FA 2024 (pg. 623) says left
I’m confused by this card and its support. In my head, any laterality of varicocele is concerning for a mass. But I also recognize that they love asking questions about this since L and R renal veins aren’t the same path and that’s an interesting way to ask about anatomy knowledge.
AMBOSS:
“[Secondary varicocele is] caused by a mass in the retroperitoneal space (Ormond disease, lymphoma, renal cell carcinoma) obstructing venous drainage into inferior vena cava (right-sided varicocele) or left renal vein (left-sided varicocele)…”
“A unilateral right-sided varicocele is uncommon and should raise suspicion of a mass in the retroperitoneal space (Ormond disease, lymphoma, renal cell carcinoma) blocking the spermatic vein.”
FA24:
p. 669: “[Varicocele is] most often on left side because of increased resistance to flow from left gonadal vein drainage into left renal vein. Right-sided varicocele may indicate IVC obstruction (eg, from RCC invading right renal vein).”
p. 623 “[RCC] originates from PCT → invades renal vein (may develop varicocele if left sided) → IVC → hematogenous spread → metastasis to lung, bone, and liver.”
What about the tagged UW QIDs?
Another solution would be to eliminate the laterality in the Text since it’s not a Cloze.