NSG 6020 Week 8 Quiz 1

A 14-year-old junior high school student is brought in by his mother and father because he seems to be

developing breasts. The mother is upset because she read on the Internet that smoking marijuana leads

to breast enlargement in males. The young man adamantly denies using any tobacco, alcohol, or drugs.

He has recently noticed changes in his penis, testicles, and pubic hair pattern. Otherwise, his past

medical history is unremarkable. His parents are both in good health. He has two older brothers who

never had this problem. On examination you see a mildly overweight teenager with enlarged breast

tissue that is slightly tender on both sides. Otherwise his examination is normal. He is agreeable to taking

a drug test.

What is the most likely cause of his gynecomastia?

- Imbalance of hormones of puberty

A 30-year-old man notices a firm, 2-cm mass under his areola. He has no other symptoms and no

diagnosis of breast cancer in his first-degree relatives. What is the most likely diagnosis?

- Breast tissue - Approximately one third of adult men will have palpable breast tissue under the

areola. While males can have breast cancer, this is much less common. There are no lymph

nodes in this area

A 28-year-old musician comes to your clinic, complaining of a "spot" on his penis. He states his partner

noticed it 2 days ago and it hasn't gone away. He says it doesn't hurt. He has had no burning with

urination and no pain during intercourse. He has had several partners in the last year and uses condoms

occasionally. His past medical history consists of nongonococcal urethritis from Chlamydia and

prostatitis. His vital signs are unremarkable. On visualization of his penis there is a 6-mm red, oval ulcer

with an indurated base just proximal to the corona. On palpation the ulcer is nontender. In the inguinal

region there is nontender lymphadenopathy.

What disorder of the penis is most likely the diagnosis?

- Syphilitic chancre

A 20-year-old part-time college student comes to your clinic, complaining of growths on his penile shaft.

They have been there for about 6 weeks and haven't gone away. In fact, he thinks there may be more

now. He denies any pain with intercourse or urination. He has had three former partners and has been

with his current girlfriend for 6 months. He says that because she is on the pill they don't use condoms.

He denies any fever, weight loss, or night sweats. He is engaged to be married and has no children. On

visualization of his penis you see several moist papules along all sides of his penile shaft and even two on

the corona. He has been circumcised. On palpation of his inguinal region there is no inguinal

lymphadenopathy.

Which abnormality of the penis does this patient most likely have?

- Condylomata acuminate

A 29-year-old married computer programmer comes to your clinic, complaining of "something

strange" going on in hisscrotum. Last month while he was doing histesticularself-examination he

felt a lump in his left testis. He waited a month and felt the area again, but the lump was still

there. He has had some aching in his left testis but denies any pain with urination or sexual

intercourse. He denies any fever, malaise, or night sweats. His past medical history consists of

groin surgery when he was a baby and a tonsillectomy as a teenager. His parents are both healthy.

On visualization the penisis circumcised with no lesions; there is a scar in his right inguinal region.

There is no lymphadenopathy. Palpation of hisscrotum is unremarkable on the right but indicates

a large mass on the left. Placing a finger through the inguinal ring on the right, you have the

patient bear down. Nothing is felt. You attempt to place your finger through the left inguinal ring

but cannot get above the mass. On rectal examination his p