FPC: male GU exam

Question 1

What amount should we typically be able to void from the bladder?

Answer 1

50% of the volume

Question 2

What is a suprapubic tube?

Answer 2

Tube that can go directly into the bladder to place a catheter if there is an inability to access the bladder otherwise

Question 3

Who gets suprapubic tubes?

Answer 3

Those who need an easy catheter change, avoiding urethral erosion, low infection risk

Question 4

What catheter has the highest infection risk?

Answer 4

Urethral catheter

Question 5

What is the first step of the penile exam?

Answer 5

Check all surfaces of the penile skin, including retracting the foreskin

Question 6

Where do most penile cancers occur?

Answer 6

The glans

Question 7

What do penile cancers typically look like?

Answer 7

Non-healing ulcers

Question 8

How do we treat HSV?

Answer 8

Valacyclovir

Question 9

How do we test for HSV?

Answer 9

Swab the lesion

Question 10

What is Peyronie’s disease?

Answer 10

Scar tissue on the corporal septum of the penis that causes a penile curvature/fibrosis

Question 11

How do we treat Peyronie’s disease?

Answer 11

Inject collagenase into the scar, surgery putting stitches opposite to the curve, or cutting out the scar. May also just involve observation if the patient is unbothered

Question 12

What is important during the testicular exam?

Answer 12

To bring the testicle up to the skin

Question 13

What is a normal testicle size?

Answer 13

18-22 ccs

Question 14

What is Klinefelter’s syndrome?

Answer 14

XXY chromosomes; testicular size is 6-8 ccs

Question 15

What is orchitis?

Answer 15

25-28 ccs testicles

Question 16

What is a varicocele?

Answer 16

Dilated veins in the spermatic cord of the scrotum

Question 17

What is important in a varicocele exam?

Answer 17

They should be standing, and a Valsalva maneuver can be used to assess for the dilation

Question 18

Why are varicoceles often on the left side?

Answer 18

The left renal vein can get compressed between the aorta and SMA

Question 19

What is the issue with varicoceles?

Answer 19

They may alter the ability to control testicular temperature, impacting their function

Question 20

What is a hydrocele?

Answer 20

Fluid between the tunica albuginea and tunica vaginalis

Question 21

What is an exam finding of a hydrocele?

Answer 21

Inability to feel the testicle due to the fluid buildup

Question 22

How do we diagnose hydrocele?

Answer 22

Ultrasound

Question 23

How do we treat hydrocele?

Answer 23

Remove tunica vaginalis and sew it back onto itself

Question 24

What is a spermatocele?

Answer 24

Fluid in the scrotum coming off the epididymis

Question 25

How do we diagnose spermatocele?

Answer 25

We can feel the testicle as well as a pocket of fluid

Question 26

What do we see on ultrasound in a testicular tumor?

Answer 26

A hypervascular region within the testicle

Question 27

How do we treat testicular tumors?

Answer 27

Surgery, ideally within a week

Question 28

What is testicular torsion?

Answer 28

Twisting of the spermatic cord that compromises blood flow to the testicle

Question 29

What is the presentation of testicular torsion?

Answer 29

Nausea, vomiting, testicular pain

Question 30

How do we treat testicular torsion?

Answer 30

Ultrasound immediately and untwisting/surgery asap

Question 31

How do we treat epididymitis?

Answer 31

Antibiotics that can penetrate the testicle

Question 32

How do we do an exam for an inguinal hernia?

Answer 32

Push through the cord and have the patient Valsalva. If they have one you should feel the bowel

Question 33

When do we do a digital rectal exam?

Answer 33

Prostate cancer and BPH (PSA greater than 2)

Question 34

When is phimosis normal?

Answer 34

In children up to age 8; we don’t really need to retract the foreskin in a kid

Question 35

What should we assess for in pediatric GU exam?

Answer 35

Undescended testicles, NO rectal/prostate exam, skin abnormality, sacrum

Question 36

At what point should the testicles be descended into the scrotum?

Answer 36

6 months