Urology Exam Graded A;Actual

Urology Exam Graded A+;Actual test What is the inability to return retracted foreskin back to its natural position over the glans? Correct answer- Paraphimosis Why is paraphimosis an emergency? Correct answer- edema and congestion of the glans can lead to penile necrosis Common causes of paraphimosis.. Correct answer- - failure to return foreskin (infants, elderly)

• infection
• sex or masturbation
• trauma
• hair/clothing touriquets
• abuse of foreskin (rare)

Common risk of paraphimosis.. Correct answer- HCP leaves foreskin retracted after penile exam, cleaning, cystoscopy, or cath insertion What is inflammation of glans (balanitis) and foreskin (posthitis)? Correct answer- Balanoposthitis What are causes of balanoposthitis? Correct answer- - infection

• chemical irritation
• trauma
• drug rxn
• contact dermatitis

What is narrowing (stenosis) of the opening of the urethra at the ext meatus? Correct answer- Meatal stenosis What is a common Sx of meatal stenosis? Correct answer- urine flow reduced, hesitant and stream goes upward instead of downward What is a bacterial infection of the skin that affects the genitals and perineum? This usually develops after a wound or abrasion becomes infected. Correct answer- Fournier's Gangrene (aka necrotizing fascitis) 1 / 3

What are some early and more sever Sx of Fournier's Gangrene? Correct answer- Early- local tenderness, edema, & erythema Later- fever, hypotension, and tachycardia progressing to necrosis of scrotal fascia What is the most common form of invasive penile CA? Correct answer- Squamous cell carcinoma (SCC) What types of lesions can lead to penile CA? Correct answer- lichen sclerosus, cutaneous horn of the penis, bowenoid papulosis, lichen planus, & condyloma acuminatum What is most common strain of HPV that causes penile CA? Correct answer- HPV 16

(Note: HPV 6 and 11 associated w/ verrucous carcinoma)

What is an in situ (localized) form of squamous cell carcinoma w/ lesions usually on glans or foreskin? (plaques usually sharply demarcated) Correct answer- Erythroplasia

of Queyrat: Bowen's disease of the glans penis

What is a common fixed drug reaction? (drug class) Correct answer- Sulfa drugs What dz usually presents w/ ulcerating, very painful lesions? Correct answer- HSV What dz presents w/ a painless ulceration that has a hard indurated edge? Correct answer- Chanre (Primary Syphilis)- ~21 days after exposure to trep pallidum What dz presents w/ a painful ulceration w/ a soft edge and inguinal adenopathy?Correct answer- Chancroid (haemophilis ducreyi) What non-infectious, non-malignant lesions appear often in uncircumcised males around glans? Correct answer- Pearly Penile Papules What is the name of sebaceous glands visible on the male genitals? Correct answer- Fordyce Spots (normal in most males) What is the name of the lesions present on the penis w/ HPV? Correct answer- Condyloma accuminata What is a mite infestation that causes severe itching, esp at night, and what is the first line Tx? Correct answer- Scabies

Tx: Permethrin

What causes urethritis commonly, when no lesions are present? Correct answer- STIs 2 / 3

What is the difference between psoriasis and lichen planus? Correct answer- Both: thick scaly plaques d/t autoimmune dz, treated w/ topical steroids lichen planus- genitals, can get severe psoriasis- all over body What are 3 common symptoms w/ reactive arthritis? Correct answer- conjunctivitis, balanitis, and arthritis (can't see, can't pee, can't climb a tree) What is a congenital defect where the urethral meatus develops more proximal than usual (on the ventral side)? Correct answer- Hypospadias What are some associated disorders with hypospadias? Correct answer- Chordee (curvature of glans only), cryptorchidism (undescended testicle), dorsal hood (prepuce deficient ventrally), inguinal hernia (w/ or w/o hydrocele) What is the dz w/ fibrous scarring/plaques within the tunica albuginea that causes curvature of the penis? Correct answer- Peyronie's Disease (evil penis!!) What are some causes of Peyronie's disease? Correct answer- rough sex- microtrauma, macrotrauma, intracavernous injection therapy, repeated use of penile ring/vacuum pump What is NOT a risk factor for Peyronie's disease? Correct answer- poor hygiene What are some associated disorders to Peyronie's disease? Correct answer- Dupuytren contractures, Ledderhose disease, (check hands and feet) and autoimmune conditions like scleroderma or SLE What is the medical condition where the foreskin cannot be fully retracted? Correct answer- Phimosis (can occur w/ chronic Lichen sclerosis and DM) What is inflammation of the glans penis? Correct answer- Balanitis What will you see on doppler US w/

• testicular torsion
• epididymitis/orchitis
• appendiceal torsion? Correct answer- 1. absent/decreased blood flow
• increased blood flow
• normal blood flow

A ten year old male presents to your clinic complaining of acute testicular pain while playing outside this afternoon. There is no history of trauma. He is afebrile and denies any recent symptoms of viral illness. On physical exam you note a tender right testicle

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