect
hernia are incorrect as they will typically contain abdominal contents such as bowel that do not
transilluminate. A direct hernia does not produce a mass in the scrotum. Testicular tumor is
incorrect. A testicular tumor is a solid mass that will not transilluminate. A varicocele is
incorrect as it is a dilatation or varicosities of veins of the spermatic cord that are filled with
blood and therefore will not transilluminate.
Remediation:
Bickley, Lynn S. Bates' Guide to Physical Examination and History Taking, 13th ed.,
Philadelphia: Wolters Kluwer, Chapter 20: Male Genitalia.
5 A 67-year-old electronics technician with a history of hypertension
and type 2 diabetes presents for his yearly physical examination and
complains of progressively worsening erectile dysfunction (ED).
While counseling him, the clinician mentions that multiple
processes must take place to achieve an erection. Which of the
following structures would be most affected by vascular deficiencies
related to his preexisting medical conditions and is likely
contributing to his symptoms?
Time Spent - 00:00:25
Your Response:Corpora cavernosa
Rationale:The corpora cavernosa are two structures within the shaft of the penis that become
engorged with venous blood during erection. Patients with a history of cardiovascular disease
such as hypertension and other diseases, such as diabetes, that cause limitations of blood flow are
common causes of ED. Ejaculatory duct is incorrect. It is a conduit for seminal fluid from the
seminal vesicle and terminal vas deferens to the urethra and is not involved in the process of an
erection. Epididymis is incorrect. It is a structure on top of each of the testicles that provides a
reservoir for storage, saturation, and transport of sperm from the testes and is also not involved in
the process of an erection. Seminal vesicle is incorrect. It produces secretions that contribute to
the seminal fluid and is also not involved in the process of an erection. Vas deferens is incorrect.
It is a cord-like structure that transports sperm from the tail of the epididymis to the urethra and
also is not involved in the process of an erection.
This study source was downloaded by 100000897929959 from CourseHero.com on 04-08-2025 05:51:32 GMT -05:00
https://www.coursehero.com/file/248388822/male-genit-copydocx/
and females as well as cervical cancer in females. Vaccination
against HPV is available and should be offered to males between
what ages?
Time Spent - 00:00:08
Your Response:9–21 years
Rationale:The current recommendation for HPV vaccination for males starts at age 9 years and
continues until age 26 years when males are most likely to be exposed to the virus. HPV can
cause genital warts in both males and females, cervical cancer in females, and has also been
linked to other types of cancers such as oropharyngeal cancers. Current literature suggests that
age groups other than 9–21 years do not have any significant benefit or need for the HPV
vaccination.
Remediation:
Bickley, Lynn S. Bates' Guide to Physical Examination and History Taking, 13th ed.,
Philadelphia: Wolters Kluwer, Chapter 20: Male Genitalia.
2 A 29-year-old graduate student states that he is able to achieve an
erection and ejaculate during sexual intercourse; however, he does
not experience any pleasurable sensation of orgasm. He is otherwise
healthy and is not on any medications. What is the most likely cause
of his problem?
Time Spent - 00:00:07
Your Response:Psychogenic
Rationale:Lack of orgasm with ejaculation is usually not a physiological or structural issue,
rather psychogenic in nature. It is fairly uncommon but does occur, and clinicians should be
aware of the problem and take a thorough history to ascertain the roots of this disorder.
Androgen insufficiency is incorrect as it is more likely to cause a decrease in libido and problems
with erectile dysfunction (ED) rather than lack of orgasm. Endocrine dysfunction is incorrect as
it may also cause ED and decreased libido as well as reduced or absent ejaculation among others;
however, it should not cause the symptoms described above. Peyronie disease is incorrect as it is
the development of fibrous scar tissue within the penis that causes disfigured and painful
erections. STI is incorrect. STIs can cause a constellation of symptoms such as urethral
discharge, fever, and pain to name a few; however, they should not cause the symptoms
described above.
Remediation:
Bickley, Lynn S. Bates' Guide to Physical Examination and History Taking, 13th
ed., Philadelphia: Wolters Kluwer, Chapter 20: Male Genitalia.
