Question 1

A student in the medical clinic is reviewing a patient's medical record and sees the diagnosis of Peyronie's disease and asks the healthcare professional for an explanation of this disorder. What statement by the professional is most accurate?

Accepted Answer

Peyronie's disease (bent nail syndrome) is a fibrotic condition of the tunica albuginea of the penis, resulting in varying degrees of curvature and sexual dysfunction. Although the exact cause is unknown, a local vasculitis-like inflammatory reaction occurs and decreased tissue oxygenation results in fibrosis and calcification. A retracted foreskin that will not reduce back over the glans is known as phimosis. Paraphimosis is the opposite condition where the foreskin is retracted and cannot be pulled back over the glans. Priapism is the term for the painful, prolonged erection.

Question 2

What is the most common infectious cause of orchitis in postpubertal boys?

Accepted Answer

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

Question 3

A man has balanitis. What action by the healthcare professional is most appropriate?

Accepted Answer

Balanitis is an inflammation of the glans penis that is usually associated with poor hygiene and most often in men with poorly controlled diabetes mellitus. The health care professional should test the man's blood glucose. Chemotherapy is not used to treat this condition. There is no difficulty retracting the foreskin so pain medication is not needed. Needle aspiration is one treatment for priapism.

Question 4

What is the reason breast cancer in men has such a poor prognosis?

Accepted Answer

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.

Question 5

A 7-year-old child has cryptorchidism. What action by the healthcare professional is most appropriate?

Accepted Answer

Cryptorchidism is a condition of testicular maldescent. Treatment often begins with administration of GnRH or human chorionic gonadotropin (hCG), hormones that may initiate descent. If medical treatment does not work the child may need to have the testis moved surgically (orchiopexy). In children over 10 years of age and adults, the testis is removed in an orchiectomy. Neither Antibiotics nor radiation therapy is needed.

Question 6

A healthcare professional is educating a community men's group on symptoms of benign prostatic hyperplasia (BPH). The professional relates that most symptoms are a result of which pathophysiologic condition?

Accepted Answer

BPH becomes problematic as prostatic tissue compresses the urethra, where it passes through the prostate. BPH is not related to infection, obstruction, or ischemia.

Question 7

Priapism has been associated with the abuse of what substance?

Accepted Answer

Priapism has been associated with cocaine use due to local ischemia.

Question 8

How does the epididymis become infected?

Accepted Answer

The pathogenic microorganisms usually reach the epididymis by ascending the vasa deferentia from an already infected urethra or bladder.

Question 9

Which age group should be targeted for testicular cancer education and screening?

Accepted Answer

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.

Question 10

A healthcare professional sees a patient in the clinic who reports that his foreskin cannot be retracted back over the glans penis. What term does the professional use to document this condition?

Accepted Answer

Phimosis is the term used to identify the condition in which the foreskin cannot be retracted back over the glans. Paraphimosis is the opposite condition where the foreskin is retracted and cannot be pulled back over the glans. Prephimosis is not a term used in the text. The healthcare professional would document this patient's condition as phimosis.

Question 11

A healthcare professional is educating a community men's group about prostate cancer. What information should the professional include in the presentation? (Select all that apply.)

Accepted Answer

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.

Question 12

Which information about urethritis does the student learn? (Select all that apply.)

Accepted Answer

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. A first-void urine is collected for diagnostic purposes.

Question 13

What are the clinical manifestations of testicular cancer?

Accepted Answer

A firm, painless testicular enlargement is commonly identified as the first sign of testicular cancer.

Question 14

A man reports to the healthcare professional that he had a sudden onset of malaise, low back pain, and perineal pain with high fever and chills, dysuria, nocturia, and urinary retention. What action by the healthcare professional is most appropriate?

Accepted Answer

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. Since it is most often associated with a urinary tract infection (UTI), the specific causative organism can usually be identified from a urinalysis. The professional should assist and educate the man on obtaining the appropriate specimen. While possible that prostatitis could be sexually transmitted, that is not as common as developing the infection secondary to a UTI. Heat and mild analgesics are helpful, but do nothing to identify the causative organism for appropriate treatment. A sample of fluid may be obtained for culture by prostatic massage, but this is very painful and would most likely not be done if other diagnostic tools are available.

Question 15

In the 95% of boys with delayed puberty, the problem is caused by which condition?

Accepted Answer

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. Hypothalamic and pituitary problems and hormone deficits account for the other 5% of cases.

Question 16

The risk of which cancer is greater if the man has a history of cryptorchidism?

Accepted Answer

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. Cryptorchidism does not increase the risk of penile, prostate, or epididymal cancer.

Question 17

A student reads in a chart that a child has been diagnosed with mixed precocious puberty and asks for an explanation. What explanation by the healthcare professional is most accurate?

Accepted Answer

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. It is not the lack of identifiable external sex organs, the effect of many causative factors mixed together, or a combination of physical and hormonal abnormalities specifically. The latter statement is accurate to a point but is too vague to be the best answer.

Question 18

What is the first sign of puberty in boys?

Accepted Answer

The first sign of puberty in boys is an enlargement of the testes and a thinning of the scrotal skin. Growth of pubic hair and voice changes come later.

Quiz 26: Alterations of the Male Reproductive System