The Male Pelvis

Which of the following is not a component of the spermatic cord? a. Epididymis b. Testicular artery c. Cremaster muscle d. Lymph nodes

a. Epididymis anatomy of the spermatic cord: The spermatic cord consists of (1) ductus deferens, (2) cremaster muscle, (3) external spermatic artery, internal spermatic artery, and arteria ductus deferentis, (4) spermatic nerve, (5) lymph of the spermatic cord, and (6) fascia.

Which of the following is consistent with the sono appearance of testicular abscess? a. Hyperemic flow around abscess but not within it. b. Onion skin sono appearance and hyperemic epididymis c. Hyperemic flow within an anechoic mass d. Hyperemic flow within the abscess but not around it

a. Hyperemic flow around abscess but not within it.

All of the following are sonographic findings consistent with the diagnosis of testicular torsion except: a. Hyperemic flow within the testis b. Hypoechoic testis c. Reactive hydrocele d. Decreased intratesticular flow (compared to unaffected contralateral testis)

a. Hyperemic flow within the testis Hyperemic flow may be present in cases where a testicle has untorsed on itself.

Secondary varicoceles are most likely associated with all of the following except? a. Left-sided location b. Right-sided location c. Hepatomegaly d. Renal mass

a. Left-sided location (Primary varicocele) thought to be causes by an increase in vascular pressure. Secondary varicocele is dilation of right sided veins wich may be associated with. a hepatic mass, hepatomegaly, hydronephrosis, renal mass, or a retroperitoneal neoplasm. If there is right sided varicocele, then a RUQ evaluation should be performed.

The endocrine function of the testicles is to produce: a. Testosterone b. hCG c. AFP d. Sperm

a. Testosterone

Which of the following techniques is useful for providing sonographic evidence of a varicocele? a. Valsalva maneuver b. Sitting position c. Pulsed Doppler d. Roll the patient RLD

a. Valsalva maneuver

What is the most common correctable cause of male infertility? a. Varicocele b. Hydrocele c. Hydrocele d. Spermatocele

a. Varicocele

The most common location of a hydrocele is the: a. Superior to the testis b. Within the scrotal wall c. Between the two layers of the tunica vaginalis d. Between the tunica vaginalis and the tunica albuginea

c. Between the two layers of the tunica vaginalis

A 7 year old boy presents to the emergency department with acute testicular pain localized to the superior pole of his right testis. Differential? a. Testicular torsion b. Hydrocele c. Torsion of a testicular appendage d. Yolk sac tumor

c. Torsion of a testicular appendage

A 23 year old male presents to sonography with a history of infertility. Which of the following is associated with male infertility? a. Spermatocele b. Choriocarcinoma c. Varicocele d. Hydrocele

c. Varicocele

Zinner syndrome consists of unilateral renal agenesis, ejaculatory duct obstruction, and: a) prostate cancer b) seminoma c) bulbourethral stones d) seminal vesicle cysts

d. Seminal vesicle cysts Zinner syndrome- a syndrome that consists of unilateral renal agenesis, ipsilateral seminal vesicle cyst, and ejaculatory duct obstruction

The exocrine function of the testicles is to produce: a. Testosterone b. hCG c. AFP d. Sperm

d. Sperm

What is the most common malignancy of the penis a. Cystadenocarcinoma b. Adenocarcinoma c. Follicular carcinoma d. Squamous cell carcinoma

d. Squamous cell carcinoma

Acute onset of testicular pain at rest is a common clinical finding with a. Testicular carcinoma b. Hydrocele c. Testicular trauma d. Testicular torsion

d. Testicular torsion

The blue dot sign is indicative of: a. Testicular torsion b. Epididymis c. Orchitits d. Torsion of a testicular appendage

d. Torsion of a testicular appendage

Which of the following is a benign intratesticular mass that typically has a whorled or onion skin sonographic appearence? a. Seminoma b. Teratoma c. Epidermoid cyst d. Adrenal rest

Epidermoid cyst

During a sonographic examination of the right testis, you visualize multiple small cysts located along the mediastinim testis. Differential?

