Questions

Testicular cancer would be more likely in a man who is: 30, 40, 50 or 60 years.

30 years old. Most common between 15-35 years.

Within what time frame should a patient with testicular torsion be treated?

6-12 hours.

At what age is a man most likely to develop benign prostatic hyperplasia?

80 y/o

Hydrocele is?

A type of swelling in the scrotum that occurs when fluid collects in the thin sheath surrounding a testicle. The testes and epididymis are completely surrounded by the tunica vaginalis, a serous pouch derived from the peritoneum during fetal descent of the testes into the scrotum.

The primary function of the epididymis is to a. store and transport sperm cells b. produce sperm c. produce testosterone d. transport blood to the testicles

A.

Which hormone is responsible for the cremasteric reflex?

Androgen levels influence the contractility exhibited in the cremasteric reflex. Transinguinal migration, thought to be under hormal control, occurs at 28-40 weeks'gestation, usually resulting in a scrotal testis by the the end of a full term of gestation.

Prostate gland enlargement that narrows the urethral lumen and leads to increased prostatic smooth muscle tone is:

BPH is an enlargement of the prostate gland that narrows the urethral lumen and leads to increased prostatic smooth muscle tone. develops primarily in the periureteral or transitional zone of the prostate.

Inflammation of the foreskin and glans is called

Balanoposthitis is an inflammation of the foreskin and glans in uncircumcised boys or men. Multiple bacterial of fungal origins have been identified, it may also be caused by contact dermatitis.

The most likely cause of epididymitis in men younger than 35 years is: proteus escherichia coli pseudomonas aerugiosa chlamydia tracomatis

Chlamydia

The most common cause of epididymitis in sexually active men A. E coli infection b. cytomegalovirus infection d chlamydia infection e. mycobacterium infection

Chlamydia infection

The most common pathogen responsible for epididymitis in men younger than age is : Haemophilius influenza Chlamydia trachomatis Staphylococcus aureus Candida albicans

Chlamydia trachomatis and N. Gonorrhea aret he most common etiologic agents of epididymitis in patients younger than 35 y/o, while enterobacteriacease and gram-positive cocci are frequent pathogens in older patients

The Np assesses a 7 week old boy and determines that the testicles that have not passed down into the scrotal sac. This condition is called:

Cryptochidism (undescended testes) is a condition seen in newborns when one or both of the testes have not passed down into the scrotal sac. More common in premature infant boys because the testes do not descend from the abdomen onto the scrotal sac until the seventh moth of fetal development.

Which patient would the NP deem least likely to devlop BPH based on the stated comorbidities? a. 50 y/o man who is obese b. 45 y/o man with multiple sclerosis c. 60 y/o w/ chronic UTI d. 65 y/o w/ renal insufficiency

D. Inflammatory infiltrate's are present in the prostate glands of a high % of pts with BPH. Causes of the inflammation include etiologies of obesity, autoimmune processes, and chronic infections.

The function of the vas deferens is to: a. secrete prostate fluid and transport it to the urethra during ejaculation b. prevent compression of the urethra during erection c. produce sperm and androgens d. transport sperm from the epididymis to the ejaculatory educts.

D. The vas deferens transports sperm from the epididymis to the ejaculatory ducts in anticipation of ejaculation. It is a partially coiled tube that exits the abdominal cavity through the inguinal canal.

What is the function of the epididymis? a. to propel sperm into the urethra b. to produce semen c. to produce sperm dd. to store and mature sperm

D. This structure allows for the storage, maturation and transport of sperm.

The structure that aids in the storage and transport of sperm cells and facilitates maturation of sperm in the a. testicle b. tunica vaginalis c. epididymis d. prostate

Epididymis

Inflammation of the testicles caused by movement of bacterial pathogens from the urethra or prostate is:

Epididymitis -usually results from the movement of bacterial pathogens from the urethra or prostate.

When performing a testicular exam, the NP assesses for the Prehn sign and the patient reports scrotal relief. What does a positive Prehn's sign suggest?

Epididymitis-The Prehn sign is assessed by elevating the testicle and determining whether the patient experiences relief from acute scrotal pain.

Epididymitis with orchitis is commonly related to: a. inflammation of the glans penis b. sexually transmitted infections c. genitourinary tract infections d. candidal infection

Genitourinary tract infections that travel to the epididymis and testes through the vas deferens or the lymphatics of the spermatic cord.

An accumulation of blood in the tunica vaginalis that causes the discoloration of the scrotal skin is called

Hematocele may develop as a result of a surgical abdominal procedure, scrotal trauma, a bleeding disorder, or a testicular tumor.

What is the term for a collection of peritoneal fluid in the tunica vaginalis?

Hydrocele is a collection of peritoneal fluid between the parietal and visceral layers of the tunic vaginalis that directly surrounds the testis and spermatic cord. It is the same layer that forms the peritoneal lining of the abdomen.

