Category: Quiz

Acute Prostatitis

Acute Prostatitis

Q. 1 Complication which commonly accompanies acute prostatitis –

 A

Epididymitis

 B

Orchitis

 C

Seminal vesiculitis

 D

Sterility

Q. 1

Complication which commonly accompanies acute prostatitis –

 A

Epididymitis

 B

Orchitis

 C

Seminal vesiculitis

 D

Sterility

Ans. C

Explanation:

Ans. is ‘c’ i.e., Seminal vesiculitis 

Quiz In Between



Carcinoma Of Prostate

Carcinoma of prostate

Q. 1 Which is the most common site of carcinoma prostate?

 A

Peripheral

 B

Centre

 C

Verumontum

 D

None of the above

Q. 1

Which is the most common site of carcinoma prostate?

 A

Peripheral

 B

Centre

 C

Verumontum

 D

None of the above

Ans. A

Explanation:

85% of prostate carcinoma arise from the peripheral zone.
Ninety five percent of tumors are adenocarcinoma.
Prostate carcinoma rarely occur before the age of 40 years, and the incidence increases with age. 

  • PSA is elevated in 60% of men with prostate cancer. Levels above 4ng/ml is considered abnormal.
  • Levels of PSA can be elevated with age and BPH. 
  • Falsely elevated PSA can be seen following cystoscopy, prostate biopsy, or urethral catheterization.
  • PSA is not elevated following digital rectal examination.

Ref: CURRENT Diagnosis & Treatment: Surgery, 13e, chapter 38


Q. 2

Trans rectal ultrasonogram in evaluation of carcinoma prostate most useful for:

 A

Taking guided biopsy

 B

Identifying seminal vesicle invasion

 C

Nodal sampling

 D

Measuring the extent of invasion

Q. 2

Trans rectal ultrasonogram in evaluation of carcinoma prostate most useful for:

 A

Taking guided biopsy

 B

Identifying seminal vesicle invasion

 C

Nodal sampling

 D

Measuring the extent of invasion

Ans. A

Explanation:

Ans. is ‘a’ Taking guided biopsy 

“TRUS is the imaging technique most frequently used to assess the primary tumor, but its chief use is directing prostate biopsies, not staging” – Harrison

  • Thus primary role of TRUS is guiding prostate biopsies
  • Other uses are

– assessing extent of invasion if cancer is detected.

– measurement of prostate volume which is needed in the calculation of the PSA density. – also used in performance of cryosurgery & brachytherapy.


Q. 3

Which is not used in carcinoma prostate ‑

 A

Estrogen

 B

Progesterone

 C

Cyproterone acetate

 D

Flutamide

Q. 3

Which is not used in carcinoma prostate ‑

 A

Estrogen

 B

Progesterone

 C

Cyproterone acetate

 D

Flutamide

Ans. C

Explanation:

Ans. is ‘c’ i.e., Conservative treatment 

Quiz In Between


Q. 4

In carcinoma prostate with matastasis which is raised

 A

ESR

 B

Alkaline phosphatase

 C

Acid phosphatase

 D

All

Q. 4

In carcinoma prostate with matastasis which is raised

 A

ESR

 B

Alkaline phosphatase

 C

Acid phosphatase

 D

All

Ans. B

Explanation:

Ans. is ‘b’ i.e., Alkaline phosphatase 


Q. 5

70 year old man with Ca.prostate with osteoblastic secondaries in pelvis and lumbar vertebra showed well differentiated Adeno Carcinoma prostate on needle biopsy. He is idealy treated by –

 A

Radical prostectomy

 B

TURP

 C

Radiation

 D

Hormonal manipulation

Q. 5

70 year old man with Ca.prostate with osteoblastic secondaries in pelvis and lumbar vertebra showed well differentiated Adeno Carcinoma prostate on needle biopsy. He is idealy treated by –

 A

Radical prostectomy

 B

TURP

 C

Radiation

 D

Hormonal manipulation

Ans. D

Explanation:

Ans. is ‘d’ i.e., Hormonal manipulation 

Quiz In Between



Epispadias

Epispadias

Q. 1 Epispadias is associated with?

 A

Bifid pubic symphysis

 B

Chordee

 C

Anal atresia

 D

Intestial obstruction

Q. 1

Epispadias is associated with?

