A 16-Year-Old Boy Is Brought to the Emergency Department Due

question 227

Multiple Choice

A 16-year-old boy is brought to the emergency department due to severe right groin pain that has worsened over the past 12 hours.  During the last month, the patient has had several episodes of mild scrotal pain while walking between classes at school.  He has no history of traumatic injury and is sexually active.  Medical history is unremarkable except for an inguinal hernia repaired a year ago.  Temperature is 36.9 C (98.4 F) , blood pressure is 116/78 mm Hg, and pulse is 86/min.  On examination, the right hemiscrotum is swollen and tender.  The bisected gross specimen from an orchiectomy is shown in the image below. Which of the following is the most likely mechanism of this patient's acute testicular pain?

• A)Abnormal collection of fluid within the scrotum
• B)Anatomic defect causing increased mobility of the testis
• C)Clonal proliferation of testicular germ cells
• D)Migration of bacteria from the urinary tract
• E)Postsurgical clotting of the pampiniform plexus