#separator:Tab
#html:false
#tags column:5
IMF-052-01-0001-en	Why should clinicians explain confidentiality and ask permission before sensitive questions or examination in male reproductive health?	Embarrassment and stigma often delay presentation, so inclusive language, clarifying anatomy and goals, and explicit consent make disclosure more likely.	Integrated Medical Foundations; chapter 52, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 12322cc938c5545f101c67a0d281643e04536184ab2cf81885cbf9500a1a8aa8; editorial review pending	imf lang::en chapter::052 module::052-01 review::pending
IMF-052-01-0002-en	Which male genital presentations are time-critical diagnoses?	Testicular torsion, Fournier gangrene, priapism, severe trauma, and incarcerated hernia, because delay threatens tissue or life.	Integrated Medical Foundations; chapter 52, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 12322cc938c5545f101c67a0d281643e04536184ab2cf81885cbf9500a1a8aa8; editorial review pending	imf lang::en chapter::052 module::052-01 review::pending
IMF-052-01-0003-en	How do luteinising and follicle-stimulating hormones divide the work of the testis?	Luteinising hormone drives Leydig-cell testosterone production, while follicle-stimulating hormone acts with intratesticular testosterone on Sertoli cells to support spermatogenesis.	Integrated Medical Foundations; chapter 52, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 12322cc938c5545f101c67a0d281643e04536184ab2cf81885cbf9500a1a8aa8; editorial review pending	imf lang::en chapter::052 module::052-01 review::pending
IMF-052-01-0004-en	Why does testosterone deficiency affect tissues beyond the genitals, such as bone and blood?	Testosterone and its peripheral products, dihydrotestosterone and oestradiol, influence hair, muscle, bone, erythropoiesis, libido, and metabolism as well as genital tissue.	Integrated Medical Foundations; chapter 52, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 12322cc938c5545f101c67a0d281643e04536184ab2cf81885cbf9500a1a8aa8; editorial review pending	imf lang::en chapter::052 module::052-01 review::pending
IMF-052-01-0005-en	How does the gonadotropin pattern distinguish primary from secondary hypogonadism?	Primary hypogonadism is testicular failure, so low testosterone releases feedback and gonadotropins rise; secondary disease lies in hypothalamus or pituitary, so drive is deficient.	Integrated Medical Foundations; chapter 52, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 12322cc938c5545f101c67a0d281643e04536184ab2cf81885cbf9500a1a8aa8; editorial review pending	imf lang::en chapter::052 module::052-01 review::pending
IMF-052-01-0006-en	Why is a single low testosterone result insufficient to diagnose deficiency?	Testosterone varies diurnally and falls transiently in acute illness, so compatible symptoms need properly timed repeated testing interpreted with binding proteins and gonadotropins.	Integrated Medical Foundations; chapter 52, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 12322cc938c5545f101c67a0d281643e04536184ab2cf81885cbf9500a1a8aa8; editorial review pending	imf lang::en chapter::052 module::052-01 review::pending
IMF-052-01-0007-en	Why is testosterone replacement not a general treatment for fatigue or ageing?	Its benefit is limited to proven deficiency, while it suppresses spermatogenesis and can cause erythrocytosis, acne, oedema, infertility, and prostate-related monitoring needs.	Integrated Medical Foundations; chapter 52, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 12322cc938c5545f101c67a0d281643e04536184ab2cf81885cbf9500a1a8aa8; editorial review pending	imf lang::en chapter::052 module::052-01 review::pending
IMF-052-01-0008-en	What must a sexual history avoid inferring, and which features of erectile difficulty should it establish?	It must not infer identity from partners or anatomy; it establishes onset, consistency, spontaneous or morning erections, situational variation, and whether masturbation differs from partnered activity.	Integrated Medical Foundations; chapter 52, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 12322cc938c5545f101c67a0d281643e04536184ab2cf81885cbf9500a1a8aa8; editorial review pending	imf lang::en chapter::052 module::052-01 review::pending
