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Team Rounding ” It has been one month since your

NAME: Patient: Martin Smith, a 25-year-old male, presents to the urgent care clinic in obvious distress. Martin indicated this pain came on suddenly, was more right sided, and swelling that was minimal at first has become more significant, causing pain with any movement. Martin said the pain started earlier in the day and has gotten progressively worse as the day wore on. Dr. Gupta, the doctor at the urgent care taking his history, asked if he remembers any recent trauma or strenuous exercise that may have caused his pain. Martin denies any history of trauma or physical activities that could explain his pain. Martin did reveal that he is sexually active with multiple partners and doesn’t always use protection when engaged in sexual activities. Dr. Gupta asks that Martin remove his jeans and underwear and put on a gown so that he can perform a physical examination. In a few minutes, Dr. Gupta returns to the exam room and notes the following: Tender, swollen right testicle with erythema Negative Prehn’s sign Temperature: 100.6 degrees Questions: 1. What are the potential causes of testicular pain and swelling in this patient? List at least 3 different causes that should be investigated in this case. Tender, swollen in right testicle with erythema. Negative Prehn sign, and high temperature 2. What additional history questions would you ask to further evaluate this patient’s symptoms? I would ask the patient When did you first notice any symptoms related to your testicles (e.g., lumps, pain, swelling)? Have the symptoms been continuous or intermittent? Have you noticed any changes in the size or shape of the testiest? Do you have a family history of cancer, especially testicular or other genitourinary cancers? Have you had any recent changes in your sexual practices or partners? Have you had any previous STIs or been treated for them in the past? 3. Why is taking a sexual history important when evaluating a male patient with the types of complaints Martin has? Give 4 reasons with details on what a sexual history reveals that helps to diagnose a patient. 4. What other body system should be considered when evaluating a male patient with symptoms as Martin described? Why is this important to include in an examination of a male patient? Martin did reveal that he is sexually active with multiple partners and doesn’t always use protection when engaged in sexual activities. 5. What is the significance of the testicular swelling noted on examination? 6. What would Dr. Gupta expect to find on examination to localize swelling to the testicle and not the scrotum itself? In other words, how would Dr. Gupta distinguish between scrotal swelling and testicular swelling? 7. What is the significance of the erythema noted on examination? 8. What diagnostic tests would you order to confirm the diagnosis? List 4 tests and what purpose they would have in diagnosing this patient. 9. Test results are in. Dr. Gupta has confirmed Martin’s diagnosis based on the patient’s history and clinical findings. What do think the diagnosis is? 10. What are treatment options for the condition suspected in this case? List 3 treatment options with their purposes. What instructions would you give to Martin that would be important to include?

 
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