Chapter 25: Alterations of the Male Reproductive System – Flashcards

ANS: D In 95% of cases, delayed puberty is a physiologic delay; that is, hormonal levels are normal and the hypothalamic-pituitary-gonadal (HPG) axis is intact, but maturation is happening slowly. This selection is the only option that accurately describes 95% of those with delayed puberty.

ANS: C The first sign of puberty in boys is an enlargement of the testes and a thinning of the scrotal skin.

ANS: A Mixed precocious puberty (i.e., virilization of a girl or feminization of a boy) causes the child to develop some secondary sex characteristics of the opposite sex. This selection is the only option that accurately identifies the type of precocious puberty described.

ANS: D Phimosis is the only term used to identify the condition in which the foreskin cannot be retracted back over the glans.

ANS: D Peyronie disease (bent nail syndrome) is a fibrotic condition of the tunica albuginea of the penis, resulting in varying degrees of curvature and sexual dysfunction (see Figure 25-2). Although the exact cause is unknown, a local vasculitis-like inflammatory reaction occurs and decreased tissue oxygenation results in fibrosis and calcification. Peyronie disease is the only term used to identify the pathophysiologic condition described.

ANS: B Balanitis is the only term used to identify an inflammation of the glans penis

ANS: D Cryptorchidism is a condition of testicular maldescent, the only option that accurately defines cryptorchidism.

ANS: C Of the options available, mumps is the most common infectious cause of orchitis and usually affects postpubertal boys.

ANS: B The risk of testicular cancer is 35 to 50 times greater in men with cryptorchidism or in those with a history of cryptorchidism than it is for the general male population. This is not true of the other options.

ANS: A Of the options available, a firm, painless testicular enlargement is commonly identified as the first sign of testicular cancer.

ANS: A The pathogenic microorganisms usually reach the epididymis by ascending the vasa deferentia from an already infected urethra or bladder. Of the selections available, this is the only option that accurately describes how the epididymis becomes infected.

ANS: D BPH becomes problematic as prostatic tissue compresses the urethra, where it passes through the prostate. Of the selections available, only this option accurately describes the pathophysiologic condition behind the symptoms of BPH.

ANS: D Bacterial prostatitis can exhibit common manifestations that include a sudden onset of malaise, low back and perineal pain, high fever (up to 40° C [104° F]), and chills, as well as dysuria, inability to empty the bladder, nocturia, and urinary retention. Myalgia and arthralgia also may occur. This selection is the only option that exhibits the symptoms described.

ANS: C Of the options available, priapism has been associated with cocaine use.

ANS: A Overall, testicular cancers are rare, yet they are the most common form of cancer in young men between the ages of 15 and 35 years.

ANS: B Breast cancer is relatively uncommon in men, but it has a poor prognosis because men tend to delay seeking treatment until the disease is advanced. This selection is the only option that accurately identifies the reason breast cancer in men has a poor prognosis.

ANS: A, B, C, E The malignant male breast lesion is usually a unilateral solid mass located near the nipple. Because the nipple is commonly involved, crusting and nipple discharge are typical clinical manifestations. Other findings include skin retraction, ulceration of the skin over the tumor, and axillary node involvement.

ANS: A, B, C, E Symptoms of urethritis include urethral tingling and itching or a burning sensation on urination (dysuria), frequency, and urgency. The individual may note a purulent or clear mucus-like discharge from the urethra. Nucleic acid detection amplification tests allow easy detection of Neisseria gonorrhoeae and Chlamydia trachomatis in first-void urine. Treatment consists of appropriate antibiotic therapy for infectious urethritis and an avoidance of future chemical or mechanical irritation.

ANS: B, C, D, E Prostate cancer is the most commonly diagnosed non-skin cancer in American men, and the incidence varies greatly worldwide. Possible causes include a genetic predisposition, environmental and dietary factors, inflammation, and alterations in levels of hormones (e.g., testosterone, dihydrotestosterone, estradiol) and growth factors. Incidence is greatest among northwestern European and North American men (particularly African Americans) older than 65 years of age.

Varicocele

Hydrocele

Testicular torsion

Spermatocele