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NSG 6020 week 8 Questions and Answers with Solutions UPDATED!!!!....pdf

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NSG 6020 week 8 Questions and Answers with Solutions
UPDATED!!!!.

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2 of 26

Term

,A 29-year-old married computer programmer comes to your clinic, complaining
of "something strange" going on in his scrotum. Last month while he was doing
his testicular self-examination he felt a lump in his left testis. He waited a
month and felt the area again, but the lump was still there. He has had some
aching in his left testis but denies any pain with urination or sexual intercourse.
He denies any fever, malaise, or night sweats. His past medical history consists
of groin surgery when he was a baby and a tonsillectomy as a teenager. His
parents are both healthy. On visualization the penis is circumcised with no
lesions; there is a scar in his right inguinal region. There is no
lymphadenopathy. Palpation of his scrotum is unremarkable on the right but
indicates a large mass on the left. Placing a finger through the inguinal ring on
the right, you have the patient bear down. Nothing is felt. You attempt to place
your finger through the left inguinal ring but cannot get above the mass. On
rectal examination his prostate is unremarkable.
What disorder of the testes is most likely the diagnosis?



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- Genital herpes - Prostatitis




- Scrotal (inguinal) hernia - Torsion of the spermatic cord


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3 of 26

Term



A 15-year-old high school football player is brought to your office by his mother.
He is complaining of severe testicular pain since exactly 8:00 this morning. He

, denies any sexual activity and states that he hurts so bad he can't even urinate.
He is nauseated and is throwing up. He denies any recent illness or fever. His
past medical history is unremarkable. He denies any tobacco, alcohol, or drug
use. His parents are both in good health. On examination you see a young
teenager lying on the bed with an emesis basin. He is very uncomfortable and
keeps shifting his position. His blood pressure is 150/100, his pulse is 110, and
his respirations are 24. On visualization of the penis he is circumcised and there
are no lesions and no discharge from the meatus. His scrotal skin is tense and
red. Palpation of the left testicle causes severe pain and the patient begins to
cry. His prostate examination is unremarkable. His cremasteric reflex is absent
on the left but is normal on the right. By catheter you get a urine sample and
the analysis is unremarkable. You send the boy with his mother to the
emergency room for further workup.
What is the most likely diagnosis for this young man's symptoms?



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- Torsion of the spermatic cord - Acute orchitis




- Scrotal (inguinal) hernia - Imbalance of hormones of puberty

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