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47 Cards in this Set
- Front
- Back
How do you tell if a mass is cystic in the testes or not?
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Transillumination
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What's the most common cancer in men under 35?
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Testicular cancer
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What races most commonly get testicular cancer?
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Caucasian > Asians > African americans
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What are risk factors for testicular cancer/
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Race
Age Previous testis cancer Cryptorchidism (SUPER HIGH RISK!!!) Male infertility |
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What are the signs and symptoms of testicular cancer?
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Mass/swelling
Pain Trauma |
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What's the best diagnostic tool for testicular cancer?
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PE
Scortal US |
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What are serum markers for testicular cancer?
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AFP
Beta-HCG |
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If there's a solid mass in the testes, what is it until proved otherwise?
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Germ cell malignancy
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What's the management of a testicular mass?
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Surgical exploration.
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What's the management of a testicular neoplasm?
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Radical Orchiectomy: you take the testes along with the entire spermatocord out up to the internal ring (lymphatic reasons)
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What imaging studies should you order up in a man with testicular cancer? Why?
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CT scan
CXR Tumor marks (pre, post-op) Look for mets. |
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What is the HCG in a:
Choriocarcionma? Embryonal? Seminoma? |
Choriocarcionoma: SUPER HIGH! (thousands.)
Embryonal: rather high Seminoma: only ocasionally elevated |
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What kinds of testicular tumors show an elevated AFP?
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Yolk sac
Pure embryonal Teratocarcinoma |
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What kind of tumor never shows an elevated AFP?
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Pure seminomas
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What's the staging of germ cell neoplamss?
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A: confined to testis
B: nodal involvmeent in retroperitoneum C: nodal spread beyond the retroperitoneum D: other solid organs. |
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What's the spread of a choriocarcinoma?
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Hematogenously
Can easily met to other organs: lungs. Commonly mets to lungs. |
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What's the therapy for a seminoma in stage A or B1?
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radical orchiectomy
External radiation. Watchful waiting (lots of CT scans) Easily curable. |
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What's the treatment for a stage B2 or C seminoma?
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Radical orchiectomy
Chemo 85% survival |
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What's the therapy for a non-seminoma germ cell tumor?
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Stage A:
Radical orchiectomy or Chemo or Close observation or Retroperitoneal lymph node dissection |
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What's the therapy for a NSGCT B2 tumor?
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Chemo
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What's the therapy for a stage B3, C, or D NSGCT?
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Radical orchietomy
Chemotherapy |
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What's the most common age for testicular torsion?
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12-18
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What's the disease process of testicular torsion?
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Twisting of the spermatic cod causes testicular ischemia
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How long does it take for ischemic damage to happen to a testicle?
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6 hours.
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What's the presentation of testicular torsion?
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Acute pain in absence of trauma (I was sound asleep and was awakened by my ballz hurting)
Nausea vomiting Low-grade fever |
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What is the presentation of a testicle that is under torsion?
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Anterior epididymis
Testicle is horizontal instead of verticle High in the scrotum TENDER TO PALPATION!! |
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What's on the differential diagnosis for acute scrotal pain?
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Epididymitits
Testicular tumor Orchitis Torsion of appendix testis Traumatic rupture of testis |
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What are some good diagnostic tests for testicular torsion?
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Doppler ultrasound: see where the blood flow is going! (if at all)
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What's the treatment for a testicular torsion?
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Surgery!
If dead, take it out If viable, suture it to the scrotal wall (as well as the other) |
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What's the effect of not taking out a dead testicle?
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Negative anti-fertility effects on the other testicle
Necrosis and all of the associated complications |
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What is pathomnemonic for a a toresed epididimyal appendix?
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Blue dot sign
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What is the normal location for epididymitis/orchitis?
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Retrograde infection up the vas deferens
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What kind of infection causes epididymitis/orchitis?
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TB
VIral |
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What's the most common cause of epididymitis/orchitis?
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Sexual activity (far and away the most common)
Congenital anomalies Bladder outlet obstruction Neurogenic bladder dysfunction |
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What's the presentation of someone with epididymitis/orchitis?
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Scrotal pain, swelling
Voiding symptoms Fever Hydrocele Epididymal pain instead of testicular |
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What found upon urinalysis in epididymitis/orchitis?
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Pyuria
Bactiruria |
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What kind of bacteria cause epididymitis/orchitis in:
Peds? Young adults? Older adults? |
Peds and older adults: gram negative enterics (E. coli)
Young adults: chlamydia, gonorrhea |
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What's the treatment for epididymitis/orchitis?
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Gm- enterics: SMX: TMP, quinolones
STDs: tetracyclines, ceftriaxone, quinolones |
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What are the benign masses of the scrotum?
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Hydrocele
Spermatocele Varicocele Hematocele |
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What underlies a hydrocele?
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Imbalance between production and absorption
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What's the difference between the location of a hydrocele and spermatocele?
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Hydrocele: anterior
Spermatocele: posterior |
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What is the cause of a varicocele?
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Abnormally dilated internal spermaticvein
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Where are varicoceles found most of the time? Why?
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Left side.
Due to the spermatic vein going into the vasculature at a right angle |
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If someone has an isolated R side varicocele, what should you do?
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IMAGE THE ABDOMEN!
-Tumors |
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What's the history of symptoms from a varicocele?
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Dull pain as the day continues
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What's the therapy for a varicocele?
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Ligate the veins.
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What's the cause of a spermatocele?
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Rupture of epididymal ducts
Asymptomatic |