 A

Bifid pubic symphysis

 B

Chordee

 C

Anal atresia

 D

Intestial obstruction

Ans. B

Explanation:

Ans is b i.e. chordee 

  • An epispadias is a rare type of congenital malformation in which the urethra opens on the dorsum (the upper aspect) of the penis. It is often part of the condition termed Epispadias-exstrophy of the bladder. Epispadias is a mild form of bladder exstrophy, and in severe cases, exstrophy and epispadias coexist.
  • The extent of the defect can vary from a mild glandular defect to complete defects as are observed in bladder exstrophy, diastasis of the pubic bones, or both.

–  In glandular epispadias, the urethra opens on the dorsal aspect of the glans, which is broad and flattened.

– In the penile type, the urethral meatus, which is broad and gaping, is located between the pubic symphysis and the coronal sulcus. A distal groove usually extends from the meatus through the splayed glans.

–  The penopubic type has the urethral opening at the penopubic junction, and the entire penis has a distal dorsal groove extending through the glans.

  • All types of epispadias are associated with varying degrees of dorsal chordee.
  • Females with epispadias have a bifid clitoris and separation of the labia.
  • Male to female ratio of epispadias is 3: 1.
  • Incontinence due to maldevelopment of urinary sphincters is commonly associated with most epispadias except for the glandular type.
  • Other associated anomaly is pubic diastasis as in exstrophy.
  • Surgery is required to correct the incontinence, remove the chordee to straighten the penis, and extend the urethra out onto the glans penis.

Note that pubic diastasis (i.e. separation of pubic bones) is not synonymous with bifid pubic symphysis.


Q. 2 Epispadias in relation to hypospadias ‑

 A

Is more common

 B

Less common

 C

Occures with the same frequency

 D

Is difficult to treat

Q. 2

Epispadias in relation to hypospadias ‑

 A

Is more common

 B

Less common

 C

Occures with the same frequency

 D

Is difficult to treat

Ans. B

Explanation:

Ans. is ‘b’ i.e., Less common 

Quiz In Between



Phimosis

Phimosis

Q. 1 The recommended treatment for preputial adhesions producing ballooning of prepuce during micturition in a 5  years old boy is:
(AIIMS June 2003)

 A

 Wait and watch policy

 B

Circumcision

 C

 Dorsal slit

 D

Preputial adhesions release and dilatation

Q. 1

The recommended treatment for preputial adhesions producing ballooning of prepuce during micturition in a 5  years old boy is:
(AIIMS June 2003)

 A

 Wait and watch policy

 B

Circumcision

 C

 Dorsal slit

 D

Preputial adhesions release and dilatation

Ans. A

Explanation:

A
If phimosis is associated with considerable infection, it should be treated with broad-spectrum antimicrobial drugs. The dorsal slit of foreskin, if improved drainage is necessary.
• Circumcision for phimosis should be avoided in children requiring general anesthesia; except in cases with recurrent infections.
• The procedure should be postponed until the child reaches an age when local anesthesia can be used.

Quiz In Between



Paraphimosis

Paraphimosis

Q. 1 Not true about paraphimosis is –

 A

Iatrogenic

 B

Seen in Diabetes mellitus

 C

Gangrene of glans

 D

Circumcision is the t/t

Q. 1

Not true about paraphimosis is –

 A

Iatrogenic

 B

Seen in Diabetes mellitus

 C

Gangrene of glans

 D

Circumcision is the t/t

Ans. B

Explanation:

Ans is ‘b’ ie Seen in Diabetes mellitns 

  • Diabetes mellitus has no role in paraphimosis.

Paraphimosis

  • Etiology: When a prepuce is forcibly retracted over the glans penis, it may get stuck behind the glans. This condition is k/a paraphimosis.
  • Pathology –>

This constricting band of phimotic prepuce causes obstruction to the venous flow, which lead to edema and congestion of the glans.

The glans swells leading to more difficulty in retracting back the prepuce.

In neglected cases gangrene may result.

  • Treatment —>
  • Ice bags, gentle manual compression and injection of a solution of hyaluronidase in normal saline may help to reduce the swelling.
  • If conservative method fails then the pt. can be t/t by circumcision*.

A dorsal slit of the prepuce under local anaesthetic may be enough in an emergency

  • It is uncommon for the urethra to be compressed, so the micturition is normally not affected.

