Author Question: A 35-year-old male patient recently noticed a nodular growth on the right testicle. He reports a ... (Read 49 times)

Mr3Hunna · **on:** Jun 25, 2018

A 35-year-old male patient recently noticed a nodular growth on the right testicle. He reports a feeling of pain and heaviness in the testicle. Physical examination reveals a smooth, firm nodule of 5 to 6 cm on the right testicle.

The right scrotum is erythematous, and inguinal lymph nodes are palpable. The clinician should order a(n) ____ to evaluate this finding.
A. Ultrasound of the scrotum
B. CT scan of the pelvis
C. Pelvic x-ray
D. Digital rectal exam

Question 2

A 12-year-old boy accompanied by his mother reports sudden severe pain in the right lower abdomen and scrotum. There is no history of trauma. Upon physical examination, the right scrotum is extremely tender to touch. These are signs of:

A. Fournier's disease
B. Testicular cancer
C. Testicular torsion
D. Varicocele of the testes

bigcheese9 · **Reply #1 on:** Jun 25, 2018

Answer to Question 1

ANS: A
The ultrasound is considered an extension of the physical examination in the case of a suspected testicular mass; a scrotal ultrasound can quickly and accurately distinguish a tumor from other intrascrotal pathologies.

Answer to Question 2

ANS: C
Testicular torsion is a urologic emergency and can result in the loss of blood flow to the affected testicle. Compromised blood flow results in swelling and tissue necrosis after 6 to 8 hours. There are no established risk factors, but it is more common during adolescence due to the rapid growth of the testes. Patients experience an acute and sudden onset of pain that localizes in the affected testicle, but it may also radiate to the inguinal areas or abdomen. This pain is often accompanied by abdominal discomfort, nausea, and vomiting. Asymmetric scrotal swelling is apparent on physical examination, with the affected testicle being somewhat elevated.