During an examination of a 3-month-old child, transillumination identifies fluid in the scrotal sac. The NP diagnosis

Hydrocele occurs when fluid collects in the thin sheath surrounding a testicle, resulting in scrotal swelling.

A congenital abnormality in which the urethral opening is located ventrally is:

Hypospadias

Which congenital disorder of the penis results from embryologic defects in the development of the urethral grove and penile urethra? a. phimosis b. hypospadias c. balanoposthitis d. peyronie's disease

Hypospadias is a congenital defect thought to occur embryologically during urethral development, between 8 weeks and 20 weeks gestation. The theory is that the urethral folds coalesce in the midline from base to tip, forming a tubularized penile urethra and median scrotal raphe.

Which of the following is NOT likely associated with the development of breast cancer in men? infertility Cryptorchidism Orchitis Advancing Age

Infertility

A comorbidity that may accompany a communicating hydrocele is: a. testicular torsion b. varicocele c. inguinal hernia d. scrotal tumor

Inguinal hernia. In utero, the testicles develop near the kidneys and prior to delivery descend through an opening (channel) in the inguinal muscle ring.

Which of the following statements describes the pathology of priapism? a. caused by increased venous blood flow to the penis b. results from a failure of venous outflow from the penis c. results from a contraction of the intracavernous smooth muscle. d. results from blockage of the spermatic cord.

It results from a failure of venous outflow from the penis.

A man presents with complaints of pain isolated to the left testicle. The NP suspects testicular torsion. Which of the following questions is most important? a. are you at risk for a sexually transmitted infection? b. have you noticed any blood in your urine? c. how long ago did the symptoms start? d. Have the symptoms been associated with fevers?

The testicle can sustain irreversible damage after 12 hours of ischemia from testicular torsion. Infertility may result, even with a normal contralateral testicle, because disruption of the immunologic "blood-testis" barrier may expose antigens from germ cells and sperm to the general circulation an d lead to the development of anti-sperm antibodies

Which of the following organisms is the most common cause of acute epididymitis in men who are younger than 35 years old? N. gonorrhea e.coli pseudomonas mycoplasma genitalium

N gonorrhea and C. trachomatis are the most common organisms responsible for acute epididymitis in men younger than 35 years old.

Presence of which of the following hormones is crucial in achieving an erection?

Nitric oxide pathway is of critical importance in the physiologic induction of erections. Sexual stimulation causes the release of neurotransmitters from cavernosal nerve endings and relaxation factors from endothelial cells lining the sinusoids.

The most important prerequisites for penile erection are adequate arterial flow and: a. nitic oxide b. noradrenaline c. acetylcholine d adenosine prostanoids

Nitric oxide. High levels of intrapenile nitric oxide act as a local neurotransmitter to facilitate the relation of intracavernosal trabeculae, thereby maximizing blood flow and penile engorgement.

A condition characterized by constriction of the opening in the foreskin and inability to retract is over the glans penis is:

Phimosis, the prepuce is too tight to be retracted to reveal the glans penis. Physiologic phimosis occurs naturally in newborn boys. Pathologic phimosis is an inability to retract the foreskin after it was previously retractable or after puberty, usually secondary to distal scarring of the foreskin.

A 40 y/o man presents w/untreated genitourinary gonococcal infection. It has been 2 months since the onset of symptoms, and the disease is now sever. At this point he may have developed: phimosis hematuria priapism balanitis

Phimosis- Gentiourinary gonococcal infections tend to be more symptomatic in men than women. IN addition to dysuria and the spontaneous profuse purulent penile discharge that typically characterizes gonococcal urethritis in men, edema and erythema commonly develop at the urethral meatus.

Which condition involves entry of microorganisms into the prostate gland via the urethra?

Prostatitis-In most cases, bacteria migrate from the urethra or bladder through the prostatic ducts, with the intraprostatic reflux of urine. as a result, concomitant infection in the bladder or epidymis may occur.

Alpha blockers are recommended in the treatment of benign prostatic hyperplasia because they:

Relax the smooth muscle of the prostate. Alpha 1 adrenoceptor subtype mediates prostate muscle contraction of the prostate. thus alpha 1 adrenergic antagonists are recommended for initial therapy of symptomatic BPH in most patients

The cremasteric reflex assesses a 6 month old patient for: a. retractile testicles b. testicular torsion c. hydrocele d. cryptochidism

Retractile testicles. When the cremaster muscle contracts, it pulls the testicle up toward the body.. The cremaster is also activated by a cold environment. If the cremaster reflex is strong enough, it can result in a retractile testicle, pulling the testicle out of the scrotum and up into the groin.

Which of the following is an inadequate fixation of the lower pole of the testis to the tunic vaginalis that causes ischemia and reduced arterial inflow?

Testicular torsion results from inadequate fixation of the lower pole of the testis to the tunica vaginalis. If fixation is absent or insufficiently broad-based, the testis may torse (twist) on the spermatic cord, potentially producing ischemia from reduced arterial inflow, as well as venous outflow obstruction.