3 While performing a physical examination on male patients, it is
possible to palpate multiple structures in relation to the inguinal
canal and related hernias. Which of the following is not palpable
during an external examination of the abdominal wall or inguinal
region?
Time Spent - 00:00:21
Your Response:External inguinal ring
Correct Response:Internal inguinal ring
Rationale:The internal inguinal ring is typically not palpable through the abdominal wall. The
internal inguinal ring is the opening through which the spermatic cord passes from the abdominal
cavity into the inguinal canal. It is sometimes palpable if the external inguinal ring is large
This study source was downloaded by 100000897929959 from CourseHero.com on 04-08-2025 05:51:32 GMT -05:00
https://www.coursehero.com/file/248388822/male-genit-copydocx/
, enough and may be found by invaginating the scrotum, angling toward the inguinal canal. The
external inguinal ring is incorrect as it is usually palpable through the abdominal wall; however,
it is better evaluated from a transscrotal approach. The pubic tubercle is incorrect as it is easily
palpable in most circumstances from an external approach. Anterior superior iliac spine is
incorrect as it is also palpable externally and is the location for the proximal attachment of the
inguinal ligament. Direct inguinal hernias is incorrect. It typically presents as a bulge near the
external inguinal ring and may be palpable from an external approach.
Remediation:
Bickley, Lynn S. Bates' Guide to Physical Examination and History Taking, 13th ed.,
Philadelphia: Wolters Kluwer, Chapter 20: Male Genitalia.
4 A 32-year-old male complains of a painless, cystic mass just above
his left testicle. During the physical examination, a strong flashlight
is placed behind the scrotum through the area in question and
transillumination is noted. What is the most likely diagnosis?
Time Spent - 00:00:21
Your Response:Spermatocele
Rationale:A spermatocele is a benign, typically painless, movable cystic mass just above the
testis that will typically transilluminate with a strong light source. Direct hernia and indirect
hernia are incorrect as they will typically contain abdominal contents such as bowel that do not
transilluminate. A direct hernia does not produce a mass in the scrotum. Testicular tumor is
incorrect. A testicular tumor is a solid mass that will not transilluminate. A varicocele is
incorrect as it is a dilatation or varicosities of veins of the spermatic cord that are filled with
blood and therefore will not transilluminate.
Remediation:
Bickley, Lynn S. Bates' Guide to Physical Examination and History Taking, 13th ed.,
Philadelphia: Wolters Kluwer, Chapter 20: Male Genitalia.
5 A 67-year-old electronics technician with a history of hypertension
and type 2 diabetes presents for his yearly physical examination and
complains of progressively worsening erectile dysfunction (ED).
While counseling him, the clinician mentions that multiple
processes must take place to achieve an erection. Which of the
following structures would be most affected by vascular deficiencies
related to his preexisting medical conditions and is likely
contributing to his symptoms?
Time Spent - 00:00:25
Your Response:Corpora cavernosa
Rationale:The corpora cavernosa are two structures within the shaft of the penis that become
engorged with venous blood during erection. Patients with a history of cardiovascular disease
such as hypertension and other diseases, such as diabetes, that cause limitations of blood flow are
common causes of ED. Ejaculatory duct is incorrect. It is a conduit for seminal fluid from the
seminal vesicle and terminal vas deferens to the urethra and is not involved in the process of an
erection. Epididymis is incorrect. It is a structure on top of each of the testicles that provides a
reservoir for storage, saturation, and transport of sperm from the testes and is also not involved in
the process of an erection. Seminal vesicle is incorrect. It produces secretions that contribute to
the seminal fluid and is also not involved in the process of an erection. Vas deferens is incorrect.
It is a cord-like structure that transports sperm from the tail of the epididymis to the urethra and
also is not involved in the process of an erection.
This study source was downloaded by 100000897929959 from CourseHero.com on 04-08-2025 05:51:32 GMT -05:00
https://www.coursehero.com/file/248388822/male-genit-copydocx/
