Bates’-Guide-to-Physical-Examination-and-History-Taking,-11th-Edition

13. Induration along the ventral surface of the penis suggests which of the following? A) Urethral stricture B) Testicular carcinoma C) Peyronie's disease D) Epidermoid cysts Ans: A Chapter: 13 Page and Header: 508, Techniques of Examination Feedback: Urethral stricture may cause induration of the ventral surface of the penis. It more rarely represents a local carcinoma. A testicular carcinoma would be much more likely to occur in the scrotum. Peyronie's disease often causes induration on the dorsal proximal penis, and epidermoid cysts are benign findings on the scrotum. 14. A tender, painful swelling of the scrotum should suggest which of the following? A) Acute epididymitis B) Strangulated inguinal hernia C) Torsion of the spermatic cord D) All of the above Ans: D Chapter: 13 Page and Header: 508, Techniques of Examination Feedback: A tender, painful swelling of the scrotum can be a medical emergency. All of these conditions should be considered, as well as acute orchitis. 15. A young man feels something in his scrotum and comes to you for clarification. On your examination, you note what feels like a “bag of worms” in the left scrotum, superior to the testicles. Which of the following is most likely? A) Hydrocele of the spermatic cord B) Varicocele C) Testicular carcinoma D) A normal vas deferens Ans: B Chapter: 13 Page and Header: 508, Techniques of Examination Feedback: Varicoceles are common in normal men. They are often found in the left scrotum or bilaterally and should normally resolve in the supine position. This is because they represent varicosities within the scrotum. These require further investigation if they occur only on the right side or do not resolve in the supine position. They can contribute to infertility because the testicles are unable to achieve a cool enough temperature for sperm production, due to increased blood flow from the varicocele. A hydrocele would be a painless mass on the spermatic cord and the vas deferens is palpated as part of the spermatic cord. You should lightly pinch the scrotum medially and move laterally until you feel the spermatic cord pass between your fingers.