EMQs in Clinical Medicine.pdf - Peshawar Medical College

152 The abdomen and surgery
64 Pain/lumps in the scrotum
A
B
C
D
E
F
epididymal cyst
chronic orchitis
ectopic testis
syphilis
torsion of testis
seminoma
G
H
I
J
K
varicocele
direct inguinal hernia
acute epididymo-orchitis
testicular aneurysm
hydrocele
For each clinical scenario below, give the most likely cause for the clinical findings.
Each option may be used only once.
1 A 34-year-old man with a history of undescended testes presents with weight
loss and a hard painless testicular lump.
2 A 12-year-old boy presents with severe pain in the testis associated with vomiting
after jumping on his bicycle.
3 A 25-year-old man presents with a testicular swelling that has increased in size
over the last couple of months. The swelling is fluctuant and the underlying
testis impalpable.
4 A 45-year-old man presenting with a scrotal swelling is worried that he is growing
a third testicle. On examination there is a smooth fluctuant swelling within
the scrotum. Both left and right testes are palpable.
5 A 19-year-old man complains of severe pain and swelling of sudden onset in his
right scrotum. Testis and epididymis are very tender. He reports that he has had
unprotected intercourse recently.
Answers: see page 178.