A 29-year-old married computer programmer comes to your clinic, complaining of “something strange” going on in his scrotum. Last month while he was doing his testicular self-examination he felt a lump in his left testis. He waited a month and felt the area again, but the lump was still there. He has had some aching in his left testis but denies any pain with urination or sexual intercourse. He denies any fever, malaise, or night sweats. His past medical history consists of groin surgery when he was a baby and a tonsillectomy as a teenager. He eats a healthy diet and works out at the gym five times a week. He denies any tobacco or illegal drugs and drinks alcohol occasionally. His parents are both healthy. On examination you see a muscular, healthy, young-appearing man with unremarkable vital signs. On visualization the penis is circumcised with no lesions; there is a scar in his right inguinal region. There is no lymphadenopathy. Palpation of his scrotum is unremarkable on the right but indicates a large mass on the left. Placing a finger through the inguinal ring on the right, you have the patient bear down. Nothing is felt. You attempt to place your finger through the left inguinal ring but cannot get above the mass. On rectal examination his prostate is unremarkable. What disorder of the testes is most likely the diagnosis?

A 22-year-old complains of pain in his penis and left testicle that began last night and has steadily become worse. It hurts when he urinates and he has not attempted intercourse since the pain began. He took Tylenol and ibuprofen without improvement. He does find elevating the scrotum on a folded hand-towel helps some if he’s lying down.  He denies any fever or night sweats. He appears mildly ill. On examination, the penis is circumcised, with no lesions or discharge from the meatus. 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 on palpation of 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.Which diagnosis is most likely in this case?

The most emergent cause of testicular pain in a young male is:

Which is true of the pectinate or dentate line?

The nurse is concerned that the Mr. P’s prostate may be malignant due to the results found on physical exam.  What is the most likely physical finding associated with prostate cancer that the nurse found?

A 32-year-old warehouse worker presents to clinic with complaints of pain in her left foot.  She states that she has been working long hours and wearing improperly fitting shoes.  Recently she noticed that she has a “bone” sticking out on the side of her big toe.  She states that at the end of the day the bulging area is warm and sore.  What is your diagnosis?

Which of the following represents metrorrhagia?

The examiner suspects that M.B. has carpal tunnel syndrome, and so the examiner asks her to perform the Phalen’s test.  To perform this test, M.B. would:

The Nurse Practitioner notes Heberden nodes at the DIP joints in a patient. This is most likely caused by:

When evaluating the patient’s knee you notice the drawer sign on your patient is positive. You highly suspect: