NURS 660 Final Exam with |! |! |! |! |!
accurate detailed solutions |! |!
epididymitis - Correct answer ✔inflammation of the epididymis (the coiled
|! |! |! |! |! |! |! |! |! |!
tube at the back of the testicle that stores and carries sperm and connects
|! |! |! |! |! |! |! |! |! |! |! |! |! |!
testes to vas deferens) due to infection from bacteria, including STI.
|! |! |! |! |! |! |! |! |! |!
Epididymitis Risk Factors - Correct answer ✔Unprotected Sex or new sexual
|! |! |! |! |! |! |! |! |! |! |!
partners
history of UTI with dysuria or discharge
|! |! |! |! |! |!
Typically caused by gonorrhea/chlamydia
|! |! |!
MSM-could be E. coli or pseudomonas |! |! |! |! |!
Epididymitis Symptoms - Correct answer ✔Fever |! |! |! |! |!
Dysuria, UTI Symptoms |! |!
acute painful enlarged scrotum
|! |! |!
Epididymitis Diagnosis - Correct answer ✔Prehn's sign-reduction of pain
|! |! |! |! |! |! |! |! |!
when scrotum is elevated above pubis symphysis
|! |! |! |! |! |!
UA-shows pyruia and leukocytosis |! |! |!
Test for STI
|! |!
Epididymitis Treatment - Correct answer ✔Scrotal Elevation-warm sitz
|! |! |! |! |! |! |! |!
bath/ice packs |!
,NSAIDs
Have partner treated
|! |!
Urology referral if symptoms don't improve
|! |! |! |! |!
Gonorrhea/chlamydia--ceftraixone 500 mg IM x 1 dose, doxy 100 mg BID x |! |! |! |! |! |! |! |! |! |! |! |!
10 days
|!
Acute gonorrhea/chlamydia or enteric organisms--ceftriaxone 500 mg IM x 1
|! |! |! |! |! |! |! |! |! |!
plus levofloxacin 500 mg PO daily x 10 days
|! |! |! |! |! |! |! |!
Acute enteric organisms-Levofloxacin 500 mg daily x 10 days over ceftriaxone
|! |! |! |! |! |! |! |! |! |! |!
1000 mg |!
Testicular Torsion - Correct answer ✔twisting or rotation of testes, resulting
|! |! |! |! |! |! |! |! |! |! |!
in acute ischemia
|! |!
UROLOGIC EMERGENCY |!
Causes of Testicular Torsion - Correct answer ✔Trauma 20% of cases
|! |! |! |! |! |! |! |! |! |! |!
Contraction of cremaster muscle-can occur during sleep
|! |! |! |! |! |!
exercise, extreme cold, sexual stimulation
|! |! |! |!
Undescended testicle |!
congenital clapper anomaly |! |!
Testicular Torsion Symptoms - Correct answer ✔acute onset of pain w/
|! |! |! |! |! |! |! |! |! |! |!
swelling
Testicular Torsion Physical Exam - Correct answer ✔absence of cremasteric
|! |! |! |! |! |! |! |! |! |!
reflex
,testicle can be high in scrotum, transverse known as bell clapper deformity
|! |! |! |! |! |! |! |! |! |! |!
edema in testicle
|! |!
abdominal pain w/ NV |! |! |!
possible fever |!
Testicular Torsion Diagnosis - Correct answer ✔hx/physical
|! |! |! |! |! |!
color doppler US of testes is 100% sensitive in detecting blood flow
|! |! |! |! |! |! |! |! |! |! |! |!
compression
Testicular Torsion Treatment - Correct answer ✔compression can lead to
|! |! |! |! |! |! |! |! |! |!
ischemic necrosis in 6 hours |! |! |! |!
immediate referral to ED |! |! |!
In ED-manual reduction-blood flow restored
|! |! |! |!
manual reduction immediately followed by surgery
|! |! |! |! |!
Hydrocele - Correct answer ✔collection of peritoneal fluid within the
|! |! |! |! |! |! |! |! |! |!
scrotum around testes, between parietal and visceral layers of the tunica
|! |! |! |! |! |! |! |! |! |! |!
vaginalis
Hydrocele Causes - Correct answer ✔congenital-patent processus vaginalis
|! |! |! |! |! |! |!
reactive inflammatory condition in scrotum
|! |! |! |!
idiopathic-chronic leaking |!
parasitic infx |!
, Hydrocele Symptoms - Correct answer ✔swelling in scrotum or inguinal
|! |! |! |! |! |! |! |! |! |!
canal
usually painless, although patients report heaviness in scrotum
|! |! |! |! |! |! |!
pain-if present can radiate to back
|! |! |! |! |!
Hydrocele Diagnosis - Correct answer ✔Edema in scrotum
|! |! |! |! |! |! |!
Trans-illumination-appears pale pink/yellow color translucent |! |! |! |!
Scrotal US |!
AXR series to rule out incarcerated hernia
|! |! |! |! |! |!
Hydrocele Management - Correct answer ✔No treatment required unless
|! |! |! |! |! |! |! |! |!
complications-such as tumor |! |!
surgical removal of hydrocele sac warranted if significant pain or compromise
|! |! |! |! |! |! |! |! |! |!
of scrotal skin
|! |! |!
Varicocele - Correct answer ✔Abnormal degree of venous dilation of
|! |! |! |! |! |! |! |! |! |!
papiniform plexus above testes, usually results in pain and engorgement of
|! |! |! |! |! |! |! |! |! |! |!
testes
varicose veins of testes |! |! |!