Q. 2 About Paraphimosis true is :

 A

Catheter induced

 B

Circumcision is treatment

 C

Hyaluronidase inj

 D

All of the above

Q. 2

About Paraphimosis true is :

 A

Catheter induced

 B

Circumcision is treatment

 C

Hyaluronidase inj

 D

All of the above

Ans. D

Explanation:

Ans. is ‘d’ i.e. All of the above 
Paraphimosis may be produced when during catheterization the prepuce is forcibly retracted over gland penis. 

Quiz In Between



Peyronie’s Disease

Peyronie disease

Q. 1

The following statements are true about Peyronie’s disease except –

 A Pt. presents with complaints of painful erection

 B

Condition affects adolescent males

 C

The condition can be associated with Dupuytren’s contracture of the tendon of the hand.

 D

Spontaneous regression occurs in 50% of the cases.

Q. 1

The following statements are true about Peyronie’s disease except –

 A

Pt. presents with complaints of painful erection

 B

Condition affects adolescent males

 C

The condition can be associated with Dupuytren’s contracture of the tendon of the hand.

 D

Spontaneous regression occurs in 50% of the cases.

Ans. B

Explanation:

Ans is (b) i.e. Condition affects adolescent males

  • Peyronie’s disease is usually seen over 40 years of age
  • Important points about Peyronie’s disease
  • It is also k/a penile fibromatosis
  • It is due to fibrous plaques in one or both corpus cavernosum.They may later calcify or ossify.
  • Fibrous plaques lead to pain and curvature of the penis on erection
  • Palpable induration or mass appears usually on the dorsolateral aspect of the penis.
  • Palmar fibromatosis (Dupuytren’s contracture), plantar fibromatosis and penile fibromatosis (Peyronie’s ds.) are components of the same pathological process called superficial fibromatosis.
  • The aetilogy is uncertain, but it may be a result of past trauma.
  • Treatment is difficult but some cases may show spontaneous regression. Medical treatments are often ineffective.
  • If the penile deformity is distressing, Nesbitt’s operation can be performed to straighten the penis

Q. 2

All are true about Peyronie’s disease except ‑

 A Self limiting

 B

Medical treatment is effective

 C

Association with Dupytren’s contracture

 D

Calcified plaques

Q. 2

All are true about Peyronie’s disease except ‑

 A

Self limiting

 B

Medical treatment is effective

 C

Association with Dupytren’s contracture

 D

Calcified plaques

Ans. B

Explanation:

Ans. is `b’ i.e., Medical treatment is effective 


Q. 3

Peyronie’s disease affects the –

 A

Breast

 B

Vagina

 C

Scrotum

 D

Penis

Q. 3

Peyronie’s disease affects the –

 A

Breast

 B

Vagina

 C

Scrotum

 D

Penis

Ans. D

Explanation:

Ans. is ‘d’ i.e., Penis 

Quiz In Between



Circumcision

Circumcision

Q. 1 Which of the following is/are TRUE about hypospadias?

1. Defect is seen in the ventral part
2. Always associated with chordee
3. Associated with hooded prepuce
4. Circumcision should be avoided

 A

1,2 & 3

 B

2,3 & 4

 C

1,3 & 4

 D

All are true

Q. 1

Which of the following is/are TRUE about hypospadias?

1. Defect is seen in the ventral part
2. Always associated with chordee
3. Associated with hooded prepuce
4. Circumcision should be avoided

 A

1,2 & 3

 B

2,3 & 4

 C

1,3 & 4

 D

All are true

Ans. C

Explanation:

About option 1
Hypospadias results from failure of fusion of the urethral folds on the undersurface of the genital tubercle so defect is seen on the ventral part
.

About option 2
“In the penile variety (not other type- so not always present) the urethra and corpus spongiosum distal to the ectopic opening are absent.

These structures are represented by a fibrous cord. Due to contracture of this fibrous cord, the penis is curved ventrally, which is known as chordee”.
 
About option 3
“In all cases the inferior aspect of the prepuce is poorly developed. As the superior aspect of the prepuce is almost normally developed whereas the inferior aspect is poorly developed, the prepuce takes the form of a hood and is called “hooded prepuce”.
About option 4
“Circumcision should not be done in these patients, as prepuce can be used later in surgical repair (85% of patients)”
Ref: L & B 25/e, Page 1362-63 ; CSDT 11/e, Page 1028 ; Textbook Of Surgery By S. Das 5/e, Page 1322-23

Q. 2 Regarding neonatal circumcision, which one of the following is true:

 A

It should be done without anaesthesia, as it is hazardous to give anaesthesia.

