An 18-year-old man comes for an examination prior to participation in school sports. He states that he has had a dull ache in the scrotum since being hit in that area during a basketball game 2 months ago. Examination shows a 2-cm, hard, nontender mass in the right testicle. The mass does not transilluminate or change in size when the patient is placed in the supine position. Which of the following is the most likely cause?
A previously healthy 16-year-old boy comes to the physician because of persistent pain in his left testicle for 24 hours. He has not had any penile discharge. There is no history of trauma, but he plays soccer every day. Two months ago, he had sexual intercourse for the first time and he used a condom. Examination shows an edematous, erythematous, exquisitely tender left scrotum that is lower than the right. Elevating the left testicle relieves the pain. The cremasteric reflex is present. Urinalysis shows 10 leukocytes/hpf and 1+ leukocyte esterase. A technetium 99m scan shows increased uptake in the left testicle. What is the most likely cause of the pain?
For patients on chronic corticosteroids, can the intake of this vitamin reverse the inhibitory effects of corticosteroids on wound healing? Are supplemental doses recommended during the pre- and postoperative periods?
A 43-year-old man was rushed to the ER because of weakness and dizziness. History revealed 3 episodes of dark red bloody bowel movement, the last episode occurring 15 minutes ago. BP is 90/70 mmHg and HR = 118 bpm, skin is cold and clammy. What should you do next?
A 37-year-old man comes to the physician 12 hours after the onset of vomiting and abdominal cramps and swelling. He has had constipation for the past 4 days. He was diagnosed with Crohn’s disease 7 years ago. Vital signs are stable. Examination shows a diffusely distended, tympanitic abdomen and visible peristalsis; high-pitched bowel sounds are heard. Rectal examination shows no stool in the rectal vault. An x-ray of the abdomen shows a small-bowel obstruction. What is the most likely cause of these findings?
Three days after undergoing colectomy for colon cancer, a 77-year-old woman complains of being unable to catch her breath. Her current medications include subcutaneous heparin and patient-controlled morphine. Her temperature is 37°C, pulse is 140 bpm, respirations are 28 cpm, and blood pressure is 110/60 mmHg. Pulse oximetry on room air shows an oxygen saturation of 89%. Arterial blood gas analysis reveals pH 7.38, pCO2 23, and pO2 55. An ECG shows nonspecific ST-T wave changes. In addition to oxygen therapy, which of the following is the most appropriate next step in management?
A previously healthy 62-year-old man comes to the emergency department because of abdominal pain for 48 hours. His temperature is 38.6 C (101.5 F), blood pressure is 130/80 mm Hg, pulse is 110/min, and respirations are 15/min. Abdominal examination shows diffuse left lower quadrant tenderness with no peritoneal signs. Rectal examination shows no abnormalities; test of the stool for occult blood is negative. His leukocyte count is 14,700/mm3. What is the most appropriate next step in diagnosis?
Which body fluids have a similar electrolyte composition to plasma, except for?
Which of the following does not constitute a positive diagnostic peritoneal lavage in a patient who sustained an anterior abdominal wall stab wound?
Which of the following patients would not require thoracotomy?