Male GU abnormalities

Question 1

Genital herpes

Answer 1

• Begins w/ painful vesicles that become ulcerated

- Often recurrent

Question 2

Molluscum contangiosum

Answer 2

• Umbilicated vesicular-like
• Contagious, usually painless
• Benign viral condition; self-limited (6-12mo)

Question 3

Primary syphilitic chancre

Answer 3

• Chancre in coronal sulcus

- Painless

Question 4

Gonorrhoea

Answer 4

• Purulent urethral discharge
  via “milking” urethra
• Associated meatitis

Question 5

Most common cause of NGU

Answer 5

Chlamydia

• Mucopurulent discharge
• More watery

Question 6

Peyronie’s disease

Answer 6

• Idiopathic
• Fibrosis of corpora cavernous
• Palpable, nontender plaques beneath skin (along dorsum of shaft)
• Penile curvature, painful erections, erectile dysfunction

Question 7

Carcinoma of penis

Answer 7

• Begins as firm nodule or ulcer that does not heal
• Usually nontender
• More common in uncircumcised

Question 8

Indirect hernia

Answer 8

• Most common
• All ages, both sexes
• Above inguinal ligament, near midpoint
• Often into scrotum
• Palpable as impulse down inguinal ligament

Question 9

Direct hernia

Answer 9

• Men over 40, rare in women
• Above inguinal ligament, near pubic tubercle
• Rarely into scrotum
• Bulges anteriorly

Question 10

Femoral hernia

Answer 10

• More common in women
• Below inguinal ligament, more lateral
• May mimic lymph node
• Never into scrotum

Question 11

Varicocele

Answer 11

• Varicose vv
• Usually on left
• Feels like “bag of worms”
• May collapse (supine)
• May be associated w/ infertility

Question 12

Hydrocele

Answer 12

• Benign, nontender, fluid-filled mass within tunica vaginalis
• Transilluminates

Question 13

Spermatocele

Answer 13

• Painless, mobile mass above testis
• Smaller than hydrocele
• Contains sperm
• May transilluminate

Question 14

Acute epididymitis

Answer 14

• Infection of epididymis
• Local pain & swelling
• Primarily in adults
• Associated w/ UTI or prostate infection

Question 15

Acute orchitis

Answer 15

• Inflammation or infection of testis
• Testicular swelling & tenderness
• Similar appearance to epididymitis
• Complication of mumps & other viral infections

Question 16

Testicular torsion

Answer 16

• Due to twisting of spermatic cord
• Intense pain
• Red, swollen, tender scrotum
• Testis may be pulled upwards
• Surgical emergency!

Question 17

Testicular tumors

Answer 17

• Firm, painless nodule

- Does not transluminate

Question 18

Internal hemorrhoid prolapse

Answer 18

Protrudes from anus

Question 19

External hemorrhoid thrombosis

Answer 19

Develops blood clot, painful

Question 20

Anal fissure

Answer 20

• Tear in lining of anus wall

- Caused by passage of hard stools

Question 21

Anal fissure sx

Answer 21

• Severe pain as stool passes

- Itching, burning, bleeding, & wet discharge

Question 22

Anal fissure dx

Answer 22

Hx & anoscopy

Question 23

Perirectal abscess

Answer 23

• Swelling & erythema of butt

- Can be very serious

Question 24

Perianal condylomata

Answer 24

HPV, usually sexually transmitted

Question 25

Prostatitis - Acute & Chronic

Answer 25

- Enlarged prostate gland - More tender during acute infection, often fever & chills - Examine carefully (avoid spread of infection - Tx w/ antibiotics

Question 26

Benign prostatic hypertrophy

Answer 26

- More common w/ increasing age - Symmetrical enlargement of gland - Slowing of urine stream w/ difficulty starting stream

Question 27

Carcinoma of prostate

Answer 27

- Enlarged, firm nodule or area of hardness - Irregular contour, median sulcus obscured - Usually slow-growing - Metastasizes locally, to bone