Please confirm topic selection

Are you sure you want to trigger topic in your Anconeus AI algorithm?

Please confirm action

You are done for today with this topic.

Would you like to start learning session with this topic items scheduled for future?

Review Question - QID 212800

In scope icon M 2 B
QID 212800 (Type "212800" in App Search)
A 16-year-old teenage boy is brought to the emergency room for severe left groin pain. He reports feeling feverish this morning but insisted on going to his basketball practice this afternoon. Shortly after the practice, he began experiencing severe pain at his left groin that is described as sharp and burning in quality. The pain does not radiate anywhere. He denies chest pain, shortness of breath, abdominal pain, hematuria, or abnormal discharge, but endorses fever and chills. He is sexually active with his girlfriend and reports consistent condom use. Per his mom, last week he had “a weird flu episode” where his left cheek was swollen but resolved within 4 days. He did not seek medical attention as his mother preferred natural/holistic management; the patient is not vaccinated. A physical examination demonstrates a relatively healthy patient in acute distress and an erythematous, swollen left scrotum. A Doppler ultrasound of the testicles is obtained and shown in Figure A. What is the most likely explanation for this patient’s presentation?
  • A

Bulging of soft tissue through the inguinal canal

0%

0/46

Inflammation of the testicles due to a viral infection

85%

39/46

Malignant growth of germ cells at the testicle

0%

0/46

Mutation of cystine-reabsorbing transporter at the proximal collecting tubule

0%

0/46

Rotation of the spermatic cord

15%

7/46

  • A

Select Answer to see Preferred Response

bookmode logo Review TC In New Tab

This patient is experiencing orchitis secondary to infection with the mumps virus (fever, severe testicular pain, and parotitis 1 week prior). He is, therefore, experiencing inflammation of the testicles due to a viral infection.

Mumps is a contagious viral illness that is largely preventable via vaccination. It is highly infectious and is transmitted via respiratory droplets, direct contact, or fomites. Patients usually present with a few days of fever, headache, myalgia, fatigue, and salivary gland swelling within 48 hours of symptom onset. The disease is self-limited, and most individuals recover within a few weeks. In postpubertal males, orchitis is the most common complication of mumps infection and typically occurs 5-10 days after the onset of parotitis. Symptoms include abrupt onset of fever, and severe testicular pain with swelling and erythema of the scrotum. Management of patients is supportive.

Figure A is a Doppler ultrasound demonstrating symmetrical blood flow to and from the testes (red indicates flow towards transducer while blue indicates flow away from transducer).

Incorrect Answers:
Answer 1: Bulging of soft tissue through the inguinal canal describes an inguinal hernia, which may present with severe groin pain secondary to tissue ischemia. However, a soft mass at the groin would be present on physical examination.

Answer 3: Malignant growth of germ cells at the testicle describes testicular cancer, which most commonly presents with a painless, nodular mass at the testicle.

Answer 4: Mutation of cystine-reabsorbing transporter at the proximal collecting tubule describes cystinuria, a hereditary condition that leads to recurrent cystine renal stones. Though this may present with acute groin pain, it would begin during childhood.

Answer 5: Rotation of the spermatic cord describes testicular torsion, which is a medical emergency. However, this patient’s Doppler ultrasound demonstrates normal blood flow bilaterally.

Bullet Summary:
Mumps infection presents with parotitis and possibly orchitis 5-10 days following initial parotitis.

Authors
Rating
Please Rate Question Quality

2.5

  • star icon star icon star icon
  • star icon star icon star icon
  • star icon star icon star icon
  • star icon star icon star icon
  • star icon star icon star icon

(4)

Attach Treatment Poll
Treatment poll is required to gain more useful feedback from members.
Please enter Question Text
Please enter at least 2 unique options
Please enter at least 2 unique options
Please enter at least 2 unique options