EMQs in Clinical Medicine.pdf - Peshawar Medical College

Lumps in the groin 151
63 Lumps in the groin
A
B
C
D
E
F
indirect inguinal hernia
femoral aneurysm
hydrocele
infected lymph node
direct inguinal hernia
psoas abscess
G
H
I
J
K
L
femoral hernia
seminoma
scrotal carcinoma
saphena varix
calcified lymph node
none of the above
For each clinical scenario below, give the most likely cause for the clinical findings.
Each option may be used only once.
1 A 45-year-old woman presents with an irreducible lump in the left groin that is
positioned below and lateral to the pubic tubercle.
2 A 26-year-old man presents after surgery with a reducible lump in the left groin
above and medial to the pubic tubercle. The lump is not controlled after
reduction by pressure over the internal inguinal ring.
3 A 40-year-old man presents with a swelling in the right groin that descends into
the scrotum. It can be controlled after reduction by pressure over the internal
inguinal ring.
4 A 55-year-old woman presents with a soft lump in her left groin. There is an
expansile cough impulse and a fluid thrill is felt when percussing lower down
the leg.
5 A 60-year-old smoker complains of a throbbing lump in his right groin.
Examination reveals an expansile pulsation in the mass.
Answers: see page 177.