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Flashcards in scrotal pain swelling and masses Deck (37):
1

what is concerning for scrotum cancer?

non painful mass that does not transluminate

2

masses that arise from w/in the testes are usually malignant T/F?

true

3

if you are unsure if an image is solid what imaging is preferred?

ultrasound

4

what are some causes of hydrocele?

patent processus vaginalus

epididymitis

trauma/testicular torsion

testicular cancer

5

what is assoicated w/ hydrocele?

testicular tumors

6

patient presents w/ heaviness in testicles that transilluminates?

hyrdrocele

7

what is the treatment for hydrocele?

watchful waiting w/ regular follow ups, surgery

DO NOT ASPIRATE

8

patient presents w/ mass <2cm that's distinct from the testical and located on the top. DX trx

epididymal cyst

benign: watchful waiting

9

patient presents w/ >2 cm lesion that arises from head of epididymis, non tender. DX TRX

maybe us US

spermatocele

watchful waiting, painful then surgery

10

pt. presents / hx of infertility. Complaining of dull ache. Sx worse w/ activity and a bag of worms that increases w/ valsalva. DX TX

varicocele

watchful waiting, scrotal support, activity mod. NSAIDS prn

if infertility and/or pain: surgery (ligartion of the gonadal vein

11

what varicocele requires further evaluation w/ CT and abdominal exam?

unilateral R side pain

lesion remains dilated w/ supination

occur abruptly or enlarge rapidly

12

what is the causeof indirect hernia?

patent process vaginalis

13

what is the cuase of a direct hernia?

weakness of the posterial waal of inguinal canal (acquired)

14

what is the treatment for hernia?

refer to general surgery for repair

15

what should you do if you are unsure if a mass is comig from w/in the testicle or not?

scrotal US and urologic consultation

16

what is necessary for diagnosis of testicular cacner?

orchiectomy

17

what is an important risk factor for testicular cancer?

cryptorchidism (r-side)

18

what is used for staging of testicular cacner?

CT/PET

19

labs for teticular cancer?

inc HCG
inc alpha fetoprotein
inc. lactate dehydrogenase
CBC for anemia
LFT (liver)

20

what is the MC secondary testicular tumor metastases?

lymphoma

21

what does the USPSTF recommend for testicular self exam?

grade D (don't)

22

who is testicualr torsion MC in?

neonates and post pubertal boys

23

what is predisposes someone to testicular torsion?

bell clapper deformity

24

what is the most sensitive finding for torsion?

absent cremasteric reflex

25

what is a negative prehn sign?

elevation of scrotum fails to relive pain: testicular torsion

26

what is the test of choice for testicular torsion?

color doppler, but lack of U/S should not delay surgery

27

what are signs of manual detorsion success?

relief of pain
lower testicle
no longer transverse, more longitudinal
blood flow on doppler U/S

28

what is the MC cause of scrotal pain in adults?

epididymitis and epidiymo-orchitis

29

what are the two types of epidiymitis and epdydmo-orchitis?

sexually transmitted (Gonorrhea, chlamydia)

nonsexually transmitted

30

what are sexually transmitted epidydimites associated w/?

urethritis in men <40

31

what are non sexually transmitted epididymitis associated w/?

old men w/ UTIs and prostatitis

32

what is the treatment for sexually transmitted epididymitis?

ceftriaxone and doxycycline (+sexual partner)

bed rest, scrotal elevation

33

what is the treatment for non-sexually transmitted epididymitis?

ciprofloxacin or levofloxacin

bed rest, scrotal elevation

34

scrotal skin reveals a blue dot?

torsion of appendix testis

35

causes of referred pain?

stones, UTI, pyelonephritis, low back pain, AAA, post surgical (herniorrhaphy)

36

fever and partotitis preceding orchitis?

mumps

37

nec fasc of perinemu and scrotal skin in diabetics?

fournier's gangrene; urgent surgery