 B

It should be done without anesthesia, as neonates do not perceive pain as adults

 C

It should be done under local anaesthesia only.

 D

General anaesthesia should be given to neonate for circumcision as they also feel pain as adults.

Q. 2

Regarding neonatal circumcision, which one of the following is true:

 A

It should be done without anaesthesia, as it is hazardous to give anaesthesia.

 B

It should be done without anesthesia, as neonates do not perceive pain as adults

 C

It should be done under local anaesthesia only.

 D

General anaesthesia should be given to neonate for circumcision as they also feel pain as adults.

Ans. D

Explanation:

D i.e. G.A. Should be given to neonate for circumcision as they also feel pain as adults


Q. 3

Circumcision cannot be used in management of 

 A

Phimosis

 B

Severe balanitis xerotica

 C

Paraphimosis

 D

Penile Cancer

Q. 3

Circumcision cannot be used in management of 

 A

Phimosis

 B

Severe balanitis xerotica

 C

Paraphimosis

 D

Penile Cancer

Ans. D

Explanation:

Answer- D. Penile Cancer

  • Phimosis
  • Balanitis 
  • Posthitis
  • Paraphimosis
  • Severe UTIs

Q. 4 Indication of circumcision includes:

 A

Hypospadias

 B

Epispadias

 C

Phimosis

 D

Balanitis

Q. 4

Indication of circumcision includes:

 A

Hypospadias

 B

Epispadias

 C

Phimosis

 D

Balanitis

Ans. C:D:E

Explanation:

Answer- C,Phimosis D,Balanitis E, Balanoposthitis
Indication- religious & phimosis
Medical indications for circumcision in boys include-

  1. recurrent attacks of balanoposthitis
  2. recurrent urinary tract infections
  3. In adults, inability to retract for intercourse, abnormally tight frenulum, balanitis

Quiz In Between



Carcinoma Of Penis

Carcinoma Penis

Q. 1 Carcinoma penis is rarest among –

 A

Americans

 B

Indians

 C

Swedes

 D

Jews

Q. 1

Carcinoma penis is rarest among –

 A

Americans

 B

Indians

 C

Swedes

 D

Jews

Ans. D

Explanation:

Ans. is `d’ i.e., Jews

Carcinoma of penis

  • Penile cancer is a malignant growth found on the skin or in the tissue of penis.
  • Circumcision confers protection hence, this cancer is extremely rare among jews and moslems and is correspondingly more common in populations in which circumcision is not routinely practiced. Predisposing factors : – 

 Smoking    

  • Infection with HPV16 and HPV- 18
  • Presence of pre-cancerous lesion —> Bowen disease.

Q. 2 Not true about carcinoma penis is –

 A

Erythroplasia of Queret is a precancerous condition

 B

40% of pts are under 40 year of age

 C

Circumcision if done any time before puberty provides 100% protection against carcinoma penis

 D

More than 50% pt. have inguinal 1.n enlargement when they present

Q. 2

Not true about carcinoma penis is –

 A

Erythroplasia of Queret is a precancerous condition

 B

40% of pts are under 40 year of age

 C

Circumcision if done any time before puberty provides 100% protection against carcinoma penis

 D

More than 50% pt. have inguinal 1.n enlargement when they present

Ans. C

Explanation:

Ans. ie ‘c’ ie Circumcision if done any time before puberty provides 100% protection 

  • The circumcision that is done soon after birth in infancy gives almost complete immunity against Ca penis; but that done later in life does not have the same effect, so Muslims circumcised between the ages of 4 and 9 years are still liable to the disease.
  • About Ca Penis

Most common histological type is –> sq. cell Ca (98%)

Erythroplasia of Queret is precancerous condition. It’s the in-situ form of Ca Penis.

