......

It is critical to make a diagnosis of testicular torsion because testicular viability decreases after:

6 hours

The majority of extra-testicular masses are:

Benign

Difficulty voiding, frequency of urination, small stream is a sign and symptom for:

Benign prostatic hyperplasia

Which of the following is not true about adenocarcinoma of the prostate?

Commonly seen in whites

Epididymitis appears sonographically as a (n):

Hypoechoic epididymis with diffuse enlargement of the gland

Which of the following would be a tumor that is consists of 3 germ layers?

Immature teratoma Leukemia

The -- -- -- -- -- -- & -- -- -- -- -- -- -are the most common primary sites for testicular metastasis.

Kidneys & the prostate

What is the most common bilateral malignancy of the testicles?

Lymphoma

Which of the following laboratory value is associated with prostate pathology?

Prostate - specific antigen

With an intratesticular mass, further investigation includes evaluations of which tumor markers:

Beta-HCG

Testicular malignancy is most often a disease affecting which of the following age group?

Between 15 & 35

Where is a hydrocele located?

Between the two layers of the tunica vaginalis

What are epididymal cysts filled with?

Clear fluid

What are the two types of benign testicular cysts?

Cysts of the tunica albuginea, intratesticular

Benign prostatic hyperplasia is an enlargement of the inner gland which appears as what?

Hypoechoic relative to the peripheral zone

A 50 year old male is seen by his MD for a painless scrotal mass and hardening of his testicle. His blood work revealed an increase in HCG. An ultrasound showed a hypoechoic, solid, intratesticular mass in his right testicle. The most likely diagnosis is:

Seminoma

A 35-year-old patient presents to the US department with a history of testicular cancer. Which of the following is not a primary testicular cancer?

Papillary carcinoma

Which of the following is the MOST common malignant tumor of the testicles?

Seminoma

Most hydroceles congenital

True

A 17-year- old boy presents in the emergency room with scrotal pain. The sonogram reveals an enlarged testicle, decreased echogenicity, thickening of the scrotal wall, and no flow. These findings are consistent with:

epididymis

Which sonographic technique is used to document a varicocele

valsalva maneuver

In older patients the prostate glands considered enlarged:

> 40 grams

On sonographic examination, a seminoma appears as:

Solid hypoechoic mass

A 20-YO afebrile patient presents with palpable scrotal mass. He denies any history of scrotal trauma. Based on his clinical history the sonographic findings are most suspicious for which of the following pathologies?

Spermatocele

Which of the following is not associated with Klinefelter syndrome?

Polyorchidism

A 75 year old man went to the doctor because of painful urination and nocturia. He was diagnosed with prostatitis and a urinary tract infection. During the ultrasound there was an incidental finding of an anechoic, well-defined, circular lesion with posterior enhancement in the transitional zone of his prostate. His doctor told him not to worry because this was a benign finding. These findings are consistent with:

Prostate Cyst

Scrotal calcification are also called what

Scrotal pearls

What is the most common extratesticular tumor?

Adenomatoid tumor

Prostate specific antigen is elevated in case of:

BPH

What is yolk sac tumors associated with?

Elevated alpha fetoprotein

The most common cause of painless scrotal swelling is?

Hydrocele

95% of all BPH arises in the:

Transitional zone

The most frequent cause of an acute scrotum in the post puberty male is?

Epididymitis

What is the congenital anomaly where the testicle is no attached to the tunica vaginalis and rotates freely on spermatic cord?

A bell clapper deformity

A varicocele is an:

Abnormal dilatation of the draining veins of the scrotum seen in association with infertility

What pathology is most likely demonstrated on a 64-year- old man with elevated prostate-specific antigen and Prostatic acid phosphatase level and the endorectal sonogram documenting an 8.9 mm hypoechoic mass in the right peripheral zone?

Adenocarcinoma of the prostate

A 42 year old male had a recent CT of his brain which detected metastasis. Labs were done after wards and an elevated hCG level was detected. His family Doctor sends him for a scrotal ultrasound. The patient reports to the sonographer that he has a history of cryptorchidism which they did not fix until he was 10. Ultrasound detects a hypoechoic mass in the right testicle and calcifications. A biopsy is performed and the patient is told he needs anorchiectomy. These findings are consistent with:

Choriocarcinoma

Which testicular carcinoma with the worst prognosis and presents as a focal or diffuse hypoechoic mass with indistinct boundaries?

Choriocarcinoma

What is the most common testicular tumor in infants and young children?

Endodermal sinus tumor

Onion ring pattern is the classic appearance of:

Epidermoid cyst

During a testicular ultrasound of a 42 year old male there were incidental findings of anechoic, well-defined, circular lesions with posterior enhancement on his epididymis heads bilaterally. They measured around 0.5 cm by 0.5 cm so they could not be palpated on physical exam and were painless for the patient. These findings are consistent with:

Epididymis cysts

A young male presents to the ultrasound department with a lower urinary tract infection, fever, pain, and a urethral discharge. A testicular ultrasound exam is performed revealing an enlarged thickened epididymis with decreased echogenicity. The echo texture is coarse. The most likely diagnosis is:

Epidiymitis

-- -- -- -- -- -- -- is elevated in case of leydig cell tumors.

