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URR 53 Flashcards

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1
Q

Leydig Cell Tumors occur in patients age __-__ years or __-__ years

A

5
10
30
60

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2
Q

painless, palpable mass in the testicle; produce testosterone and sometimes estrogen

A

leydig cell tumor

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3
Q

Leydig cell tumors have ___ AFP and ___ beta hcG levels

A

normal
normal

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4
Q

Leydig cell tumors can cause endocrine imbalance with estrogen and testosterone (endocrinopathy) leading to ___, ___, ___

A

precocious puberty
impotence
gynecomastia

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5
Q

small (<1m), solid, homogenous mass in the testicle; large, mildly irregular borders; hypoechoic; area of hemorrhage may be seen

A

leydig cell tumor

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6
Q

If there is increased peripheral vascularity around a Leydig cell tumor it is usually ___

A

benign

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7
Q

rare; malignant or benign; painless mass in the testicle; may calcify; usually bilateral and multifocal

A

Sertoli cell tumors

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8
Q

Sertoli Cell Tumors can cause endocrine imbalance with ___ and ___ (endocrinopathy_ leading to precocious puberty, impotence, gynecomastia

A

estrogen and testosterone

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9
Q

Sertoli cell tumors are similar to ____ in symptoms and appearance

A

Leydig cell tumors

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10
Q

Gonadal stomal tumor cells combined with germ cell tumor cells

A

gonadoblastoma

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11
Q

The majority of gonadoblastomas occur with ___ and ___

A

cryptorchidism
hypospadias

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12
Q

sex cord cells

A

germ cell stromal

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13
Q

Testicular metastasis usuallly comes from ___ or ___ primary

A

prostate
lung

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14
Q

Testicular metastasis is more common than germ cell tumors in patients >__ years old

A

50

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15
Q

___ carcinoma is typically unilateral, while ___ carcinoma is typically bilateral

A

primary
secondary

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16
Q

most common bilateral testicular tumor

A

lymphoma

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17
Q

most common secondary malignancy of the testes

A

lymphoma

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18
Q

The majority of patients with lymphoma diagnosed with testicular masses are between the ages of __ and __

A

60
70

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19
Q

When lymphoma metastasizes to the testicles, extension into ___ and ___ is common

A

epididymis
cord

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20
Q

homogeneous and hypoechoic tissue replaces the testes tissue; hemorrhage and necrosis is rare; increased vascularity

A

lymphoma

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21
Q

2nd most common metastatic neoplasm to the testicles; can be focal or diffuse; can be unilateral or bilateral

A

leukemia

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22
Q

nonspecific, similar to lymphoma; hypoechoic enlargement of the teste; hypervascularity

