ACS 3 - Week 2 (testicles)
Which of the following statements is NOT TRUE regarding inguinal hernia? Use a Dynamed article named" Groin Hernia in Adults and Adolescents" to help you answer the following question. A direct inguinal hernia protrudes through the posterior wall of the inguinal canal, medial to the inferior epigastric vessels. Auscultation of bowel sounds over the region of suspected hernia may be helpful in confirming diagnosis An indirect inguinal hernia protrudes through the internal inguinal ring, lateral to the inferior epigastric vessels. A femoral hernia is characterized by protrusion below the inguinal ligament and medial to the femoral vessels in the femoral space and it is more common in men.
A femoral hernia is characterized by protrusion below the inguinal ligament and medial to the femoral vessels in the femoral space and it is more common in men.
Your patient is a 37-year-old male who practices insertive anal intercourse. Based on his symptoms and your PE, you think he has epididymitis. Which of the following is likely the choice of antibiotics? Use the article "Acute Epididymitis" to help you answer the following question" Ceftriaxone IM injection plus doxycycline Ceftriaxone IM injection plus a fluoroquinolone Trimethoprim/sulfamethoxazole Doxycyline alone
Ceftriaxone IM injection plus a fluoroquinolone
True or False: Testicular cancer is a painless, firm nodule mass that can be palpated. Therefore, if it is painful on palpation, testicular cancer can be definitely ruled out. Use Dynamed's article "testicular cancer" to help you answer the question. True False
False
You are the camp doctor for a summer camp that is in the mountains, hours away from a hospital. You have an 8-year-old patient that comes to you with scrotal pain after a particularly intense game of soccer. He denies being kicked or having any trauma to the groin area. You notice that his right testicle is significantly higher than the left and there is significant swelling on the right side of his scrotum. You assume that this patient has testicular torsion and decide to perform manual detorsion since you are far from the hospital. You perform the maneuver and your patient is in significantly less pain, so you feel that you have corrected the torsion. True or False: It is no longer necessary for you to send the patient for any further imaging or treatment as the problem has resolved. This question was answered during the lecture. True False
False Confirmation of restoration of blood flow through imaging is still necessary.
Please use the various Dynamed article and AAFP articles attached this week to help answer the following questions. Dynamed Articles: -"Varicocele in Adults" - "Acute Epididymitis" - "Vasectomy" - "Inguinal hernia in Adults and Adolescents" - "Testicular torsion" Which of the following labs/imaging should you consider running on a patient with testicular pain that seems fairly consistent with epididymitis but had an acute onset? Please mark all correct answers. Use Dynamed Article named "Acute Epididymitis" to help you answer the question. CBC Nucleic acid amplification testing for chlamydia and gonorrhea Urinalysis Urine culture
Nucleic acid amplification testing for chlamydia and gonorrhea Urinalysis Urine culture
Painful nodule post-vasectomy is due to an immunologic response of the body to the "foreign" protein that was previously separated by the blood-testis barrier, this is nodule is a: Use the "Vasectomy" article from Dynamed to help you answer the question. Spermatocele Sperm granuloma Epididymal cyst Pyocele
Sperm granuloma
Clinical signs of testicular torsion include which of the following. Chose all that apply. Use Dynamed article " testicular torsion" to help you answer the question. Sudden onset of pain Presence of cremasteric reflex Abnormally positioned testis (typically higher than normal) Ipsilateral scrotal skin may be indurated, erythematous, and warm, though changes in overlying skin can progress over time, reflecting degree of inflammation
Sudden onset of pain Abnormally positioned testis (typically higher than normal) Ipsilateral scrotal skin may be indurated, erythematous, and warm, though changes in overlying skin can progress over time, reflecting degree of inflammation
You are the camp doctor for a summer camp that is in the mountains, hours away from a hospital. You have an 8-year-old patient that comes to you with scrotal pain after a particularly intense game of soccer. He denies being kicked or having any trauma to the groin area. You notice that his right testicle is significantly higher than the left and there is significant swelling in the right side of his scrotum. You assume that this patient has testicular torsion and decides to perform manual detorsion since you are far from the hospital. True or False: The testes usually rotate medially during torsion so you generally want to rotate the testes laterally (outward toward the thighs) during manual detorsion. Use AAFP article and in class lecture to help you answer the question. True False
True This is generally true but keep in mind that testes may be laterally torsed as well. Other signs and symptoms to assess are: 1. Relief of Pain 2. Resolution of the transverse lie of the testis to a longitudinal orientation 3. Lower position of the testis in the scrotum 4. Return of normal arterial pulsations detected with a color Doppler study
Which of the following physical exam statements are true in those with varicocele? Select all that apply. Use Dynamed's article " Varicocele" to help you answer the question. Varicocele is more common on the L side than the R Pampiniform plexus of spermatic veins can feel like a "bag of worms" on palpation. The chief complaint typically may be painful scrotal swelling, scrotal pain, or infertility Physical exam is unnecessary in this case
Varicocele is more common on the L side than the R (((About 90% of cases of varicocele develop on the left side, due to the typical drainage of the left gonadal vein into the left renal vein.))) Pampiniform plexus of spermatic veins can feel like a "bag of worms" on palpation.
Which of the following are possible causes of non-infectious epididymitis, please choose that apply. Use "Acute Epididymitis" from Dynamed and the lecture slide to help you answer the question. Trauma related to intensive exercise such as heavy lifting Bike or motorcycle riding Amiodarone Idiopathic Prolonged sitting
all