Estrogen

A 40 year old male presents to the outpatient center with an enlarged scrotum. The patient indicates that the symptoms began after he had a mountain biking accident. He eventually saw his family doctor who ordered an ultrasound. U/S: Ultrasound revealed a large anechoic space around the testis. Doppler demonstrated normal flow in the testicle, and torsion was ruled out. The most likely diagnosis is:

Hydrocele

Association of prostatic utricle cysts with a variety of genitourinary abnormalities includes all of the following except:

Hydronephrosis

Compared to the normal testicular parenchyma, what is the predominant sonographic appearance of malignant testicular tumors?

Hypoechoic

A 19 year old male comes for a scrotal ultrasound because of a palpable mass in the right testicle. He has gynecomastia and labs showing an increase in estrogen. The most likely diagnosis is:

Leydig cell tumor

Seminoma spread initially to:

Lymph nodes

The majority of intratesticular masses are:

Malignant

Yolk sac tumors are also called what?

Orchidoblastoma

Infection of the testicle, it is called?

Orchits

When an intratesticular mass is discovered, which region should be evaluated for lymph node enlargement?

Para-aortic region

The largest percentage of cancer originates from which are of the prostate

Peripheral zone

A scrotal hernia occurs when bowel protrudes through the inguinal canal into the scrotal sac. The presence of which of the following confirms the diagnosis?

Peristalsis

Prostatic acid phosphatase elevation is associated with what?

Prostate cancer

What pathology is most likely demonstrated on a patient with fever chills and painfully swollen prostate gland, an elevated prostate-specific antigen level, and the endorectal sonogram documenting hypoechoic prostate with increased blood flow. The most likely diagnosis is:

Prostatitis

What is the method of treatment for non-seminomas?

Radical (inguinal) orchiectomy

A 22-year- old man presents with an elevated human chorionic gonadotropin (HCG) level. The sonographer should scan the:

Scrotum

A 10 year old boy went to the doctor because he felt a painless lump in his right testicle. Ultrasound was ordered and a complex mass was seen on the right testicle. The mass appeared to contain a tooth. Lab work came back and both hCG and Alpha feto protein were elevated. These findings are consistent with

Scotal teratoma

Bowel protruding through the inguinal canal into the tunica vaginalis of the scrotum is called:

Scrotal hernia

A 54 year old male comes in for a scrotal ultrasound. He is asymptomatic and his labs are normal. The ultrasound reveals normal testicles but on the right there are two, mobile, echogenic, shadowing, 5mm masses within the scrotal wall. The most likely diagnosis is?

Scrotal pearls

What has the most favorable prognosis of all testicular tumors?

Seminomas

A 12 year old male is brought to the ER after getting into a fight at school during which he was hit in the crotch. The patient reports pain and swelling of his scrotum. Labs show a decreased hematocrit. An ultrasound is ordered and shows an enlarged left testicle with irregular borders and hypoechoic areas. The most likely diagnosis is:

Testicular rupture

A 14 year old boy woke up in the middle of night with severe scrotal pain that caused nausea and vomiting. His mother rushed him to the emergency room where an ultrasound was ordered. On ultrasound the left testicle and epididymis were enlarged, a hydrocele was present, and no intratesticular blood flow was noted on the left. The mother informed everyone that her son had a condition known as "bell-clapper deformity". The boy was rushed to the operating room. These findings are consistent with:

Torsion

Clinical findings of sudden scrotal pain and swelling are suggestive of:

Torsion

A 60 year old male is sent for an ultrasound because of a painless palpable mass in his right testicle. He was seen the week before for epididymitis. US show numerous small tubular cystic structures within the rete testis. The most likely diagnosis is:

Tubular ectasia

What dilatation of the seminiferous tubules is usually seen bilaterally and is associated with epididymal cysts and spermatoceles?

Tubular ectasia

Which one of the following is not the risk factor for seminoma?

Turner syndrome

The most common cause of epididymitis in men older than 35 years of age is:

Urinary tract infections

Which prostate anomaly is located midline near the verumontanum?

Utricle cyst

A 36 year old male comes in for scheduled scrotal ultrasound to assess for infertility. The right testicle appears normal measuring 4cm x 3cm x 3cm with good color flow. The left testicle measures 3.5cm x 2.8cm x 3cm which appears normal but the sonographer detects a group of anechoic tubular structures located outside of the testicle. Color Doppler is used and the patient is told to Valsalva, which makes the tubular structures fill with color. These findings are consistent with:

Varicocele

What is the most common correctable cause of male infertility?

Varicoceles

Prostatic utricle cysts always arise from the level of the:

Verumontanum

What should varicoceles distend with all of the following except:

With LLD patient positioning

7 year old boy comes in for a scrotal ultrasound after finding a palpable lump in his left testicle. Lab work shows an increased AFP. Ultrasound reveals a 3.0 cm hypoechoic mass with cystic areas and calcification's. The most likely diagnosis is

Yolk sac tumor