IMF-052-01-0009-en	During testicular examination, what finding distinguishes a normal adult testis, and why is ultrasound preferred over transillumination?	A normal testis is smooth and firm, not hard; transillumination may support a fluid collection, but ultrasound is more reliable.	Integrated Medical Foundations; chapter 52, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 12322cc938c5545f101c67a0d281643e04536184ab2cf81885cbf9500a1a8aa8; editorial review pending	imf lang::en chapter::052 module::052-01 review::pending
IMF-052-01-0010-en	Why may erectile dysfunction precede symptomatic cardiovascular disease?	Penile arteries are small, so vascular disease can impair erection before larger vessels cause symptoms; assess blood pressure, diabetes, lipids, smoking, and fitness for sex.	Integrated Medical Foundations; chapter 52, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 12322cc938c5545f101c67a0d281643e04536184ab2cf81885cbf9500a1a8aa8; editorial review pending	imf lang::en chapter::052 module::052-01 review::pending
IMF-052-01-0011-en	Which physiological components must all be intact for erection?	Parasympathetic nitric-oxide signalling, arterial inflow, smooth-muscle relaxation, venous occlusion, intact nerves, and psychological engagement, so causes are often mixed.	Integrated Medical Foundations; chapter 52, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 12322cc938c5545f101c67a0d281643e04536184ab2cf81885cbf9500a1a8aa8; editorial review pending	imf lang::en chapter::052 module::052-01 review::pending
IMF-052-01-0012-en	Why do phosphodiesterase type five inhibitors require sexual stimulation, and why must they not be combined with nitrates?	They amplify existing nitric-oxide signalling rather than initiate it, and with nitrates the combined vasodilation can cause profound hypotension.	Integrated Medical Foundations; chapter 52, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 12322cc938c5545f101c67a0d281643e04536184ab2cf81885cbf9500a1a8aa8; editorial review pending	imf lang::en chapter::052 module::052-01 review::pending
IMF-052-01-0013-en	What mechanism causes retrograde ejaculation, and in what settings does it usually occur?	The bladder outlet fails to close, so semen passes into the bladder; it often follows surgery or autonomic dysfunction.	Integrated Medical Foundations; chapter 52, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 12322cc938c5545f101c67a0d281643e04536184ab2cf81885cbf9500a1a8aa8; editorial review pending	imf lang::en chapter::052 module::052-01 review::pending
IMF-052-01-0014-en	What defines premature ejaculation beyond timing alone?	Persistent ejaculation sooner than desired accompanied by distress and poor control; behavioural, topical anaesthetic, and serotonergic approaches may help.	Integrated Medical Foundations; chapter 52, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 12322cc938c5545f101c67a0d281643e04536184ab2cf81885cbf9500a1a8aa8; editorial review pending	imf lang::en chapter::052 module::052-01 review::pending
IMF-052-01-0015-en	Why is ischaemic priapism an emergency while non-ischaemic priapism is managed differently?	Ischaemic priapism is a painful rigid compartment syndrome threatening smooth muscle and needs urgent aspiration and sympathomimetics; non-ischaemic priapism usually follows arterial trauma and is less painful.	Integrated Medical Foundations; chapter 52, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 12322cc938c5545f101c67a0d281643e04536184ab2cf81885cbf9500a1a8aa8; editorial review pending	imf lang::en chapter::052 module::052-01 review::pending
IMF-052-01-0016-en	Why does paraphimosis require urgent reduction?	The retracted foreskin is trapped behind the glans, and the resulting oedema compromises blood flow.	Integrated Medical Foundations; chapter 52, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 12322cc938c5545f101c67a0d281643e04536184ab2cf81885cbf9500a1a8aa8; editorial review pending	imf lang::en chapter::052 module::052-01 review::pending
