A 14-Year-Old Boy Is Brought to the Emergency Department for Evaluation

question 83

Multiple Choice

A 14-year-old boy is brought to the emergency department for evaluation of severe scrotal pain.  Half an hour ago, the patient was accidentally hit in the scrotum during wrestling practice.  He applied ice and took acetaminophen, neither of which relieved the pain.  He has not tried urinating due to fear of the pain.  The patient underwent a right orchiopexy as an infant due to unilateral cryptorchidism but has no chronic medical conditions.  Temperature is 36.7 C (98.1 F) , blood pressure is 114/76 mm Hg, and pulse is 108/min.  Abdominal examination is unremarkable.  There is moderate bruising on the right hemiscrotum but not on the medial thigh or perineum.  The right testis is exquisitely tender to palpation but has normal contours.  Bilateral testes retract with stroking of the medial thigh.  The penis has no blood at the meatus or open wounds.  Intravenous morphine provides significant pain relief, and the patient is able to urinate spontaneously.  Urinalysis results are as follows: Which of the following is the best next step in management of this patient?

• A)Emergent orchiopexy
• B)Oral analgesics and outpatient follow-up
• C)Retrograde urethrogram
• D)Scrotal ultrasound
• E)Testicular fine-needle aspiration

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Definitions:

Sharing Profits And Losses

A method used in partnerships and some other business arrangements to distribute the financial results of the business among its owners or members.

Equally

In a manner that is the same in quantity, size, degree, or value for all parties involved.

Salary Allowance

Additional compensation provided to employees on top of their regular salary, often for specific purposes or expenses.

Capital Balance

The amount of capital attributable to the owners or shareholders of a company, often reflected in the equity section of the balance sheet.