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WorksheetsPreTest Kuliah 1 - Scrotal Mass
Total questions: 20
Worksheet time: 20mins
A 15 year old boy presents to emergency room with severe lower abdominal pain that awoke him from sleep about 5 hours ago. The pain is sharp and radiating to the left thigh. While in the emergency room, the patient has one episode of vomiting. He denied any fever, dysuria or chills. Physical examination reveals normal vitals with blood pressure 100/60 and temperature of 37C. Abdominal examination is relatively benign. Scrotal examination reveals an elevated left testis that is diffusely tender to palpation. Cremasteric reflex is present on the right but absent on the left. Most important next step in managing this patient :
CT scan Abdomen and Pevlis
Testicular Ultrasound
Surgical Exploration
Intravenos Antibiotics
Plain X-Ray KUB
A 10-year-old Caucasian boy presents with right scrotal pain of 7 hours duration. The pain is acute in onset, constant and does not change with position. The patient denies any fever, chills, dysuria, nausea or vomiting. He denies any recent history of trauma. On physical examination, the patient is afebrile and is in moderate distress secondary to pain. There is no urethral discharge. Cremasteric reflex is present bilaterally. There is bluish discoloration and localized tenderness in the upper part of the testes. Labs reveal a normal Complete Blood Count and Urinalysis. What is the most likely clinical diagnosis in this patient?
Testicular torsion
Strangulated Hernia
Congenital Hydrocele
Torsion of Testicular appendix
Acute Epidydimitis
Red tender scrotal sweling pain worsen with lifting up testes
torsion
epididymitis
orchitis
none of above
all of above
The optimum temperature for sperm production is:
About 2 to 3 degrees below body temperature
About 4 to 5 degrees below body temperature
About 4 to 5 degrees above body temperature
About 2 to 3 degrees above body temperature
About 1 to 2 degrees above body temperature
When examining a scrotal mass all are TRUE EXCEPT:
If it transilluminates it is almost always a Hydrocele
If you cannot get above it consider a hernia as a possible diagnosis
If it is painful it is rarely cancer
If scrotal masses are bilateral think hydroceles or scrotal oedema
An infant with hydrocele is seen in the clinic for a follow-up visit at 1 month of age. The scrotum is smaller than it was at birth. but fluid is still visible on illumination. Which of the following actions is the physician likely to recommend?
Massaging the groin area twice a day until the fluid is gone.
Referral to a surgeon for repair.
No treatment is necessary; the fluid is reabsorbing normally.
Keeping the infant in a flat. supine position until the fluid is gone.
I honestly don't know
False statement regarding testicular torsion
The highest incidence is in the neonatal and peripubertal periods
May present with abdominal pain and vomiting and few testicular symptoms
Radiological investigation with doppler ultrasound or isotope scanning is mandatory
Testicular viability is reduced if surgery is delayed more than 6 hours
Contralateral orchidopexy should also be performed if a torsion is confirmed
A 14 year old boy presents with a 4 h history of right testicular pain. It developed acutely and was associated with nausea and vomiting. The pain has been intense for most the day and continues to be so. On physical exam, the right testis is very tender to palpation and is high riding. The cremasteric reflex is absent on the right side and present on the left. Urinalysis was negative for esterase, nitrites and heme. The most appropriate next step is:
Observe the patient to see if the pain improves with intravenous analgetics
Perform a testicular Doppler ultrasonography to evaluate testicular blood flow.
Take the patient immediately to the operating room for scrotal exploration and possible bilateral orchidopexy.
Treat the patient with anti-inflammatory medication and scrota elevation.
Perform an abdominal and pelvic CT to evaluate for metastatic nodal disease.
Surgery for correction of cryptorchidism is best done before?
1 month of age
6 months of age
1 year of age
2 years of age
3 years of age
5 years old male child has been brought with a complaint that there is only one testis in the scrotum. On examination, it is found that the testis on the opposite side is felt in the inguinal canal. The patients should be advised:
Orchiopexy
To wait till puberty
Orchidectomy
Administration of androgens
Massaging the testicle
Which one the following statement is true of undescended testis?
Usually descends spontaneously puberty
Orchidopexy to be done if descent by puberty
Has a higher incidence of malignancy
Maintains normal sperm production
Surgery is not necessary
Best time for surgery of undescended testis is:
Just after birth
6 months of age
12 months of age
24 months of age
Puberty
A most common site of the ectopic testis:
Superficial inguinal pouch
Root of penis
Femoral triangle
Perineum
Scrotal
The incidence of undescended testis in a normal newborn:
3%
6%
9%
12%
15%
Which of the following investigation is used to confirm anorchia?
PET scan
MRI
CT SCAN
USG
Laparoscopy
A 12-month-old boy came to the clinic. The routine physical examination reveals palpable right testis in the inguinal canal but the left testis is descended and normal in size. Difference between a retractile testis and an undescended testis is made by the following finding:
Retractile testis has an empty scrotum.
Retractile testis is larger than that of undescended testis
Retractile inguinal testis can be pushed down into the scrotum
Scrotum is fully formed in undescended testis
Sonogram findings can distinguish between retractile and undescended testes.
Painless enlargement of the testis without involvement of the epididymis is most characteristic of:
torsion of the testis
germ cell tumor
hydrocele
spermatocele
orchitis
Increased incidence of malignant testicular germ cell tumors correlates with:
old age
a history of orchitis
undescended testis
a history of trauma to the testis
the presence of adrenal hyperplasia
Varicocele is common in left testis because :
Left testicular vein drains into IVC which has high pressure
Left testicular vein drains into left renal vein which has high pressure
Left testis is lower situated
Compression of testicular vein by rectum
Left testis is higher
Not true about varicocele :
Common of the right side
Can present as a late sign of renal cell cacinoma
Has bag of worm like feeling
Can lead to infertility
