A 19 year old male presents to the ED with complaints of right testicular pain
| | | | | | | | | | | | | |
that started 3 days ago. Patient denies penile discharge. What should be
| | | | | | | | | | | |
included in his differential diagnosis? Select all that apply.
| | | | | | | | |
- Acute epididymitis
| |
- STI
|
- Testicular torsion
| |
- Varicocele
|
- Hydrocele
|
- Spermatocele/Epididymal cyst
| |
- Fournier's gangrene - correct answer ✔All of the above.
| | | | | | | | |
- Acute epididymitis: fever, pos Cremasteric, pos Prehn sign
| | | | | | | |
- STI: discharge
| |
- Testicular torsion: extreme pain, N/V, neg Cremasteric reflex
| | | | | | | |
- Varicocele: dull ache, bag o' worms
| | | | | |
- Hydrocele: painless swelling anterior or lateral to the testicle
| | | | | | | | | |
- Spermatocele/Epididymal cyst: painless swelling from the head of the testicle
| | | | | | | | | |
- Fournier's gangrene
| |
The AGACNP is concerned with acute epididymitis after eliciting a positive:
| | | | | | | | | |
,- Prehn's sign
| |
- Cremasteric reflex
| |
- Tinel sign
| |
- Phalen test - correct answer ✔Prehn sign
| | | | | | |
- Elevation of the scrotal contents alleviates the pain associated with
| | | | | | | | | |
|epididymitis.
- Cremasteric reflex: lifting of the testicle in response to stroking of the thigh
| | | | | | | | | | | | |
- Due to STI in young men and UTI in older men
| | | | | | | | | | |
- R/O amiodarone as a cause
| | | | |
A 15yo male presents with complaints of testicular pain the woke him up while
| | | | | | | | | | | | |
sleeping. The AGACNP has a high suspicion that:
| | | | | | | |
- the patient needs to be treated with antibiotics and notify their partners to be
| | | | | | | | | | | | | |
|treated as well | |
- the patient will need to be evaluated by GI surgery for concerns for an
| | | | | | | | | | | | | |
|inguinal hernia incarceration | |
- the patient needs to be evaluated by urology for concerns of testicular torsion
| | | | | | | | | | | | |
- the patient has a spermatocele an will need to follow up with urology in clinic
| | | | | | | | | | | | | | |
|- correct answer ✔The patient needs to be evaluated by urology for concerns
| | | | | | | | | | | |
|of testicular torsion
| |
The most common age range for testicular cancer is:
| | | | | | | |
- 10-20 years
| |
- 20-35 years
| |
- 35-55 years
| |
,- 55-75 years - correct answer ✔20-35 years, involves painless testicular
| | | | | | | | | |
|enlargement
Check HCG, AFP, and LDH
| | | |
Where is the most common origin for testicular cancer?
| | | | | | | |
- Lung
|
- Colon
|
- Prostate
|
- Thyroid - correct answer ✔Prostate
| | | | |
- Discrete painless mass
| | |
- Follow up every 3-6 months for the first two years and every 4-6 month in the
| | | | | | | | | | | | | | | |
|3rd year |
Using the TNM staging system, when there are signs of distant metastasis, this
| | | | | | | | | | | |
would indicated stage ___. When lesions are confined to the testes, this would
| | | | | | | | | | | | |
be stage ___.
| | |
When regional lymph node involvement is seen in the retroperitoneum, this
| | | | | | | | | |
would be stage ___. - correct answer ✔Stage 3 - distant metastases; primary
| | | | | | | | | | | | |
chemo, radical orchiectomy and resection of residual retroperitoneal nodes
| | | | | | | | |
Stage 1 - confined to the testes; surveillance, single-agent chemo, or adjuvant
| | | | | | | | | | |
radiation
|
Stage 2 - lymph node involvement in the retroperitoneum; treat with radical
| | | | | | | | | | |
orchiectomy and retroperitoneal irradiation
| | | |
, A male patient present to urgent care with complaints of penile discharge and
| | | | | | | | | | | |
lesions. What are your differentials?
| | | | |
- Gonorrhea/chlamydia
|
- Acute bacterial prostatitis
| | |
- Herpes simplex
| |
- Syphilis - correct answer ✔All of the above
| | | | | | | |
Discharge: gonorrhea/chlamydia, epididymitis | |
Chancre: syphilis, treat with penicillin G
| | | | |
What are the symptoms of primary, secondary, tertiary, and latent syphilis? -
| | | | | | | | | | |
correct answer ✔1: Chancre, local lymphadenopathy
| | | | | |
2: Flu-like symptoms, maculopapular rash on the palms, and systemic
| | | | | | | | |
lymphadenopathy
|
3: Cardiac and gummous lesions
| | | |
L: Lacking clinical manifestations
| | |
Neurosyphilis can occur at any stage. Tabes dorsales and general paresis are
| | | | | | | | | | |
late signs.
| |
A 19yo presents with complaints of dysuria and denies any other complaint.
| | | | | | | | | | |
What diagnostics will you order?
