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35 Cards in this Set
- Front
- Back
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Describe normal testes.
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4.5 x 2.5 cm, rubbery
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Masses arising from testes are usually benign or malignant?
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malignant
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Masses arising from the epididymis and spermatic cord are usually benign or malignant?
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benign
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What can be used to distinguish solid from cystic lesions?
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transillumination
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Describe tumors of the testes.
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usually painless, firm, solid lesions within the substance of the testes that do not transilluminate
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What is hydrocele?
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collection of peritoneal fluid between 2 layers of tunica vaginalis
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Two types of hydrocele
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communicating and noncommunicating
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What can hydrocele be secondary to?
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congenital cause, infection (epididymitis), trauma/torsion, tumors (testicular cancer), S/P ipsilateral renal transplant
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When is hydrocele more common?
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first year of life
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When is hydrocele painful?
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if large or infected, otherwise may have heaviness
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How is diagnosis of hydrocele made?
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with transillumination (but do full testicular exam)
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If you are unsure about diagnosis of hydrocele, what imaging can be used to confirm?
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US
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Tx for hydrocele
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watchful waiting with regular follow ups, surgery to excise the hydrocele sac, but do NOT aspirate
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Why do you not aspirate a hydrocele?
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it will reaccumulate
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If you detect a testicular mass, what must be done the same day?
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call to urology
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How are testis palpated?
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between fingertips of both hands
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What is varicocele?
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engorgement of the internal spermatic veins above the testes
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What does varicocele result from?
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incompetence of the venous valves of internal spermatic venous system
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What side is varicocele usually on?
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left side
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What should you suspect of a varicocele is only on the right side, remains dilated while patient assumes supine position, or if they occur abruptly or grow rapidly?
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suspicious of retroperitoneal or renal mass causing obstruction--do abdominal exam and CT PRN
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Patient complains of a "bag of worms"
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varicocele
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Why is the varicocele usually on left side?
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left spermatic vein empties into L renal vein and then into the IVC, whereas the R spermatic vein empties directly into the IVC (less direct blood flow on left)
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This condition should diminish or disappear when supine
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varicocele
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Tx for varicocele
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reassurance esp. if no symptoms, left sided, and long standing; if new or right- work it up; scrotal support and NSAIDS PRN, watch and wait, surgery indicated if infertility or pain
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What type of hernia is usually found within the scrotum?
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indirect that comes through the external inguinal rings
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What will cause complete intestinal obstruction with hernia?
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bowel may become entrapped in hernia sac and lead to gangrene
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Tx for hernia
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general surgery
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What is a spermatocele?
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refers to a benign, 2-5 cm cystic accumulation of sperm that arises from the head of the epididymis
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If a spermatocele is large, what symptoms might patient have?
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heaviness or pain
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Where is spermatocele palpated?
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near upper pole of the testicle
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If unsure of a spermatocele, what imaging to use?
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US
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If a spermatocele is less than 2 cm, what is it called?
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epididymal cyst
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What is tx for spermatocele?
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watchful waiting; surgery is symptomatic
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What do you do if you are unsure if a mass is within or outside the testis?
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scrotal US and urologic consultation
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