At what age is a child able to respond to a pediatric pain scale?

You are seeing a 52 year old who has been a poorly controlled diabetic for the past 28 years.  The patient also smokes 1 – 1 1/2 packs per day since age 18.  You recognize this patient at higher risk for each of the following except:  

You are seeing a 52 year old with a 26 year history of poorly controlled blood sugars.  Which exam finding would you anticipate? 

A 28-year-old male presents to the clinic with a painless lump in his left testicle that he noticed three weeks ago. He denies any history of trauma or infection. On physical examination, there is a firm, non-tender mass in the left testicle. The transillumination test is negative. Which of the following is the most appropriate next step in management?

You are performing a pelvic exam on a 15 year old and note a soft cervix with a bluish hue. You recognize these findings as positive:   

On physical exam, you observe the following abnormal findings: spacing between the teeth, a widened maxilla, an enlarged mandible, and unusually large hands and feet. An EKG shows evidence of left ventricular hypertrophy. Based on these findings, which diagnosis is most likely?

A 65-year-old male presents with difficulty starting urination, a weak urine stream, and a feeling of incomplete bladder emptying. During the digital rectal exam, you note a uniformly enlarged, firm, and non-tender prostate. What is the most likely diagnosis?

Bonus Question: You are seeing a patient in follow up for an uncomplicated pregnancy. You will ask her to begin kick counts at what week of gestation?  

You are interpreting orthostatic BP readings of a patient.  You will diagnosis Orthostatic Hypotension when: 

A 26-year-old sexually active male presents to the clinic with concerns about lesions on his genitalia. He reports multiple small, flesh-colored bumps on his penis that have been present for a few months. He denies pain or itching. On physical examination, you observe several small, raised, and cauliflower-like lesions on the shaft of the penis. There are no vesicles or ulcerations. Which of the following is the most likely diagnosis?