Jim is a 47-year-old man having difficulties with sexual function. He
recently separated from his wife of 20 years. He reports early morning
erections but otherwise cannot function. Which of the following is alikely
cause for his problem?
a) Abnormal hypogastric arterialcirculation
b) Psychological issues
c) Decreased testosterone levels
d) Impaired neural innervations
A 12-year-old is brought to your clinic by his father. He was taught in his
health class at school to do monthly testicular self-examinations. Yesterday,
when he felt his left testicle, it was enlarged and tender. He isn't sure if he
has had burning with urination and he says he has never had sexual
intercourse. He has had a sore throat, cough, and runny nose for the last
three days. His past medical history is significant for a tonsillectomy as a
small child. His father has high blood pressure and his mother is healthy. On
examination, you see a child in no acute distress. His temperature is 100.8
and his blood pressure and pulse are unremarkable. On visualization of his
penis, he is uncircumcised and has no lesions or discharge. His scrotum is
red and tense on the left and normal appearing on the right. Palpating his left
testicle reveals a mildly sore swollen testicle. The right testicle is
unremarkable. An examining finger is put through both inguinal rings, and
there are no bulges with bearing down. His prostate examination is
unremarkable. Urine analysis is also unremarkable.
What abnormality of the testes does this child most likely have?
Acute orchitis
Acute epididymitis
Torsion of the spermatic cord
Prostatitis