This is a quiz to explore lower abdominal pain differentials.
Reviewed by: awaiting review
Stem 1 of 5
Stephen is a 12 year old male who presented to A&E with an acute onset of severe left sided testicular pain radiating to the abdomen, nausea and vomiting. On examination he is apyrexic with left testicular enlargement.
What is the most likely diagnosis
Stem 2 of 5Given the likely diagnosis what else would you find on examination?
Lost cremaster reflex
Stem 3 of 5
What structure is first involved in this pathology?
Genital brach of genitofemoral nerve
Internal spermatic fascia
Stem 4 of 5What bedside tests are important to perform?
Urine dip stick
None: Clinical diagnosis
Stem 5 of 5What is/are the definitive management/s for this patient?
External manual testicular rotation
If it has self resolved before do nothing as it will do so again
Stem 1 of 5
David is a 16 year old male who has presented to A&E with a gradual onset of severe left sided testicular pain radiating to the abdomen for the past four days. On examination has a swollen, tender, hot and erythematous left scrotum.
What important questions would you ask to differentiate this Davids presentation from Stephens to make a diagnosis?
History of testicular cancer
Any blood in urine?
Are you sexually active?
Any recent dysuria?
Stem 2 of 5Given the likely diagnosis what is likely found on examination?
Positive Prehn’s sign
Negative cremaster reflex
Bloody urethral discharge
Lump originating from testicle
Stem 3 of 5Given David's age what is the most likely cause of this infection?
Stem 4 of 5What is the management for the likely causative agent?
Ceftriaxone 500mg IM and Doxycycline 100mg PO O.D for 10-14 days
Doxycycline 100mg PO B.D 7 days
Azithromycin 1g PO then 500mg OD for 2 days
Ciprofloxacin 500mg PO OD
Ceftriaxone 1g IM
Stem 5 of 5Prior to David's discharge, what other management should be done?
Report to social services referral
Request patient to use condoms during treatment
Request patient to abstain from sex during treatment
Further STI screens