08-22-2010, 09:58 PM
A 14-year-old white male presents to the ED with
acute onset left testicular pain when running, 1 hour
prior to presentation. His past medical history is negative,
he is on no medications, and he has no allergies.
He denies any trauma to the region. He states that his
pain is severe and only on the left. The pain is increased with ambulation and movement. He denies nausea,
vomiting, diarrhea, fever, chills, dysuria, hematuria, or
penile discharge.
His vital signs and physical exam are as follows: temperature
37.0°C, pulse 110, respirations 18, blood pressure
120/85. He is a well-nourished, well-developed
male in distress secondary to pain. Abdomen: Normal
bowel sounds, nontender, soft, no masses. Genitourinary:
Circumcised male, no penile lesions, no discharge;
left testicle tender to palpation but has a
normal lay in the scrotum. The cremasteric reflex is
normal bilaterally.
What is the significance of the normal lay and
cremasteric reflex?
A) The cremasteric reflex should be abnormal in
epididymitis.
B) The presence of a cremasteric reflex effectively
rules out testicular torsion.
C) The normal lay of the testicle in the scrotum
effectively rules out testicular torsion.
D) The presence or absence of a cremasteric reflex is
not helpful in ruling out testicular torsion.
What is the most reliable method for diagnosing
testicular torsion?
A) Doppler (Duplex color).
B) Radionuclide scan.
C) Surgical exploration.
D) Checking the cremasteric reflex.
E) MRI.
What is the most common agent causing epididymitis
in a 21-year-old male?
A) E. coli.
B) Neisseria gonorrhoeae.
C) Chlamydia trachomatis.
D) Pseudomonas species.
E) Ureaplasma urealyticum.
What is the most common agent causing epididymitis
in a 55-year-old male?
A) E. coli.
B) Neisseria gonorrhoeae.
C) Chlamydia trachomatis.
D) Pseudomonas species.
E) Ureaplasma urealyticum.
acute onset left testicular pain when running, 1 hour
prior to presentation. His past medical history is negative,
he is on no medications, and he has no allergies.
He denies any trauma to the region. He states that his
pain is severe and only on the left. The pain is increased with ambulation and movement. He denies nausea,
vomiting, diarrhea, fever, chills, dysuria, hematuria, or
penile discharge.
His vital signs and physical exam are as follows: temperature
37.0°C, pulse 110, respirations 18, blood pressure
120/85. He is a well-nourished, well-developed
male in distress secondary to pain. Abdomen: Normal
bowel sounds, nontender, soft, no masses. Genitourinary:
Circumcised male, no penile lesions, no discharge;
left testicle tender to palpation but has a
normal lay in the scrotum. The cremasteric reflex is
normal bilaterally.
What is the significance of the normal lay and
cremasteric reflex?
A) The cremasteric reflex should be abnormal in
epididymitis.
B) The presence of a cremasteric reflex effectively
rules out testicular torsion.
C) The normal lay of the testicle in the scrotum
effectively rules out testicular torsion.
D) The presence or absence of a cremasteric reflex is
not helpful in ruling out testicular torsion.
What is the most reliable method for diagnosing
testicular torsion?
A) Doppler (Duplex color).
B) Radionuclide scan.
C) Surgical exploration.
D) Checking the cremasteric reflex.
E) MRI.
What is the most common agent causing epididymitis
in a 21-year-old male?
A) E. coli.
B) Neisseria gonorrhoeae.
C) Chlamydia trachomatis.
D) Pseudomonas species.
E) Ureaplasma urealyticum.
What is the most common agent causing epididymitis
in a 55-year-old male?
A) E. coli.
B) Neisseria gonorrhoeae.
C) Chlamydia trachomatis.
D) Pseudomonas species.
E) Ureaplasma urealyticum.