Inguinal

At what age in gestation does the testicle began its descent?
1. 1 month gestation
2. 2 months gestation
3. 3 months gestation
4. 6 months gestation
What nerve innervates the cremasteric muscles?
1. Ileoinguinal nerve
2. Genitofemoral nerve
3. Ileofemoral nerve
What is the incidence of clinical inguinal hernia in term infants?
1. Under 3 Percent
2. 3 to 5 Percent
3. 5 to 10 Percent
4. 10 to 15 Percent
Which is more common: a left inguinal hernia or a right inguinal hernia?
1. Right
2. Left
3. Equal incidence
Which is NOT associated with an increased incidence of inguinal hernia?
1. Connective tissue disorder
2. Family history
3. Hypospadias
4. Ventriculoartial shunt
Incarceration of a hernia is more common on the right or left?
1. Right
2. Left
3. Equal incidence
What is the incidence of gonadal infarction due to an incarcerated hernia?
1. 5 Percent
2. 15 Percent
3. 25 Percent
During repair of an incarcerated hernia, purulent or bloody fluid is found in the hernia sac. What should be done?
1. Contralateral exploration
2. Laparotomy
3. Admit and observe for 24 - 48 hours
4. This is not clinically significant
What percent of girls with inguinal hernia have a sliding hernia of the ovary or fallopian tube?
1. 5 Percent
2. 10 Percent
3. 15 Percent
4. 25 Percent
Which is NOT associated with a higher risk of hernia recurrence?
1. Cystic fibrosis
2. Ascites
3. Down's syndrome
4. Connective tissue disorder
True or false: femoral hernias are more common in girls than boys?
1. True
2. False
What is the incidence of cryptorchidism?
1. About 1 Percent
2. 5 Percent
3. 10 Percent
The testes originate from the ____ on either side of the fetal spine?
1. Metanephric ridge
2. Mesonephric ridge
3. Mullerian tissue
The gubernaculum testis is attached superiorly to what?
1. Inguinal ligament
2. Cremasteric muscle
3. Proximal tip of vas deferens
4. Genitofemoral nerve
After the gonad reaches the scrotum, what happens to the gubernaculum?
1. Atttaches to the Colles fascia
2. Becomes indistinct
3. Becomes ligaments inguale
4. Blends into Dartos muscle
Gonadotropic hormones persist in the human maternal circulation until what trimester?
1. 1st trimester
2. 2nd trimester
3. 3rd trimester
What is the incidence of an empty scrotum in premature infants vs. term newborns?
1. 10 Percent
2. 25 Percent
3. 50 Percent
4. 75 Percent
True or false: the higher the undescended testis, the more dysgenetic the testicle is likely to be?
1. True
2. False
True or false: the undescended testis has little or no histological or morphological changes during the first two years of life?
1. True
2. False
What happens to the undescended testis with increasing age?
1. Seminiferous tubular atrophy
2. Decreased spermatogonia
3. Interstitial fibrosis
4. All of the above
What is responsible for the blood-testis barrier?
1. Basement membrane of seminiferous tubules
2. Leydig cell membrane
3. Sertoli cell membrane
4. Tight junctions of interstitial cells
T or F: There is NO evidence that orchiopexy results in increased spermatogonia counts?
1. True
2. False
What percent of undescended testicles have epididymal abnormalities?
1. 15 Percent
2. 33 Percent
3. 50 Percent
4. 66 Percent
What is the La Roque maneuver?
1. Division of testicular vessels
2. Transperitoneal exploration via same inguinal incision
3. Pexing the testis to pubis
4. Moving testis medially to increase length
True or false: identification of a blind ending vas defrens alone is sufficient in exploration for undescended testis?
1. True
2. False
What is the incidence of intraoperative vascular injury resulting in testicular atrophy after an orchiopexy?
1. Less than 1 Percent
2. Less than 3 Percent
3. Less than 8 Percent
4. About 12 Percent
What is the incidence of retraction of the testicle up to the external inguinal ring after orchiopexy?
1. Under 3 Percent
2. 5 - 10 Percent
3. 15 - 20 Percent
4. 20 - 30 Percent
What is the fertility rate for bilateral undescended testes?
1. 10 Percent
2. 25 Percent
3. 50 Percent
4. 75 Percent
The level of what hormone varies inversely with spermatogenesis?
1. FSH
2. LH
3. HCG
4. FSH and LH
What does elevated luteinizing hormone levels suggest?
1. Gonadal atrophy
2. Precocious puberty
3. Adrenogenital syndrome
4. It is normal in 1st year of life
What percent of testicular tumors occur in undescended testis?
1. 12 Percent
2. 24 Percent
3. 53 Percent
4. 75 Percent
Atrophic and intrabdominal testes have what amount of increased risk of tumor formation?
1. 10 fold
2. 50 fold
3. 100 fold
4. 200 fold
What is the average age of tumor development in cryptorchidism?
1. 5 years
2. 10 years
3. 25 years
4. 35 - 40 years
What is the most common cause of an acute scrotum in children less 6 years?
1. Testicular torsion
2. Torsion of appendix testis
3. Epidiymitis
4. Inguinal hernia
What is the most common cause of an acute scrotum in older children or early adolescents?
1. Testicular torsion
2. Torsion of appendix testis
3. Epidiymitis
4. Inguinal hernia
What is the most common cause of an acute scrotum in younger adults and older adolescents?
1. Testicular torsion
2. Torsion of appendix testis
3. Epidiymitis
4. Inguinal hernia
How many degrees does the torsed testicle rotate?
1. 90 degrees
2. 180 degrees
3. 320 - 720 degrees
What type of torsion occurs in the newborn?
1. Extravaginal torsion
2. Intravaginal torsion
3. Either
Which type of torsion is associated with a bell clapper deformity?
1. Extravaginal torsion
2. Intravaginal torsion
3. Either
In cases of QUESTIONable viability of the testicle at exploration for torsion, an incision is made into what structure to assess bleeding?
1. Tunica vaginalis
2. Epidiymis
3. Tunica albuginea
Which is NOT one of the main causes of epididymitis in children?
1. Reflux of infected urine
2. Sexually transmitted disease
3. Prostatic infection
Which is NOT an indication for operation in patients with varicocele?
1. Atrophic testis
2. Tesiticular enlargement
3. Subfertility
4. Pain or discomfort
Which patients with varicocele should undergo ultrasonography of the abdomen to rule out an underlying causative pathology?
1. Sudden acute onset of varicocele
2. Right sided varicoele
3. Varicocele in a prepubertal child
4. All of the above

Inguinal

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