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
skin:Diaphoretic
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
Differential diagnosis:
– hernia, inguinal
– epididymitis
– testicular torsion
– nephrolitiasis/ kidney calculi
Final diagnosis:
hernia, inguinal
Scrotal ultrasound reveals the following:
- Loop of bowel in the left scrotum
- Normal blood flow to each testicle
- Normal testicular size bilaterally
QUESTIONS:
- 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
Housing: Condominium
Occupation: Accountant
Tobacco use: Smokes 1 ppd;
Alcohol: 1 to 2 drinks/day;
History of: narcotic abuse (Percocet)
Sexual history: Monogamous