Varicocele Causes - Correct answer ✔a weak wall in spermatic vein and
|! |! |! |! |! |! |! |! |! |! |! |!
excessive pressure leading cause |! |! |!
most commonly on left side
|! |! |! |!
can cause infertility
|! |!
accurate detailed solutions |! |!
epididymitis - Correct answer ✔inflammation of the epididymis (the coiled
|! |! |! |! |! |! |! |! |! |!
tube at the back of the testicle that stores and carries sperm and connects
|! |! |! |! |! |! |! |! |! |! |! |! |! |!
testes to vas deferens) due to infection from bacteria, including STI.
|! |! |! |! |! |! |! |! |! |!
Epididymitis Risk Factors - Correct answer ✔Unprotected Sex or new sexual
|! |! |! |! |! |! |! |! |! |! |!
partners
history of UTI with dysuria or discharge
|! |! |! |! |! |!
Typically caused by gonorrhea/chlamydia
|! |! |!
MSM-could be E. coli or pseudomonas |! |! |! |! |!
Epididymitis Symptoms - Correct answer ✔Fever |! |! |! |! |!
Dysuria, UTI Symptoms |! |!
acute painful enlarged scrotum
|! |! |!
Epididymitis Diagnosis - Correct answer ✔Prehn's sign-reduction of pain
|! |! |! |! |! |! |! |! |!
when scrotum is elevated above pubis symphysis
|! |! |! |! |! |!
UA-shows pyruia and leukocytosis |! |! |!
Test for STI
|! |!
Epididymitis Treatment - Correct answer ✔Scrotal Elevation-warm sitz
|! |! |! |! |! |! |! |!
bath/ice packs |!
,NSAIDs
Have partner treated
|! |!
Urology referral if symptoms don't improve
|! |! |! |! |!
Gonorrhea/chlamydia--ceftraixone 500 mg IM x 1 dose, doxy 100 mg BID x |! |! |! |! |! |! |! |! |! |! |! |!
10 days
|!
Acute gonorrhea/chlamydia or enteric organisms--ceftriaxone 500 mg IM x 1
|! |! |! |! |! |! |! |! |! |!
plus levofloxacin 500 mg PO daily x 10 days
|! |! |! |! |! |! |! |!
Acute enteric organisms-Levofloxacin 500 mg daily x 10 days over ceftriaxone
|! |! |! |! |! |! |! |! |! |! |!
1000 mg |!
Testicular Torsion - Correct answer ✔twisting or rotation of testes, resulting
|! |! |! |! |! |! |! |! |! |! |!
in acute ischemia
|! |!
UROLOGIC EMERGENCY |!
Causes of Testicular Torsion - Correct answer ✔Trauma 20% of cases
|! |! |! |! |! |! |! |! |! |! |!
Contraction of cremaster muscle-can occur during sleep
|! |! |! |! |! |!
exercise, extreme cold, sexual stimulation
|! |! |! |!
Undescended testicle |!
congenital clapper anomaly |! |!
Testicular Torsion Symptoms - Correct answer ✔acute onset of pain w/
|! |! |! |! |! |! |! |! |! |! |!
swelling
Testicular Torsion Physical Exam - Correct answer ✔absence of cremasteric
|! |! |! |! |! |! |! |! |! |!
reflex
,testicle can be high in scrotum, transverse known as bell clapper deformity
|! |! |! |! |! |! |! |! |! |! |!
edema in testicle
|! |!
abdominal pain w/ NV |! |! |!
possible fever |!
Testicular Torsion Diagnosis - Correct answer ✔hx/physical
|! |! |! |! |! |!
color doppler US of testes is 100% sensitive in detecting blood flow
|! |! |! |! |! |! |! |! |! |! |! |!
compression
Testicular Torsion Treatment - Correct answer ✔compression can lead to
|! |! |! |! |! |! |! |! |! |!
ischemic necrosis in 6 hours |! |! |! |!
immediate referral to ED |! |! |!
In ED-manual reduction-blood flow restored
|! |! |! |!
manual reduction immediately followed by surgery
|! |! |! |! |!
Hydrocele - Correct answer ✔collection of peritoneal fluid within the
|! |! |! |! |! |! |! |! |! |!
scrotum around testes, between parietal and visceral layers of the tunica
|! |! |! |! |! |! |! |! |! |! |!
vaginalis
Hydrocele Causes - Correct answer ✔congenital-patent processus vaginalis
|! |! |! |! |! |! |!
reactive inflammatory condition in scrotum
|! |! |! |!
idiopathic-chronic leaking |!
parasitic infx |!
, Hydrocele Symptoms - Correct answer ✔swelling in scrotum or inguinal
|! |! |! |! |! |! |! |! |! |!
canal
usually painless, although patients report heaviness in scrotum
|! |! |! |! |! |! |!
pain-if present can radiate to back
|! |! |! |! |!
Hydrocele Diagnosis - Correct answer ✔Edema in scrotum
|! |! |! |! |! |! |!
Trans-illumination-appears pale pink/yellow color translucent |! |! |! |!
Scrotal US |!
AXR series to rule out incarcerated hernia
|! |! |! |! |! |!
Hydrocele Management - Correct answer ✔No treatment required unless
|! |! |! |! |! |! |! |! |!
complications-such as tumor |! |!
surgical removal of hydrocele sac warranted if significant pain or compromise
|! |! |! |! |! |! |! |! |! |!
of scrotal skin
|! |! |!
Varicocele - Correct answer ✔Abnormal degree of venous dilation of
|! |! |! |! |! |! |! |! |! |!
papiniform plexus above testes, usually results in pain and engorgement of
|! |! |! |! |! |! |! |! |! |! |!
testes
varicose veins of testes |! |! |!
Varicocele Causes - Correct answer ✔a weak wall in spermatic vein and
|! |! |! |! |! |! |! |! |! |! |! |!
excessive pressure leading cause |! |! |!
most commonly on left side
|! |! |! |!
can cause infertility
|! |!
