Chapter 25: Alterations of the Male Reproductive R eproductive System MULTIL! C"#IC!
1. In the 95% of those with delayed dela yed puberty, the problem is caused by which condition? a. Disruption in the hypothalamus c. Deficit in estrogen or testosterone b. Disruption of the pituitary d. Physiologic hormonal delays !"# D
In 95% of cases, delayed puberty pub erty is a physiologic delay$ that is, hormonal leels are normal and the hypothalamic&pituitary&gonadal '(P)* a+is is intact, but maturation is happening slowly. his selection is the only option that accurately describes 95 % of those with delayed puberty. P"# 1
-/# Page 00
2. 3hat is the first sign of puberty in boys? a. hic4ening of the scrotal s4in b. )rowth of pubic hair
c. nlargement of the testes d. hange in oice
!"#
he first sign of puberty in boys is an enlargement of the testes and a thinning of the scrotal s4in. P"# 1
-/# Page 00
6. 3hich type of precocious puberty causes the child to deelop some secondary se+
characteristics of the opposite se+? a. 7i+ed b. Incomplete
c. Isose+ual d. (omose+ual
!"#
7i+ed precocious puberty 'i.e., irili8ation of a girl or femini8ation of a boy* causes the child to deelop some secondary se+ characteristics of the opposite se+. his selection is the only option that accurately identifies the type of precocious puberty described. P"# 1
-/# Page 00
:. 3hat term is used to identify a condition in which the fores4in cannot be retracted oer o er the
glans penis? a. Paraphimosis b. Priapism
c. Prephimosis d. Phimosis
!"# D
Phimosis is the only term used to identify the condition in which the fores4in cannot be retracted bac4 oer the glans. P"# 1
-/# Page 000
5. 3hat term is used to identify a fibrotic condition that causes lateral curature of the penis
during erection, which is associated with a local asculitis&li4e inflammatory reaction and decreased tissue o+ygenation? a. Phimosis c. ;ateral paraphimosis b. ;ateral phimosis d. Peyronie disease !"# D
Peyronie disease 'bent nail syndrome* is a fibrotic condition of the tunica albuginea of the penis, resulting in arying degrees of curature and se+ual dysfunction 'see /igure 25&2*. lthough the e+act cause is un4nown, a local asculitis&li4e inflammatory reaction occurs and decreased tissue o+ygenation results in fibrosis and calcification. Peyronie disease is the o nly term used to identify the pathophysiologic condition d escribed. P"# 1
-/# Pages 009&09<
. 3hat term is used to identify an inflammation of the glans penis? a. )lanitis c. Priapism b. =alanitis d. (ydrocelitis !"# =
=alanitis is the only term used to identify an inflammation of the glans penis 'see /igure 25& :*. P"# 1
-/# Page 09<
. ryptorchidism can be defined as which of the following? a. !ormal deelopmental state of the testes b. bnormal state in which the testes are oerdeeloped c. ;ac4 of scrotum d. esticular esticular maldescent !"# D
ryptorchidism is a condition of testicular maldescent, the only option that accurately defines cryptorchidism. P"# 1
-/# Page 092
0. 3hat is the most common infectious cause of orchitis and one that usually affects postpubertal
boys? a. (erpes b. Escherichia coli
c. 7umps d. ytomegaloirus
!"#
>f the options aailable, mumps is the most common infectious cause of orchitis and usually affects postpubertal boys. P"# 1
-/# Pages 09:&095
9. he ris4 of which cancer is greater if the man has a history of cryptorchidism? a. Penile c. Prostate b. esticular d. pididymal !"# =
he ris4 of testicular cancer is 65 to 5< 5 < times greater in men with cryptorchidism or in those with a history of cryptorchidism than it is for the general male population. his is not true of the other options. P"# 1
-/# Pages 096&09:
1<. 3hat are the clinical manifestations of testicular cancer? a. /irm, nontender testicular mass c. Painful fluid&filled testicular mass b. Painful, mobile, firm testicular mass d. "oft, nontender testicular mass !"#
>f the options aailable, a firm, painless testicular enlargement is commonly identified as the first sign of testicular cancer. P"# 1
-/# Pages 095&09
11. (ow does the epididymis become infected? a. he pathogenic microorganisms ascend the asa deferentia from an already
infected urethra or bladder. b. he pathogenic microorganisms are attached to sperm that trael through the genital tract. c. he pathogenic microorganisms from the tunica aginalis are transported to the epididymis. d. he pathogenic microorganisms from the prostate fluid ascend to the ep ididymis. !"#
he pathogenic microorganisms usually reach the epididymis by ascend ing the asa deferentia from an already infected urethra or bladder. bladd er. >f the selections aailable, this is the only option that accurately describes how the epididymis becomes infected. P"# 1
-/# Page 09
12. "ymptoms of benign prostatic hyperplasia '=P(* are a result of which pathophysiologic
condition? a. Infection of the prostate b. >bstruction of the urethra
c. Ischemia of the urethra d. ompression of the urethra
!"# D
=P( becomes problematic as prostatic tissue compresses the urethra, where it passes through the prostate. >f the selections aailable, only this option ac curately describes the pathophysiologic condition behind the symptoms of =P(. P"# 1
-/# Pages 09&099