[Carcinoma in situ of the penis is called Erythroplasia of Queyrat if it involves the glans penis, prepuce or penile shaft, and is called Bowen’s disease if it involves the remainder of the genitalia or perinea! region” – Cambell’s Urology 8/e, p 2950]

  • Premalignant lesions of Ca Penis

a.          Penile cutaneous horn
b.          Balanitis xerotica obliterans
c.          Leukoplakia
d.          Viral (Human papilloma virus) related Dermatologic lesion

– Condyloma acuminata (also k/a genital warts)

– Bowenoid papulori

  • The one etiological factor most commonly associated with penile carcinoma is poor hygine.
  • Clinical features
  • Age – Penile Ca occurs most commonly in the sixth decade of life, but its presentation in younger age group is not uncommon (“40% of pts are under 40 years of age” – Bailey)
  • Most common complaint at presentation is the lesion itself. Pain is rare.
  • Most common site of involvement (% from Cambell’s Urology 8/e, p 2953)

Glans

—>

-48%

Prepuce

—>

-21%

Both Glans & Prepuce

-4

9%

Coronal sulcus

 

-6%

Shaft

—>

-2%

  • Lymph node involvement

More than 50% of patients present with enlarged inguinal lymph nodes (but half of these are reactive enlargement d/t sepsis).

–  The presence and the extent of metastasis to the inguinal region is the most important prognostic factor for survival in patients with Ca Penis.

  • Distant metastasis is infrequent
  • Diagnosis is made by biopsy of lesion.
  • Treatment is discussed ahead.

Q. 3

Cause of death in Carcinoma penis is usually –

 A Metastasis to lung

 B

Metastasis to liver

 C

Erosion of Femoral blood vessels

 D

Urinary obstruction

Q. 3

Cause of death in Carcinoma penis is usually –

 A

Metastasis to lung

 B

Metastasis to liver

 C

Erosion of Femoral blood vessels

 D

Urinary obstruction

Ans. C

Explanation:

Ans. is ‘c’ i.e., Erosion of femoral blood vessels 

Inguinal lymph nodes erode the skin of the groin and the death of the patient may be due to involvement of the femoral or external iliac artery with torrential haemorrhage.

Quiz In Between


Q. 4 What is true about carcinoma penis – 

 A

Metastasis is rare

 B

Occurs more commonly in circumcised male

 C

Arises from corona of glans

 D

Pain is frequent

Q. 4

What is true about carcinoma penis – 

 A

Metastasis is rare

 B

Occurs more commonly in circumcised male

 C

Arises from corona of glans

 D

Pain is frequent

Ans. C

Explanation:

Ans. is ‘c’ i.e., Arises from corona of glans 

  • As already mentioned persons circumcised at birth or soon after are immune to Ca Penis.
  • Metastasis to lymph nodes is quite common. Distant metastasis occurs in less than 10% of pts.
  • MC site is glans penis
  • Pain is infrequent
  • Bailey writes – “There is little or no pain”

Q. 5

Features of carcinoma penis are all EXCEPT:

March 2013

 A

Circumcision soon after birth provides total immunity

 B

Pagets disease is not a premalignant disease

 C

Metastasis to inguinal nodes

 D

Surgery is treatment of choice

Q. 5

Features of carcinoma penis are all EXCEPT:
March 2013

 A

Circumcision soon after birth provides total immunity

 B

Pagets disease is not a premalignant disease

 C

Metastasis to inguinal nodes

 D

Surgery is treatment of choice

Ans. B

Explanation:

Ans. B i.e. Pagets disease is not a premalignant disease

Quiz In Between


Q. 6

Features of carcinoma penis include all except:
March 2007

 A

Metastasize to inguinal lymph nodes

 B

Surgery is the treatment of choice

 C

Hypospadias is a premalignant lesion

 D

Circumcision provides protection

Q. 6

Features of carcinoma penis include all except:
March 2007

 A

Metastasize to inguinal lymph nodes

 B

Surgery is the treatment of choice

 C

Hypospadias is a premalignant lesion

 D

Circumcision provides protection

Ans. C

Explanation:

Ans. C: Hypospadias is a premalignant lesion

Following as risk factors for penile cancer:

Human papillomavirus (HPV) infection, smoking, smegma, phimosis, treatment of psoriasis, age, and AIDS. The other etiologic factor most commonly associated with penile carcinoma is poor hygiene. Lichen sclerosus (also known as balanitis xerotica obliterans) may also be a risk factor.

Symptoms

Redness, irritation and a sore or a lump on the penis.

Pathology

  • Precancerous Dermatologic Lesions
  • Carcinoma in Situ (Bowen Disease, Erythroplasia of Queyrat)
  • Invasive Carcinoma of the Penis

A Squamous cell carcinoma usually originating in the glans or foreskin is by far the most common type, occurring in 9 out of 10 cases.

