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  #1  
Old 02-05-2013
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Question Penile Mass Ultrasound

A 45-year-old male presented with the complaint of a penile mass, which had been present for 8 months. The mass appeared, grew rapidly for 3 months, and then remained stable in size. The patient denied associated pain except with sexual intercourse, also he admits use of sildenafil sometime. He denied any traumatic injury or pain during intercourse or masturbation before the development of this condition. Physical examination revealed hard plaques in the dorsal and ventral penis. ultrasound of penis was done (see it below ). What is MOST likely be true concerning this mass?
a.) increase in cGMP secondary to decrease NO
b.) increase cGMP secondary to increase NO
c.) anti depressant side effects
d.) similar pathophysiology can be seen secondary to Hepatitis B
e.) similar pathophysiology can be seen secondary to gonorrhea
f.) this occur mostly due to untiming use of sildenafil
g.) malignancy
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Old 02-05-2013
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I would go with G
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Old 02-05-2013
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Do we have such mixed answers covering different subjects in real exam tooo?
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  #4  
Old 02-05-2013
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Quote:
Originally Posted by koyi View Post
A 45-year-old male presented with the complaint of a penile mass, which had been present for 8 months. The mass appeared, grew rapidly for 3 months, and then remained stable in size. The patient denied associated pain except with sexual intercourse, also he admits use of sildenafil sometime. He denied any traumatic injury or pain during intercourse or masturbation before the development of this condition. Physical examination revealed hard plaques in the dorsal and ventral penis. ultrasound of penis was done (see it below ). What is MOST likely be true concerning this mass?
a.) increase in cGMP secondary to decrease NO
b.) increase cGMP secondary to increase NO
c.) anti depressant side effects
d.) similar pathophysiology can be seen secondary to Hepatitis B
e.) similar pathophysiology can be seen secondary to gonorrhea
f.) this occur mostly due to untiming use of sildenafil
g.) malignancy

It' malignancy.:sorry:
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Old 02-05-2013
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this is my own formulated quetsion . scenario is a typical presentaion of PEYRONIE DISEASE ( see FA 2011 page 496 , Penile pathology ) . wat seen in those image is calcification (secondary to fibrotic tissue formation as always case in Peyronie disease)
choice A and B ..both talk about mechanism of erection under NO . (though B is correct mechanism but dasnt apply here )
choice C . i put it just make u run idea of thinking ooh is priapism (Trazodone side effects) but truth isnt and isnt presented in that way , first is painful (vs ths non painful ) second should have Hx of depression to pt (the guy has normal mood , though research has been showing that most pt suffer from depression secondary to poor sexual perfomance )
choice E and F ... simply dasnt relate and dasnt make logic .
choice G . malignancy is very rare in penis , but if happen is always painful , redness ,discharge etc ( note the guy dasnt have pain normaly , but feel pain during sexual intercourse due to his curveliniar penis ) . also note that peyronie isnt precursor for carcinoma of penis (V/S bowen disease and Erythroplasia of Queryat , FA 2011 page 496 )
CONCLUSION : right answer is D , why ? secondary to hepatitis B infection(or liver cirhhosis of any etiology) , CIRRHOSIS is a possible sequelae . recall that is not uncommon these patients presented with PALMAR FIBROMATOSIS (syn: DUPUYTREN CONTRACTURE) where small and ring fingure are mostly affected in palmar side secondary to substituion of collagen type 1 (normal palmar) with collagen type 3 (dupuytren ) . pathophysiology is similar to PEYRONIE disease , with only difference location of fibrosis occurs . palmar (dupuytren) v/s penis (peyronie)
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Old 02-06-2013
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dude, this question is Step 1 Jedi-level
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Pathology-, Radiographs-, Reproductive-, Step-1-Questions

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