Jim is a 47-year-old man having difficulties with sexual function. He
recently separated from his wife of 20 years. He reports early morning
erections but otherwise cannot function. Which of the following is alikely
cause for his problem?
a) Abnormal hypogastric arterialcirculation
b) Psychological issues
c) Decreased testosterone levels
d) Impaired neural innervations
A 12-year-old is brought to your clinic by his father. He was taught in his
health class at school to do monthly testicular self-examinations. Yesterday,
when he felt his left testicle, it was enlarged and tender. He isn't sure if he
has had burning with urination and he says he has never had sexual
intercourse. He has had a sore throat, cough, and runny nose for the last
three days. His past medical history is significant for a tonsillectomy as a
small child. His father has high blood pressure and his mother is healthy. On
examination, you see a child in no acute distress. His temperature is 100.8
and his blood pressure and pulse are unremarkable. On visualization of his
penis, he is uncircumcised and has no lesions or discharge. His scrotum is
red and tense on the left and normal appearing on the right. Palpating his left
testicle reveals a mildly sore swollen testicle. The right testicle is
unremarkable. An examining finger is put through both inguinal rings, and
there are no bulges with bearing down. His prostate examination is
unremarkable. Urine analysis is also unremarkable.
What abnormality of the testes does this child most likely have?
Acute orchitis
Acute epididymitis
Torsion of the spermatic cord
Prostatitis
,
Important techniques in performing the rectal examination include which of
the following?
Lubrication
Waiting for the sphincter to relax
Explaining what the patient should expect with each step before it occurs
All of the above
Which of the following conditions involves a tight prepuce which, once
retracted, cannot be returned?
Phimosis
Paraphimosis
Balanitis
Balanoposthitisn
22-year-old unemployed roofer presents to your clinic, complaining of pain
in his testicle and penis. He states the pain began last night and has steadily
become worse. He states it hurts when he urinates and he has not attempted
intercourse since the pain began. He has tried Tylenol and Ibuprofen without
improvement. He denies any fever or night sweats. His past medical history
is unremarkable. He has had four previous sexual partners and has had a new
partner for the last month. She is on oral contraceptives, so he has not used
condoms. His parents are both in good health. On examination, you see a
young man lying on his side. He appears mildly ill. His temperature is 100.2
and his blood pressure, respirations, and pulse are normal. On visualization
of the penis he is circumcised, with no lesions or discharge from the meatus.
Visualization of the scrotal skin appears unremarkable. Palpation of the
testes shows severe tenderness at the superior pole of the normal-sized left
testicle. He also has tenderness when you palpate the structures superior to
the testicle through the scrotal wall. The right testicle is unremarkable. An
examining finger is placed through each inguinal ring without bulges being
noted with bearing down. His prostate examination is unremarkable. Urine
analysis shows white blood cells and bacteria. What diagnosis of the male
genitalia is most likely in this case?
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