Jack Baldwin is a 50 years old man who come to the hospital c/o left groin sharp pain that irradiate to the left testicle that started 6 hours ago, he feels nausea and threw up once. he stated he was helping a friend with some moving when the pain started. Standing makes it worse, especially standing up straight and bending over makes it worse, too. I haven’t found anything that makes it better. My scrotum feels achy mostly on the left side.
Physical Exam: HR:130 BP:170/94
abdomen: Visible swelling in the left groin with extension into the scrotum, without erythema
•Mildly swollen, indurated left groin causing tension to overlying skin
•Diffuse left-groin tenderness to palpation
genitourinary: The left groin region is visibly swollen and indurated to palpation. Right side normal.
•There is tenderness within the left inguinal canal; right inguinal canal normal;
•The scrotum is swollen on left side
•The testicles are normal in size and nontender to palpation
•Normal penile shaft, without lesions or discharge
•No flank tenderness to percussion
– hernia, inguinal
– testicular torsion
– nephrolitiasis/ kidney calculi
Scrotal ultrasound reveals the following:
- Loop of bowel in the left scrotum
- Normal blood flow to each testicle
- Normal testicular size bilaterally
- Provide a reference for your treatment plan (in APA format). The reference may come from a journal, a book, etc.
- Cite all sources using APA format.
- Include three differential diagnoses and support your diagnoses with supporting literature.
Other active problems:HypertensionMedical, surgical, obstetric, hospitalizations:Kidney stone requiring lithotripsyAllergies:NoneMedications:LisinoprilPreventive Health:Cancer-screening modalities for gender/age: prostate exam
Recommend smoking cessation – patient not ready
Fitness: encouraging increasing exercise
Nutrition: recommending better choices when eats out
Stress reduction: exercise recommendationImmunizations:Up to dateFHx:Father: Hypertension, CAD, prostate cancer
Mother: Hypothyroidism, breast cancer
Siblings: NoneSHx:Marital status/personal support system: Married x 20 years
Tobacco use: Smokes 1 ppd;
Alcohol: 1 to 2 drinks/day;
History of: narcotic abuse (Percocet)
Sexual history: Monogamous