Which one of the following conditions occurs when a testicle rotates on the long axis in the tunica vaginalis?

Testicular torsion. Most cases, congenital abnormalities of the tunica vaginalis or spermatic cord exist.

When assessing a man for hypogonadism it is important to check: a. FSH level b. androstenedione level c. testosterone level d. cortisol level

Testosterone level.

Which of the following tests is performed to distinguish testicular torsion from epididymitis? a. The "turn & cough" test b. The digital rectal exam c. The prehn sign d. the cremasteric reflex

The Prehn sign. Elevation of the scrotal contents relieves pain in the patients with epididymitis an aggravates or has no effect on the pain in patients with testicular torsion.

The fascia layer of the male anatomy that the anterior 2/3 of the testicle is

Tunic vaginalis fascia layer that encapsulates the anterior 2/3 of the testis.

Which one of the following is NOT a cause of subacute epididymitis?

Urinary tract infection- Several factors may predispose postpubertal boys to develop subacute epididymitis, including sexual activity, extreme physical exertion, and direct trauma. (bicycle or motorcycle riding)

The assessment that is performed to determine a variocele is the: a. Phalen's sign b. Valsalva maneuver c. cremasteric reflex d. Allen's test

Valsalva Maneuver- Varicocele is diagnosed by its characteristic physical findings which range from minimal Left-sided scrotal fullness on Valsalva maneuver to a large, soft, left-sided scrotal mass(bag of worms) that decompresses and disappears when the patient is in the recumbent position.

A collection of abnormally large dilated veins in the scrotum is a

Varicocele is a collection of abnormally large dilated veins (typically the internal spermatic vein and pampiniform plexus) in the scrotum, usually situated above a testicle. Varicocele is a recognized cause of decreased testicular function and occurs in approx. 15-20% of all men and in 40% of infertile men.

Phimosis refers to

a tightening of the foreskin that prevents retraction over the glans. The prepuce (foreskin) is too tight to be retracted to reveal the glans penis.

A 10 y/o boy reports sudden onset of left testicular pain and the NP suspects torsion of the

appendix testis- the most common cause of acute scrotum pain in children. the appendix testis is a small vestigial structure on the anterosuperior aspect of the testis, and it is an embryoloic remnant of the Mullerian duct system.

In a young boy, an exaggerated cremasteric reflex may lead to the misdiagnosis of :

cryptorchidism- The cremasteric reflex is dependent upon L1 and L2 nerve roots. The ilioinguinal nerve and the genital branch of the genitofemoral nerve pass through the inguinal canal.

An elongated cordlike structure on the posterior border of the testes that is responsible for the storage, transport, and maturation of sperm is the:

epididymis. its coiled duct provides for the storage, transport, and maturation of sperm. The von deferens carries sperm from the testicle to the urethra.

Gynecomastia is caused by: a. depletion of testosterone b. estrogen-androgen imbalance c. elevated progestin levels d. increased cortisol secretion

estrogen-androgen imbalance. Gynecomastia is the benign hypertrophy of mammary tissue in males. It can affect one or goth breasts, sometimes unevenly. It may be caused by increased estrogen activity, decreased testosterone activity, or the use of numerous medications.

A noncommunicating hydrocele is not caused by genetics infection injury blockage of the spermatic cord

genetics -A hydrocele is a collection of serous peritoneal fluid within the scrotum. A noncommunicating hydrocele may result from increased fluid production or impaired fluid absorption.

Priapism is caused by

impaired blood flow in the corpora cavernosa Priapism is an involuntary, prolonged (4-6 hrs), abnormal and painful erection caused by impaired blood flow in the corpora cavernosa. In ischemic priapism, a stasis of blood flow in the corpora cavernosa nd detumescence (relaxation of an erect penis) occur. In non-ischemic priapism , persistent arterial flow into the corpora cavernous occurs.

A consequence of cryptorchidism is: hypospadias atrophic testes infertility hydrocele

infertility Cryptorchidism is the incomplete descent of one or both testicles into the scrotum. The impairment of germ cell maturation is a recognized consequence. Early positioning of the testis into the scrotum increases the likelihood of fertility.

The gonad that is responsible for the production of sperm and androgens is the a. testicle b. tunica vaginalis c. epididymis d. von deferens

testicle-the gonad that is responsible for the production of spern and androgens (primarily testosterone).

Which men's health disorder leads to irreversible damage if it is not treated immediately? epididymitis bph testicular torsion gonorrhea

testicular torsion may experience irreversible damage after 12 hours of ischemia. Infertility may result, even with a normal contralateral testicle, because disruption of the immunologic "blood-testicle" barrier may expose antigens from germ cells and sperm to the general circulation and lead to the development of antisperm antibodies.

In which condition is the cremasteric reflex absent?

testicular torsion- The finding of an absent ipsilateral cremasteric reflex is the most accurate sign of testicular torsion. The cremasteric reflex is a superficial reflex in men that is elicited when the inner part of the thigh is stroked.