A 26-year-old male admits to unprotected sexual activity with ...

[jman1234]

A 26-year-old male admits to unprotected sexual activity with men. He complains of pain in the left scrotal region and burning on urination that started 2 days ago. The scrotum is swollen and tender to palpation.
 
  A urethral discharge is evident. Pain decreases with elevation of the left scrotum. There is no pain on DRE. These are signs of:
  A. Testicular torsion
  B. Testicular cancer
  C. Epididymitis
  D. Prostatitis

Question 2

A 7-year-old male presents with fever and swollen parotid glands. He is diagnosed with mumps. A complication that can occur with mumps in a male patient is:
 
  A. Orchitis
  B. Prostatitis
  C. Testicular torsion
  D. Varicocele

[frre432]

Answer to Question 1

ANS: C
Complaints associated with epididymitis usually involve a sudden onset (over 24 to 48 hours) of painful swelling in the scrotum, which can be unilateral or bilateral. Pain may decrease with elevation of the scrotum (Prehn's sign), although this is an unreliable indicator. There may be an associated urethral discharge and/or fever, and complaints of urethritis, cystitis or prostatitis are possible. On physical examination, the pain will localize to the affected epididymis with palpation, which will be swollen and indurated.

Answer to Question 2

ANS: A
Orchitis is usually caused by the extension of an infection from the epididymis to the testicle and rarely exists independent of epididymitis. The risks and causative organisms are the same as for epididymitis. Orchitis may also occur as a sequela of mumps and occurs in up to 30 of prepubertal male patients with mumps.