Tubular ectasia of the rete testis

A dilated group of veins found within the scrotum is called: a. Varcicele b. Spermatocele c. Hydrocele d. Tubular ectasia of the rete testis

Varicocele

Which of the following houses the male urethra? a. Corpus spongiosum b. Buck fascia c. Bulbouretrhal gland d. Corpus cavernosum

a. Corpus songiosum

The most common location of prostatic cancer is the: a. Peripheral zone b. Transitional zone c. Central zone d. Verumontanum

a. Peripheral zone

All of the following are sonographic findings consistent with torsion of the testicular appendage: a. No intratesticular flow b. small hypoechoic mass adjacent to the testis c. Reactive hydrocele d. Scrotal wall thickening

a. no intratesticular flow

A simple fluid collection surrounding the testis is referred to as a: a. hematocele b. hydrocele c. varicocele d. spermatocele

b. Hydrocele

The most common location of a varicocele is: a. Right side of scrotum b. Left side of scrotum c. Within the inguinal canal d. Within the rete testis

b. Left side of scrotum

A patient presents to the sonography department for a penile sonogram. He complains of a painful curvature of the penis and impotence. Differential? a. Squamous cell carcinoma b. Peyronie disease c. Tinner syndrome d. Testicular fracture

b. Peyronie disease

What is the most common malignancy of the testicles? a. Embyronal cell carcinoma b. Seminoma c. Choriocarcinoma d. Spermatocele

b. Seminoma

The most common location of the BPH is the: a. Peripheral zone b. Transitional zone c. Central zone d. Verumontanum

b. Transitional zone Benign Prostatic hypertrophy (BPH) is the most common reason for enlarged prostate and is most commonly located within the transitional zone. Appears as an enlarged prostate with hypoechoic areas, calcifications, and diffusely heterogeneous. Prostate cancer is most commonly located within the peripheral zone.

Primary varicoceles are associated with all of the following except: a. left-sided location b. retroperitoneal mass c. infertility d. palpable extratesticular mass

b. retroperitoneal mass

Which of the following best describes a spermatocele? a. The most common malignant neoplasm of the scrotum b. A benign intratesticular cyst c. A cyst, found within the head of the epididymis, that may contain debris d. A dilated group of veins fond within the scrotum

c. A cyst, found within the head of the epididymis, that may contain debris

Enlargement of the prostate in older men is most often caused by: a. Prostatitis b. Prostate cancer c. BPH d. Klinefelter syndrome

c. BPH (possibly due to changes in hormone levels)

The lack of the normal fixation of the testis to the posterior scrotal wall is referred to as: a. Klinefelter syndrome b. Blue dot sign c. Bell-clapper deformity d. Cryptorchidism

c. Bell-clapper deformity

The most common germ cell tumor of the testis is: a. Yolk sac tumor b. Embryonal cell carcinoma c. Seminoma d. Teratoma

c. Seminoma

A common cyst most often seen in the head of the epididymis that contains nonviable sperm is the : a. epididymal cyst b. tunica albuginea cyst c. spermatocele d. seminoma

c. spermatocele

What laboratory value can be assessed as a tumor marker to evaluate a patient for testicular malignancy? a. Serum bilirubin b. Amylase c. Alpha-Fetoprotein d. Adrenocorticotropic hormone

c.AFP elevation in Human chorionic gonadotropin (hCG) can also be used as tumor marker for testicular cancer.

Dilated veins of a varicocele will measure: a. >8 mm b. >4 mm c. <2 mm d. >2 mm

d. >2mm

Which of the following would most likely resemble a solid intratesticular mass and be associated with cushing syndrome? a. Choriocarcinoma b. Epidermoid cyst c. Intrastesticular varicocele d. Adrenal rest

d. Adrenal rest Aberrant adrenal rests represent collections of cells that have become trapped within the developing gonad during fetal development. The rests are usually less than 5 mm. They are associated with patients with congenital adrenal hyperplasia and rarely in patients with Cushing syndrome. The sonographic appearance of adrenal rests is variable, with some series describing predominantly hypoechoic masses and others reporting heterogeneously hyperechoic masses with shadowing. Lesions are typically multiple, bilateral, and eccentrically located, usually within the mediastinum testis. Variable vascularity on color Doppler has been reported, being hypovascular rather than hypervascular 4.

What would be the most likely sono appearance of a seminoma? a. Hyperechoic b. Whorled appearance c. Heterogeneous with calcifications d. Hypoechoic

d. Hypoechoic hypoechoic intratesticular mass.

Spermatogenesis occurs within the: a. Tunica albuginea b. Rete testis c. Mediastinum testis d. Seminiferous tubules

d. Seminiferous tubules

What scrotal abnormality is caused by incompetent valves within the pampiniform plexus? a. testicular carcinoma b. testicular microlithiasis c. testicular torsion d. varicocele

d. varicocele

The term cryptorchidism denotes

one or both of the testicles have not descended into the scrotum

What is the most common cancer found in men?

prostate cancer