IMF-052-01-0017-en	Which penile lesion requires biopsy, and which factors raise penile cancer risk?	A persistent ulcer, mass, bleeding, or skin change needs biopsy; smoking, phimosis, and oncogenic human papillomavirus increase risk.	Integrated Medical Foundations; chapter 52, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 12322cc938c5545f101c67a0d281643e04536184ab2cf81885cbf9500a1a8aa8; editorial review pending	imf lang::en chapter::052 module::052-01 review::pending
IMF-052-01-0018-en	In suspected testicular torsion, why should surgery not wait for imaging?	Twisting obstructs venous then arterial flow, salvage falls rapidly with time, and no clinical sign safely excludes torsion, so high suspicion warrants exploration and bilateral fixation.	Integrated Medical Foundations; chapter 52, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 12322cc938c5545f101c67a0d281643e04536184ab2cf81885cbf9500a1a8aa8; editorial review pending	imf lang::en chapter::052 module::052-01 review::pending
IMF-052-01-0019-en	Which features favour epididymitis over torsion, and why is torsion still reconsidered?	Gradual onset, posterior tenderness, urinary or urethral symptoms, and sometimes fever favour epididymitis, but torsion is reconsidered while uncertainty remains because no sign safely excludes it.	Integrated Medical Foundations; chapter 52, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 12322cc938c5545f101c67a0d281643e04536184ab2cf81885cbf9500a1a8aa8; editorial review pending	imf lang::en chapter::052 module::052-01 review::pending
IMF-052-01-0020-en	What clue suggests Fournier gangrene before skin changes look severe, and what management is essential?	Pain beyond visible findings in rapidly progressive genital or perineal necrosis; resuscitation, broad antibiotics, and immediate debridement are essential.	Integrated Medical Foundations; chapter 52, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 12322cc938c5545f101c67a0d281643e04536184ab2cf81885cbf9500a1a8aa8; editorial review pending	imf lang::en chapter::052 module::052-01 review::pending
IMF-052-01-0021-en	Which varicocele features raise concern for secondary obstruction?	A new right-sided, non-reducing, or supine-persistent varicocele, since typical varicoceles are left-sided dilated pampiniform veins.	Integrated Medical Foundations; chapter 52, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 12322cc938c5545f101c67a0d281643e04536184ab2cf81885cbf9500a1a8aa8; editorial review pending	imf lang::en chapter::052 module::052-01 review::pending
IMF-052-01-0022-en	How is a solid intratesticular mass handled, and why do normal tumour markers not reassure?	It is treated as malignant until urgent ultrasound and markers evaluate it, without trans-scrotal biopsy; radical inguinal orchidectomy diagnoses it, and markers can be normal in cancer.	Integrated Medical Foundations; chapter 52, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 12322cc938c5545f101c67a0d281643e04536184ab2cf81885cbf9500a1a8aa8; editorial review pending	imf lang::en chapter::052 module::052-01 review::pending
IMF-052-01-0023-en	Why do benign prostatic hyperplasia symptoms not correlate with gland size alone, and how do the two drug classes differ?	Symptoms depend on smooth-muscle tone, narrowing, bladder compensation, and nerves; alpha-one blockers relax tone quickly, whereas five-alpha-reductase inhibitors shrink larger glands over months.	Integrated Medical Foundations; chapter 52, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 12322cc938c5545f101c67a0d281643e04536184ab2cf81885cbf9500a1a8aa8; editorial review pending	imf lang::en chapter::052 module::052-01 review::pending
IMF-052-01-0024-en	Why is prostate cancer screening a preference-sensitive decision?	Early detection can prevent some deaths, but prostate-specific antigen also rises with benign causes, bringing false positives, biopsy harms, overdiagnosis, and treatment-related dysfunction.	Integrated Medical Foundations; chapter 52, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 12322cc938c5545f101c67a0d281643e04536184ab2cf81885cbf9500a1a8aa8; editorial review pending	imf lang::en chapter::052 module::052-01 review::pending