Disorders and Anomalies of Scrotal Contents

Question 1

Cryptorchidism

Answer 1

Undescended testis

Question 2

MC disorder of sexual differentiation in boys

Answer 2

Cryptorchidism

Question 3

Testicular descent occurs when

Answer 3

7-8m AOG

Question 4

___% of premature male infants have undescended testis

Answer 4

30%

Question 5

Majority of undescended testes descend spontaneously when

Answer 5

During the first 3 months of life

Question 6

If the testis has not descended by ___ it will remain undescended

Answer 6

4 months

Question 7

T/F Risk of germ cell malignancy in an undescended testis is 2-4x higher than in the general population

Answer 7

T

Question 8

T/F Risk of germ cell malignancy in bilateral undescended testes is higher than with a unilateral undescended testis

Answer 8

T

Question 9

MC tumor developing in an undescended testis in an adolescent or adult

Answer 9

Seminoma (65%)

Question 10

T/F Contralateral testicular hypertrophy is 100% diagnostic that a testis is absent

Answer 10

F, not 100% but is a soft sign

Question 11

Congenital undescended testis should be treated surgically not later than

Answer 11

9-15 mos of age

Question 12

Hormonal treatment is INFREQUENTLY used for undescended testis but what hormone may stimulate testicular descent

Answer 12

HCG, stimulates Leydig cell production of testosterone or LHRH

Question 13

Torsion is the MCC of testicular pain in boys of what age

Answer 13

22 yrs and older

Question 14

Torsion is uncommon in what age group

Answer 14

Before 10y/o

Question 15

Torsion is caused by

Answer 15

Redundant tunica vaginalis resulting in inadequate fixation of the testis (bell clapper deformity)

Question 16

Within ___ hours, absent of blood flow to the testis, irreversible loss of spermatogenesis can occur

Answer 16

4-6

Question 17

Testicular torsion can be differentiated from incarcerated since ___ is absent with torsion

Answer 17

Swelling in the inguinal area

Question 18

T/F Cremasteric reflex is nearly always absent with torsion

Answer 18

T

Question 19

T/F Manual detorsion may be attempted with testicular torsion

Answer 19

T, if pain duration is <4-6 hours

Question 20

Treatment for testicular torsion

Answer 20

Prompt surgical exploration and detorsion

Question 21

If the testis is explored within ___, up to 90% of the gonads survivce

Answer 21

6 hours of torsion

Question 22

T/F Fertility is reduced in men with a history of spermatic cord torsion in adolescence, irrespective of whether detorsion or orchiectomy is performed

Answer 22

T

Question 23

MCC of testicular pain in boys 2-10y/o

Answer 23

Torsion of appendix testis (rare in adolescents

Question 24

Varicocele is a congenital condition in which there is an abnormal dilation of the

Answer 24

Pampiniform plexus

Question 25

MC and virtually the only surgically correctable cause of subfertility in men

Answer 25

Varicocele

Question 26

Varicocele that might indicate an abdominal or retroperitoneal mass

Answer 26

Boy <10 OR located on the right

Question 27

T/F Varicocele is typically a PAINLESS paratesticular mass

Answer 27

T

Question 28

Described as a bag of worms

Answer 28

Varicocele

Question 29

Grades of varicocele

Answer 29

Examined with the boy standing: Gr 1 palpable only with valsalva, Gr 2 palpable without valsalva but is not visible on inspection, Gr 3 visible with inspection

Question 30

Gole of varicocelectomy

Answer 30

Maximize chances of fertility

Question 31

Hydrocele is accumulation of fluid in the

Answer 31

Tunica vaginalis

Question 32

T/F in most cases, varicocele is noncommunicating

Answer 32

T, procesus was obliterated during development

Question 33

T/F Fluid of hydrocele disappears spontaneously by what age

Answer 33

1y/o

Question 34

If there is a persistently patent processus, how does the hydrocele present as

Answer 34

Becomes progressively larger during the day and small in the morning

Question 35

Long-term risk of a communicating hydrocele

Answer 35

Development of an inguinal hernia

Question 36

Confirms the fluid-filled nature of the hydrocele

Answer 36

Transillumination of the scrotum