| | | | |
- Urine
|
- Gonorrhea urine test
| | |
- Chlamydia urine test
| | |
| | | | | | | | | | | | | |
that started 3 days ago. Patient denies penile discharge. What should be
| | | | | | | | | | | |
included in his differential diagnosis? Select all that apply.
| | | | | | | | |
- Acute epididymitis
| |
- STI
|
- Testicular torsion
| |
- Varicocele
|
- Hydrocele
|
- Spermatocele/Epididymal cyst
| |
- Fournier's gangrene - correct answer ✔All of the above.
| | | | | | | | |
- Acute epididymitis: fever, pos Cremasteric, pos Prehn sign
| | | | | | | |
- STI: discharge
| |
- Testicular torsion: extreme pain, N/V, neg Cremasteric reflex
| | | | | | | |
- Varicocele: dull ache, bag o' worms
| | | | | |
- Hydrocele: painless swelling anterior or lateral to the testicle
| | | | | | | | | |
- Spermatocele/Epididymal cyst: painless swelling from the head of the testicle
| | | | | | | | | |
- Fournier's gangrene
| |
The AGACNP is concerned with acute epididymitis after eliciting a positive:
| | | | | | | | | |
,- Prehn's sign
| |
- Cremasteric reflex
| |
- Tinel sign
| |
- Phalen test - correct answer ✔Prehn sign
| | | | | | |
- Elevation of the scrotal contents alleviates the pain associated with
| | | | | | | | | |
|epididymitis.
- Cremasteric reflex: lifting of the testicle in response to stroking of the thigh
| | | | | | | | | | | | |
- Due to STI in young men and UTI in older men
| | | | | | | | | | |
- R/O amiodarone as a cause
| | | | |
A 15yo male presents with complaints of testicular pain the woke him up while
| | | | | | | | | | | | |
sleeping. The AGACNP has a high suspicion that:
| | | | | | | |
- the patient needs to be treated with antibiotics and notify their partners to be
| | | | | | | | | | | | | |
|treated as well | |
- the patient will need to be evaluated by GI surgery for concerns for an
| | | | | | | | | | | | | |
|inguinal hernia incarceration | |
- the patient needs to be evaluated by urology for concerns of testicular torsion
| | | | | | | | | | | | |
- the patient has a spermatocele an will need to follow up with urology in clinic
| | | | | | | | | | | | | | |
|- correct answer ✔The patient needs to be evaluated by urology for concerns
| | | | | | | | | | | |
|of testicular torsion
| |
The most common age range for testicular cancer is:
| | | | | | | |
- 10-20 years
| |
- 20-35 years
| |
- 35-55 years
| |
,- 55-75 years - correct answer ✔20-35 years, involves painless testicular
| | | | | | | | | |
|enlargement
Check HCG, AFP, and LDH
| | | |
Where is the most common origin for testicular cancer?
| | | | | | | |
- Lung
|
- Colon
|
- Prostate
|
- Thyroid - correct answer ✔Prostate
| | | | |
- Discrete painless mass
| | |
- Follow up every 3-6 months for the first two years and every 4-6 month in the
| | | | | | | | | | | | | | | |
|3rd year |
Using the TNM staging system, when there are signs of distant metastasis, this
| | | | | | | | | | | |
would indicated stage ___. When lesions are confined to the testes, this would
| | | | | | | | | | | | |
be stage ___.
| | |
When regional lymph node involvement is seen in the retroperitoneum, this
| | | | | | | | | |
would be stage ___. - correct answer ✔Stage 3 - distant metastases; primary
| | | | | | | | | | | | |
chemo, radical orchiectomy and resection of residual retroperitoneal nodes
| | | | | | | | |
Stage 1 - confined to the testes; surveillance, single-agent chemo, or adjuvant
| | | | | | | | | | |
radiation
|
Stage 2 - lymph node involvement in the retroperitoneum; treat with radical
| | | | | | | | | | |
orchiectomy and retroperitoneal irradiation
| | | |
, A male patient present to urgent care with complaints of penile discharge and
| | | | | | | | | | | |
lesions. What are your differentials?
| | | | |
- Gonorrhea/chlamydia
|
- Acute bacterial prostatitis
| | |
- Herpes simplex
| |
- Syphilis - correct answer ✔All of the above
| | | | | | | |
Discharge: gonorrhea/chlamydia, epididymitis | |
Chancre: syphilis, treat with penicillin G
| | | | |
What are the symptoms of primary, secondary, tertiary, and latent syphilis? -
| | | | | | | | | | |
correct answer ✔1: Chancre, local lymphadenopathy
| | | | | |
2: Flu-like symptoms, maculopapular rash on the palms, and systemic
| | | | | | | | |
lymphadenopathy
|
3: Cardiac and gummous lesions
| | | |
L: Lacking clinical manifestations
| | |
Neurosyphilis can occur at any stage. Tabes dorsales and general paresis are
| | | | | | | | | | |
late signs.
| |
A 19yo presents with complaints of dysuria and denies any other complaint.
| | | | | | | | | | |
What diagnostics will you order?
| | | | |
- Urine
|
- Gonorrhea urine test
| | |
- Chlamydia urine test
| | |