16. 3hich infection has clinical manifestations that include the sudden on set of malaise, low bac4
pain, and perineal pain with high feer and chills, dysuria, nocturia, and urinary retention? a. >rchitis c. pididymitis b. =alanitis d. =acterial prostatitis !"# D
=acterial prostatitis can e+hibit common manifestations that include a sudden onset o f malaise, low bac4 and perineal pain, high feer 'up to :< @1<: /A*, and chills, as well as dysuria, inability to empty the bladder, nocturia, and urinary retention. 7yalgia and arthralgia also may occur. his selection is the only option that e+hibits the symptoms described. P"# 1
-/# Pages 099&9<<
1:. Priapism has been associated with the abuse of what substance? a. 7ariBuana c. ocaine b. lcohol d. (eroin !"#
>f the options aailable, priapism has been a ssociated with cocaine use. P"# 1
-/# Page 09<
15. 3hich age group should be targeted for testicular cancer education and screening? a. 15 to 65 year olds c. 6< to 55 year olds b. 2< to :5 year olds d. :5 to < year olds !"#
>erall, testicular cancers are rare, yet they are the most common form of cancer in young men between the ages of 15 and 65 years. P"# 1
-/# Page 095
1. 3hat is the reason breast cancer in men has such a poor prognosis? progno sis? a. =reast cancer is e+tremely aggressie in men. b. reatment is usually delayed as a result of late detection. c. hemotherapies are not as effectie in men. d. =reast tumors tend to be small and hard to isolate. !"# =
=reast cancer is relatiely uncommon in men, but it has a poor prognosis because men tend to delay see4ing treatment until the disease is adanced. his selection is the only option that accurately identifies the reason breast cancer in men has a poor prognosis. P"# 1
-/# Page 91:
MULTIL! R!S#$S!
1. 3hich are clinical manifestations of male breast cancer? (Select all that apply.) a. Clceration present on the breast b. -etraction of breast tissue c. !ipple discharge d. Palpable mass midline of the nipple e. Cnilateral solid mass !"# !"# , =, =, , ,
he malignant male breast lesion is usually a unilateral solid mass located near the nipple. =ecause the nipple is commonly inoled, crusting and nipple discharge are typical clinical manifestations. >ther findings include s4in retraction, ulceration of the s4in oer the tumor, and a+illary node inolement. P"# 1
-/# Page 91:
10. 3hich statements are true regarding true regarding urethritis? (Select all that apply.) a. purulent drainage may be present. b. clear mucus&li4e discharge may be present. c. "ymptoms include urethral tingling and itching or burning on urination. d. 2:&hour urine test is reuired to diagnose the disorder. e. reatment includes appropriate antibiotic therapy. !"# !"# , =, =, , ,
"ymptoms of urethritis include urethral tingling and itching or a burning sensation on urination 'dysuria*, freuency, and urgency. he indiidual may note a purulent or clear mucus&li4e discharge from the urethra. !ucleic acid detection amplification tests allow easy detection of Neisseria of Neisseria gonorrhoeae and gonorrhoeae and Chlamydia trachomatis in trachomatis in first&oid urine. reatment consists of appropriate antibiotic therapy for infectious urethritis and an aoidance of future chemical or mechanical irritation. P"# 1
-/# Page 000
19. 3hich statements are true regarding prostate cancer? (Select all that apply.) a. It ran4s second to lung cancer as being most common among merican men. b. familial history of prostate cancer is a ris4 factor. c. Dietary habits seem to play a role in its deelopment. d. frican&merican men hae an increased ris4 for its deelopment. e. =eing oer 5 years of age increases the ris4 for deeloping prostate cancer. !"# !"# =, , , D, D,
Prostate cancer is the most commonly diagnosed nonEs4in cancer in merican men, and the incidence aries greatly worldwide. Possible causes include a genetic predisposition, enironmental and dietary factors, inflammation, and alterations in leels of hormones 'e.g., testosterone, dihydrotestosterone, estradiol* and growth factors. Incidence is greatest among northwestern uropean and !orth merican men 'particularly frican frican mericans* older than 5 years of age. P"# 1
-/# Pages 9<<&91<
MATC"I
%$ Match the description with the disorder. disorder. FFFFFF . Painless dierticulum dierticulum of the epididymis located between the head of the epididymis and the testis FFFFFF =. ollection of fluid in the tunica aginalis FFFFFF . -otation of a testis, which twists blood essels of the the spermatic cord FFFFFF D. bnormal dilation dilation of the ein within the spermatic cord 2<. Garicocele
21. (ydrocele 22. esticular torsion 26. "permatocele 2<. !"# D P"# 1 -/# Page 091 7"# aricocele aricocele is an abnormal dilation dilation of a ein within within the spermatic cord and is classically classically described as a bag of worms 21. !"# = P"# 1 -/# Page 092 7"# hydrocele is a collection of fluid within the tunica aginalis aginalis 22. !"# P"# 1 -/# Page 09: 7"# orsion orsion of the testis is rotation of a testis, testis, which twists blood blood essels in the spermatic spermatic cord. 26. !"# P"# 1 -/# Page 092 7"# spermatocele spermatocele is a painless dierticulum of the epididymis epididymis located between between the head of the epididymis and the testis.
