Module 4 Men's Health/STD Flashcards
(25 cards)
When is surgery indicated for cryptorchidism?
a) 2-6 months
b) 6-18 months
c) 18-24 months
d) 24-36 months
Answer: b) 6-18 months
Note: usually by one year of age and age 6 months to 18 months is best for fertility
How do you differentiate epididymitis and testicular torsion?
a) positive Prehn’s sign
b) normal Cremaster reflex
c) negative Prehn’s sign
d) absent Cremaster reflex
e) one or more of the above
Answer: e) one or more of the above
In epididymitis: Prehn’s sign is positive; normal cremaster reflex
In testicular torsion: Prehn’s sign is negative; absent cremaster reflex
What symptoms are seen in epididymitis?
a) positive Prehn’s sign
b) normal Cremaster reflex
c) negative Prehn’s sign
d) absent Cremaster reflex
e) one or more of the above
Answer: e) one or more of the above
In epididymitis: Prehn’s sign is positive; normal cremaster reflex
What symptoms are seen in testicular torsion?
a) positive Prehn’s sign
b) normal Cremaster reflex
c) negative Prehn’s sign
d) absent Cremaster reflex
e) one or more of the above
Answer: e) one or more of the above
In testicular torsion: Prehn’s sign is negative; absent cremaster reflex
What is the Prehn’s sign?
a) the thigh is stroked and the testicle on the same side will retract
b) the thigh is strooked and the testicle on the opposite side will retract
c) testicle pain subsides when scrotum lifted
d) testicle pain increases when scrotum lifted
Answer: c) testicle pain subsides when scrotum lifted
Which of the following is a side effect of phosphodiesterase inhibitors (PDE-5) drugs?
a) hypertension
b) optic neuropathy
c) dependence
d) fetal harm
Answer: b) optic neuropathy
Which of the following is a side effect of phosphodiesterase inhibitors (PDE-5) drugs?
a) fetal harm
b) hepatotoxicity
c) urinary retention
d) hearing loss
Answer: d) hearing loss
Other SE: optic neuropathy, headache, flushing, HYPOtension, and priapism
What is the gold standard for diagnosing testicular cancer?
a) abdominal CT
b) PSA
c) biopsy
d) scrotal U/S
Answer: d) scrotal ultrasound
Patients with cryptorchidism should be counseled:
a) to avoid circumcision
b) to monitor for testicular cancer as they are more at risk
c) to avoid intercourse during flare up
d) to have surgery no earlier than 24 months of age
Answer: b) to monitor for testicular cancer as they are more at risk
They are also at risk for infertility
Which is diagnostic for epididymitis?
a) Scrotal u/s
b) STD test with urine culture
c) DRE
d) AFP >25; beta-HCG >7; LDH>25
Answer: b) STD test with urine culture
Rationale: in males under 35 the causative factor is usually an STD; in makes 35+ the causative factor is NOT usually an STD
Treatment for epididymitis for sexually active adults is (choose all that apply):
a) levofloxacin 500 mg/day Q10days
b) doxycycline 100 mg BID Q10days
c) ofloxacin 300 mg BID Q10days
d) metronidazole 500 mg PO BID Q7days
e) ceftriaxone 500 mg IM once
Answer: b & e
For sexually active adults: doxycycline 100 mg BID Q10days (treats chlamydia) + ceftriaxone 500 mg IM once (treats gonorrhea)
Treatment for epididymitis for not sexually active adults (or not suspecting STD) is (choose all that apply):
a) levofloxacin 500 mg/day Q10days
b) doxycycline 100 mg BID Q10days
c) ofloxacin 300 mg BID Q10days
d) metronidazole 500 mg PO BID Q7days
e) ceftriaxone 500 mg IM once
Answer: a OR c
Levofloxacin 500 mg/day Q10days or ofloxacin 300 mg BID Q10days
Note: tendon rupture BBW so consider TMZ/SMZ for mild infection
Which is not a risk factor for hydrocele development:
a) prematurity
b) peritoneal dialysis
c) injury
d) STD
e) late testes descention
Answer: d) STD
All the other choices are risk factors for hydrocele
True or false, a hydrocele is painful.
False, it is usually painless and transilluminates
A spermatocele is characterized by:
a) painful freely moveable mass
b) benign cyst along spermatic cord
c) inferior to the testicle
d) immediate need for treatment
Answer: b) benign cyst along spermatic cord
It is PAINLESS, freely moveable, superior to testicle, and no tx required usually
Which presentation of varicocele requires referral?
a) grade I
b) grade 2 with decreased sperm count
c) grade 2-3 with <20% size differential between the two testicles
d) grade 2-3 with >20% size differential between two testicles
Answer: d)grade 2-3 with >20% size differential between two testicles
Will refer to urology
Match the following grade scales for varioceles with their description:
Grade I:
Grade II:
Grade III:
a) visible on gross inspection
b) palpable w/ valsalva maneuver
c) not visible on inspection, palpable upon standing
Answer:
Grade I: b
Grade II: c
Grade III: a
Which is not a symptom of varicocele:
a) nontender
b) decreased sperm count
c) positive Prehn’s
d) bag of worms appearance
e) infertility
Answer: c) positive Prehn’s
Prehn’s sign helps delineate between testicular torsion (negative) and epididymitis (positive)
What is the key management point for hypospadias?
Circumcision must not be done because the foreskin is used to repair the urethral opening on ventral surface when surgery is done at ~12 months of age.
What is phimosis?
a) urethral opening on ventral surface of penis
b) interruption of vascular flow
c) painful curvature to penis due to inury
d) abnormal constriction of opening in foreskin
Answer: d) abnormal constriction of opening in foreskin
Note: secondary/pathologic phimosis can be due to infection, inflammation, and scarring
A digital rectal exam (DRE) is performed and the findings are an enlarged, nontender, and rubbery prostate. This is consistent with what diagnosis?
a) BPH
b) prostate cancer
c) prostatitis
d) epiditimitis
Answer: a) BPH
A digital rectal exam (DRE) is performed and the findings are a hard prostate with asymmetric/obscure boundaries. This is consistent with what diagnosis?
a) BPH
b) prostate cancer
c) prostatitis
d) epiditimitis
Answer: b) prostate cancer
Primary treatment for BPH is what?
a) 5-alpha reductase inhibitors
b) PDE-5 inhibitors
c) alpha-1-blockers
d) alpha-adrenergic antagonists
Answer: d) alpha-adrenergic antagonists
These drugs include alfuzosin, doxazosin, and tamsulosin and may cause hypotension
Treatment for BPH to decrease prostatic volume is achieved with what type of medication?
a) 5-alpha reductase inhibitors
b) PDE-5 inhibitors
c) alpha-1-blockers
d) alpha-adrenergic antagonists
Answer: a) 5-alpha reductase inhibitors
These include: finasteride & dutasteride and are used ONLY when prostatic volume/enlarged prostate
SE: decreased libido and ED
Can harm developing fetus so pregnant women should use caution when handling.