A

leukemia

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23
Q

Adrenal Rests are associated with ___ and ___

A

Cushing syndrome
adrenal hyperplasia

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24
Q

hypoechoic, multifocal masses; wheel spoke vascularity

A

adrenal rests

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25
Rare tumors of the scrotum and testicles
adrenal rests epidermoid cysts malakoplakia carcinoid mesenchymal
26
Sarcoidosis presents as:
recurrent epididymitis
27
inflammatory disease that can affect multiple organs; can be found in testicles and/or epididymis; irregular, hypoechoic solid mass in testicle; can also be diffuse with multiple hypoechoic nodules; enlarged epididymis with hypoechoic nodule formation
sarcoidosis
28
While most ____ tumors are malignant, most ____ tumors are benign
intratesticular extratesticular
29
Most extratesticular tumors involve the:
epididymis
30
___ can form nodules in the epididymia
Sarcoidosis
31
___ are a common residual effect of a vasectomy
spermatic granulomas
32
most common extratesticular tumor
adenomatoid tumor
33
rouded or ovoid with varying echogenicity; well circumscribed; hypovascular/avavsular
Adenomatoid tumor
34
Extratesticular malignant neoplasms (4)
fibrosarcoma liposarcoma lymphoma rhabdomyosarcoma
35
Metastasis to the ___ is rare
epididymis
36
Which of the following is normal with seminomatous tumors but abnormal with non-seminomatous tumors? a. AFP levels b. bhCH levels c. testosterone d. white blood cell count
a
37
When a solid tumor is identified in the testicle, what should be done to further evaluate this patient? a. post void bladder volume b. Penile Doppler c. Aortic evaluation d. Segmental pressure exam
c
38
Which of the following can be used to describe the expected ultrasound appearance of a testicular seminoma tumor? a. homogeneous b. microcalcification c. cystic degeneration d. hypoechoic with low level internal echoes
d
39
Non-seminomatous tumors are: a. more aggressive than seminomatous tumors b. unresponsive to treatment c. cause visceral metastasis d. all the above
d
40
Which of the following tumors would present with elevated AFP and bhCG levels? a. mixed germ cell b. embryonal cell carcinoma c. testicular teratoma d. all the above
d
41
Any germ cell tumor that secretes high levels of bhCG can lead to the formation of: a. gynecomastia b. ascites c.microcalcifications d. abscess
a
42
What benign tumor is associated with estrogen and testosterone production? a. adenomatoid b. leydig cell c. lymphoma d. leukemia
b
43
Primary testicular cancer is typically __, while secondary testicular cancer is typically __. a. unilateral, bilateral b. heterogeneou, homogenous c. hypovascular, hypervascular d. fatal, treatable
a
44
What are the two most common secondary testicular cancers? a. embryonal cell, yolk sac b. choriocarcinoma, Leydig cell c. lymphoma, leukemia d. adrenal rest, adenomatoid
c
45
Which scrotal mass is associated with Cushing syndrome? a. Leydig cell b. Sertoli cell c. Adrenal rest d. adenomatoid
c
46
Collection of abnormal dilated serpiginous veins posterior to the tests that extend to the spermatic cord (pampiniform plexus)
varicocele
47
Normal serpiginous veins diameter
0.5-1.5 mm
48
Most common cause of male infertility
varicocele
49
____ varicoceles are caused by incompetent valves in internal spermatic vein
idiopathic
50
___ varicoceles are caused by abdominal mass or hydronephrosis
secondary
51
The ____ side is more common for a varicocele
left
52
Why is the left side more common for a varicocele?
left gonadal vein emptying into left renal vein, not IVC
53
Varicocele can also be related to __ or ___
inguinal hernia herniorrhaphy
54
superior mesenteric artery compresses the left renal vein caused increased pressure and stasis in the venous systems of the left kidney and left testicle
Nutcracker Syndrome
55
multiple tortuous anechoic structures proximal to the upper pole of the testis
extratesticular varicoceles
56
Multiple cystic structures within the rete testes that fill with color on Doppler evaluation
intratesicular varicocele
57
When investigating for varicoceles, the ___ will aid in showing the serpiginous veins dilate
Valsalva maneuver
58
A serpiginous vein >__ diameter is abnormal with patient supine
2mm
59
If the patient stands for scrotal exam, ____ causes serpiginous vessels to dilate
hydrostatic pressure
60
Serpiginous vessel >__ is abnormal for standing scrotal exam
2.5
61
The upper abdomen should be evaluated for the presence of a mass when a varicocele is found on the ___ side
right
62
The ___ should be scanned when a varicocele is found on the left side
left kidney
63
loss of blood flow to a portion or all of the testicle; can be focal or diffuse
infarction
64
Testicular infarction is related to ___, ___, ___, ___, and ___
torsion trauma bacterial endocarditis leukemia vasculitis
65
varying echogenicity with age; acute shows a hypoechoic area; chronic shows hyperechoic, calcifications, reduced size of testicle
testicular infarction
66
Testicular torsion <4 hours
absent flow in testicle, normal teste
67
Testicular torsion >4 hours
increased teste size, heterogeneous, hydrocele, absent flow
68
Testicular torsion >24 hours
scrotal wall thickening areas of infarct and necrosis within teste
69
Testicular torsion most common before age of:
30
70
___ and those with ___ present a greater risk for torsion
larger testicles tumor formation
71
Symptoms of testicular torsion
acute testicular pain swollen scrotum nausea vomiting
72
Teste salvage rate <6 hours
excellent
73
Teste salvage rate 6-12 hours
declining
74
Teste salvage rate >12 hours
poor
75
Treatment for testicular torsion
manual detorsion orchiectomy with possible prosthetic placement
76
___ and ___ can undergo torsion without the testicle being affected
epididymis appendix testis
77
clinical finding with torsion of the appendage; blue dot just under skin surface of scrotum
blue dot sign
78
most common cause of acute scrotal pain in prepubertal boys
torsion of the appendix testis
79
variable echogenicity of the testis; area of infarct may be seen in progressive; thickened scrotal wall and spermatic cord
testicular torsion
80
Sonographic appearance of acute testicular torsion
enlarged testicle hypoechoic and mottled appearance
81
absence of intratesticular flow
complete testicular torsion
82
may still demonstrate some high resistance flow with absent or reversed diastolic flow in the affected teste
partial testicular torsion
83
RI value greater than 0.7 in one testicle suggests:
partial torsion
84
Complete testicular torsion results in an RI value of:
1
85
hypoechoic enlarged epididymis with variable echotexture and no vascularity; normal testicular appearance and vascularity
epididymal torsion
86
hypoechoic enlarged mass with variable echotexture and no vascularity; located between a normal teste and a normal epididymis; normal testicular and epididymal appearance and vascularity
torsion of the appendix testis
87
areas of hemorrhage and infarction can be seen; hematocele formation; critical finding
ruptured testicle
88
Treatment for a ruptured testicle
orchiectomy with possible prosthetic placement
89
small intestine, colon, and/or omentum falls into scrotal sac through abnormal opening in the inguinal canal
scrotal hernia
90
echogenic material within scrotal sac; may see dirty shadowing from air within bowel; valsalva used to demonstrate peristalsis of herniated abdominal contents
scrotal hernia
91
extravasation of the spermatozoa into tissues around epididymis; solid hypoechoic or heterogeneous mass; may contain calcification
sperm granulomas
92
rare, non-neoplastic mass, made of fibrous tissue; solid hypoechoic or heterogeneous mass
fibrous pseudotumor
93
fluid accumulates in the tissues of the scrotum
scrotal wall thickening
94
Inflammatory causes of scrotal wall thickening include __ and __
cellulitis Fournier gangrene
95
Risk factors for inflammatory scrotal wall thickening include __, __, or the patient is __
obesity diabetes immunocompromsed
96
Sonographic features of scrotal wall thickening
scrotal wall thickness >8mm presence of hypoechoic areas with increased vascularity
97
Non-inflammatory causes of scrotal wall thickening include ___, ___, ___, ___
CHF lymphedema liver failure lymphatic and venous obstruction
98
epididymal enlargment and inhomogeneity; development of sperm granulomas and cysts; dilated rete testis no hypervascularity
post-vasectomy changes
99
___ and ___ are common complications of cryptorchidism
infertility cancer
100
most common scrotal mass and is commonly seen in the post-vasectomy patients
spermatocele

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