Staging

The stages are assessed as follows:

  • Stage I – Cancer has only affected the glans and/or foreskin.
  • Stage II – Cancer has spread to the shaft of the penis.
  • Stage III – Cancer has affected the penis and surrounding lymph nodes.
  • Stage IV – Cancer has moved beyond the groin area to other parts of the body.
  • Recurrent – Cancer that has returned after treatment.

The most common treatment is one of five types of surgery:

  • Wide local excision – The tumor and some surrounding healthy tissue are removed
  • Microsurgery – Surgery performed with a microscope is used to remove the tumor and as little healthy tissue as possible
  • Laser surgery – laser light is used to burn or cut away cancerous cells
  • Circumcision – cancerous foreskin is removed
  • Amputation (penectomy) – a partial or total removal of the penis, and possibly the associated lymph nodes. This is the most common and effective treatment.

Radiation therapy is usually used adjuvantly with surgery to reduce the risk of recurrence.

With earlier stages of penile cancer, a combination of topical chemotherapy and less invasive surgery may be used. More advanced stages of penile cancer usually require a combination of surgery, radiation and chemotherapy.


Q. 7 All of the following are features of carcinoma penis Except:        
March 2005

 A

Surgery is the treatment of choice

 B

Balanoposthitis may be a predisposing factor

 C

Metastaizes to inguinal nodes

 D

Histologically a transitional cell carcinoma

Q. 7

All of the following are features of carcinoma penis Except:        
March 2005

 A

Surgery is the treatment of choice

 B

Balanoposthitis may be a predisposing factor

 C

Metastaizes to inguinal nodes

 D

Histologically a transitional cell carcinoma

Ans. D

Explanation:

Ans. D: Histologically a transitional cell carcinoma

Penile squamous cell carcinoma, the most common penile malignancy, behaves similarly to squamous cell carcinoma in other parts of the skin.

Chronic balanoposthitis is known to be a contributory factor for penile carcinoma.

Metastasis, which is possible with this type of carcinoma, is often lethal.

Quiz In Between



Priapism

Priapism

Q. 1 In children persistent priapism may result due to

 A

Thrombosis of venous plexus

 B

Leukaemia

 C

Wilm’s tumour

 D

Trauma

Q. 1

In children persistent priapism may result due to

 A

Thrombosis of venous plexus

 B

Leukaemia

 C

Wilm’s tumour

 D

Trauma

Ans. B

Explanation:

Ans. is ‘b’ i.e., Leukaemia 


Q. 2

Priapism occurs in:         
AIIMS 06; 13

 A

Snake bite

 B

Rati poisoning

 C

Cantharide poisoning

 D

Arsenic poisoning

Q. 2

Priapism occurs in:         
AIIMS 06; 13

 A

Snake bite

 B

Rati poisoning

 C

Cantharide poisoning

 D

Arsenic poisoning

Ans. C

Explanation:

Ans. Cantharide poisoning


Q. 3

Persistent priapism is due to

 A

Sickle cell anaemia

 B

Hairy cell leukaemia

 C

Paraphimosis

 D

Urethral stenosis

Q. 3

Persistent priapism is due to

 A

Sickle cell anaemia

 B

Hairy cell leukaemia

 C

Paraphimosis

 D

Urethral stenosis

Ans. A

Explanation:

Ans. is ‘a’ i.e., Sickle cell anemia

  • Priapism is defined as erection lasting for > 4 hours.
  • Low-flow priapism may be due to any of the following:
  • An excessive release of neurotransmitters
  • Blockage of draining venules (eg, mechanical interference in sickle cell crisis, leukemia, or excessive use of intravenous parenteral lipids)
  • Paralysis of the intrinsic detumescence mechanism
  • Prolonged relaxation of the intracavernous smooth muscles (most often caused by the use of exogenous smooth-muscle relaxants such as injectable intra-cavernosal prostaglandin E I)
  • Prolonged low-flow priapism leads to a painful ischemic state, which can cause fibrosis of the corporeal smooth muscle and cavernosal artery thrombosis. The degree of ischemia is a function of the number of emissary veins involved and the duration of occlusion

