Testicular and Scrotal Disease Flashcards Preview

Hugh's MD2 Intersession 3 > Testicular and Scrotal Disease > Flashcards

Flashcards in Testicular and Scrotal Disease Deck (24)
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1
Q

Does testicular cancer usually present with local or metastatic disease?

A

Local

2
Q

What is the best imaging modality for the scrotum?

A

US

3
Q

What is crypto-orchidism?

A

Non-descending, dysplastic testes

Increased risk of cancer

4
Q

How can you tell if a lump arises in the scrotom or abdomen?

A

Can you get above it when squeezing

5
Q

DDx for painless scrotal lumps?

A

Hydrocele

Epididymo-orchidis

Epididymal cyst

Inguinal hernia

Varicocele

Benign tumour

Malignancy - Primary, lymphoma

6
Q

What are some infective causes of epididymo-orchidis?

A

Gonorrhoea

Chlamydia

E. coli

Mumps

Coxsachie

TB

BCG

7
Q

How are testicular cancers characterised?

A

Germcell (95-99%) and non-germcell

8
Q

What are the classic examination findings of testicular torsion?

A

Loss of cremasteric reflex

Loss of orientation of the testes

Tender, firm testicle that is high riding

9
Q

How do you assess a scrotal lump on Hx?

A

Hx

  • Time course
  • Associated features: pain, discharge, fever, salivary glands
  • Association with coughing and lying/standing
  • FHx
  • ?Crypto-orchidism (non descending, dysplasic testes)
  • ?STI or UTI
10
Q

Which type of cancers cause cannon mets in the lung?

A

Testicular

Renal cell cancer

11
Q

Why do you ask about the size of a patient’s salivary glands?

A

Looking for mumps as a cause of epididymo-orchitis

12
Q

What are some types of germcell tumours?

A

Seminoma

Non-seminoma

13
Q

How do urine samples differ when looking for UTI vs STI?

A

UTI - midstream

STI - fall pass/urethral swob

14
Q

How do you assess a scrotal lump on examination?

A

General inspection - fever

Abdominal exam

Inguinal exam

  • Erythema
  • Translumination - simple fluids transluminate

Feel the lump

  • Hard/soft
  • Reducible
  • Position in relation to other structures
15
Q

DDx for acute scrotum?

A

Testicular torsion

Torsion of testicular appendage

Epididymitis

Trauma

Incarcerated hernia

16
Q

How do you examine for a varicocele?

A

Get the patient to stand

Valsalva/cough

17
Q

How can you Ix a testicular lump?

A

Urinalysis

FBE

Markers

  • Alpha-foetal protein
  • beta-hCG
  • LDH

Urine M/C/S

US

18
Q

Which testicular cancers produce tumour markers?

A

Non seminoma, germ cell tumours

19
Q

What are two causes of epididymo-orchidis?

A

STI

UTI - risk factors

20
Q

Where does testicular cancer commonly metastasize to?

A

Retroperitoneal LNs

Lungs

21
Q

Is testicular cancer usually painful?

A

No

22
Q

Which LNs does testicular cancer metastasize to?

A

Retroperitoneal

23
Q

What are some predisposing factors fro testicular torsion?

A

Cryptorchism

Bell clapper deformity (tunica vaginalis joins high on the spermatic cord - easier to rotate)

24
Q

How does epididymo-orchitis present? How is it treated?

A

Insidious onset pain

+/- discharge and LUTS

Elevation

Analgesia

Empirical Abx