“Doc, Are My Guys Swimming?!”

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“Doc, Are My Guys Swimming?!”

June 25, 2021 | Family Medicine Exam Prep Course | CCFP

We are excited to see so many of you join our spring FMEP courses. Several of you have requested we continue to post more practice SAMPs, so here you go!

Just a reminder… pay attention to the questions. Here are our general tips one more time:

1. Pay attention to the questions. Look carefully at how many items you are being asked to list. If the question asks for five items, you will not get more marks if you list eight items; the examiner will look at the first five and allocate marks only for the first five answers – so be careful. On a SAMP, if it is not clearly stated how many items you should list, look at the amount of points/marks being allocated for the question to get an idea of how many answers the examiner may be anticipating you write down.

2. Do not write lengthy answers. Most questions can be answered in 10 words or less!

3. Be specific when writing down investigations (hemoglobin instead of CBC; CT abdomen instead of CT).

4. Remember that trade names and generic names are both acceptable when writing down medications.

5. For more helpful tips, you can refer to CCFP’s SAMP instructions by clicking here.



Brian is a 37 year old male who presents to your office – you notice that he is visibly upset. He says, “Doc what is wrong with me? My girlfriend and I have been trying to get pregnant for 1 year. She spoke to her doc and apparently, her work-up is normal so she told me to get tested. Are my guys not swimming?†(11 points)

1. List three health conditions that can affect male fertility. (3 points)

    • Diabetes
    • Genitourinary or testicular infections (acute or chronic – think childhood mumps, orchitis, etc.)
    • Trauma to scrotum, pelvis, or spine (including surgery – e.g., inguinal hernia surgery)
    • Sickle cell disease
    • Cystic fibrosis
    • Hemochromatosis
    • Klinefelter syndrome
    • Kallman syndrome
    • Obesity
    • Chronic kidney disease
    • Alcohol use disorder
    • Testicular cancer

2. List two classes of medications that can affect male fertility. (2 points)

    • Steroids
    • Antibiotics
    • Chemotherapy
    • Narcotics
    • Alpha-blockers
    • Antiandrogens

3. During your scrotal examination, list two physical findings that would be important to note in a man presenting with a history of infertility? (2 points)

    • Varicocele
    • Absence of vas deferens
    • Abnormal consistency or size of testicles
    • Enlarged, full, non-tender epididymis (often minimally palpable)

4. What can you use to measure testicular size? (1 point)

    • An orchidometer

5. True or false: one semen sample analysis is enough to assess semen quality and quantity. (1 point)

    • False. Two properly collected semen samples are required for a proper analysis.

6. If the sperm count is low, list two additional lab tests you would consider ordering? (2 points)

    • Total testosterone
    • Luteinizing hormone
    • Follicle-stimulating hormone
    • Prolactin levels
    • Estradiol Level

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