Quiz In Between



Fournier Gangrene

Fournier gangrene

Q. 1 Following statements are true for Fournier’s gangrene except:
 A It is a vascular disaster of infective origin  
 B Sudden appearance of scrotal inflammation
 C Rapid onset of gangrene   
 D Testes are never exposed
Q. 1 Following statements are true for Fournier’s gangrene except:
 A It is a vascular disaster of infective origin  
 B Sudden appearance of scrotal inflammation
 C Rapid onset of gangrene   
 D Testes are never exposed
Ans. D

Explanation:Necrotising facilities (Syn Meleney’s streptococcal gangrene, Fournier’s gangrene).
Necrotising facilities is a destructive invasive infection of skin, subcutaneous tissue and deep fascia, with relative sparing of muscle.Common sites are the genitalia, groins and lower abdomen.


Q. 2

All cause fournier gangrene except-

 A

Staphylococcus

 B

Streptococcus

 C

Clostridium

 D

Bacteroides

Q. 2

All cause fournier gangrene except-

 A

Staphylococcus

 B

Streptococcus

 C

Clostridium

 D

Bacteroides

Ans. C

Explanation:

Ans. is ‘c’ i.e., Clostridium 

  • Fournier’s gangrene is a necrotising fascitis of genitalia, usually affecting the scrotum and penis.
  • There have been many types of bacteriological culture encountered in Fournier’s gangrene, both single strain and polymicrobial culture. Majority of cases are due to mixed infection caused by both aerobic and anaerobic bacteria.
  • Following are common causative organisms : Staphylococcus aureus, streptococcus pyogenes ((3-hemolytic streptococci), enterobacteriaceae (E. coli, klebsiella, proteus), enterococci, pseudomonas, and anaerobes like bacteroides and peptostreptococcus.

Q. 3 All are features of Fournier’s gangrene except 

 A

Testicles are involved

 B

Obliterative arteritis seen

 C

Haemolytic streptococci, E.coli, Staphylococci, Cl. welchi can be isolated

 D

Necrotising fascitis

Q. 3

All are features of Fournier’s gangrene except 

 A

Testicles are involved

 B

Obliterative arteritis seen

 C

Haemolytic streptococci, E.coli, Staphylococci, Cl. welchi can be isolated

 D

Necrotising fascitis

Ans. A

Explanation:

Ans. is ‘a’ i.e., Testicles are involved 

Quiz In Between


Q. 4

Fournier’s gangrene is seen in:  
September 2008

 A

Scrotum

 B

Shaft of penis

 C

Base of penis

 D

Glans penis

Q. 4

Fournier’s gangrene is seen in:  
September 2008

 A

Scrotum

 B

Shaft of penis

 C

Base of penis

 D

Glans penis

Ans. A

Explanation:

Ans. A: Scrotum
Idiopathic scrotal gangrene/Fournier’s gangrene is an uncommon condition of the scrotum.

Hemolytic streptococci are associated with other organisms (Staph., E.coli etc.) in a fulminating inflammation of the subcutaneous tissues, which results in obliterative arteritis of the arterioles to the scrotal skin.


Q. 5 Feature(s) of Fournier’s gangrene:

 A

Necrotizing fasciitis of the male genitalia and perineum

 B

Diabetes is risk factor

 C

Urgent wide surgical excision of the dead and infected tissue is essential

 D

Testis need to be removed in all cases

Q. 5

Feature(s) of Fournier’s gangrene:

 A

Necrotizing fasciitis of the male genitalia and perineum

 B

Diabetes is risk factor

 C

Urgent wide surgical excision of the dead and infected tissue is essential

 D

Testis need to be removed in all cases

Ans. A:B:C

Explanation:

Answer- A,Necrotizing fasciitis of the male genitalia and perineum B,Diabetes is risk factor C,Urgent wide surgical excision of the dead and infected tissue is essential

  • Fournier’s gangrene is a necrotizing fasctitis of the male genitalia and perineum that can be rapidly progressing and fatal if not treated promptly.

Risk factors-

  • urethral
  • strictures,
  • perirectal abscesses,
  • poor perineal hygiene,
  • diabetes,
  • cancer,
  • human immunodeficiency virus (HIV)

Clinical features-

  • Clinical signs include fevers, perineal and scrotal pain.
  • Cellulitis, eschars, necrosis, flaking skin, and crepitus may all be observed.
  • Treatment-
  • Urgent wide surgical excision of the dead and infected tissue is essential.

Quiz In Between



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