Get Help With Your Essay

"Place your order now for a similar assignment and have exceptional work written by our team of experts, guaranteeing you A results."

For This or a Similar Paper Click To Order Now

 

I​‌‍‍‍‌‍‌‍‍‍‌‌‌‍‌‌‌‌‌‌​nstructions:
The leading diagnosis for this patient is ****. As evidenced by presenting symptoms of ***** (citation of reference supporting findings). Supporting physical assessment findings include ****** (citation).
Differential Diagnoses
Differential diagnoses for this patient include *** and ***. (must have 2 differentials)
Differential 1 (e.g. Influeza)
The first differential in this case is **** supported by patient presentation of *** (citation). The differential is further supported by physical exam findings of **** (citation). *** is less likely however due *(here you would present s/s, history physical exam findings that rule out differential)* (citation).
Differential 2 (e.g. Viral pharyngitis)
*** is the second possible differential in this case. Differential is supported by patient’s presenting symptoms of **** (citation). Patient’s physical assessment findings of *** further support the differential however, differential is less likely due to *** (citation).
Diagnostics
Based on current practice guideline recommendations, **this would be any pertinent diagnostic test(s) or exam(s) indicated for diagnosis** (must include citation of a Clinical Practice Guideline or Problem Specific Peer Reviewed Reference). Brief statement regarding why the test(s) is/are being used, e.g. Positive RADT results are confirmatory for GAS in pediatric patients (Clinical Practice Guideline or Problem Specific Peer Reviewed Reference citation).
Treatment Plan
*** is the first line treatment for *** (Clinical Practice Guideline or Problem Specific Peer Reviewed Reference) Any medications should include name, route, dose, and duration (Clinical Practice Guideline or Problem Specific Peer Reviewed Reference citation). Supportive measures recommended, including ***** (citation). Follow up **** (citation)
References
Include references cited documented per APA 7 guidelineAndrew Hailey is a 17-year-old male who presents to the clinic today with a four-hour history of severe right groin pain radiating to
the right scrotum and associated nausea but no vomiting, fever, or urinary symptoms.
II. Prioritized Cues from Hx and PE. (Do not include lab, x-?ray, or other diagnostic test results here.)
• Tier 1: The cues (may be positive or negative) that contribute most to the diagnosis of the active problem.
• Tier 2: These are cues of intermediate importance (list only positive cues).
• Tier 3: Of least importance (list only positive cues).
Tier 1 Tier 2 Tier 3
Right sided groin pain that began 4 hours ago Previous episode of similar pain that resolved
spontaneously
Similar episode in the part that resolved
spontaneously
Swollen, tender, and erythematous right scrotum Sexually active but uses condoms Appendectomy at age 12
Associated nausea Denies vomiting, fever, urinary symptoms
Denies injury or trauma No penile discharge
III. Problem Statement
Andrew, a sexually active 17-year-old boy, has a four-hour history of significant right groin pain with radiation to the right scrotum
and nausea, but no vomiting, fever, or urinary symptoms. A similar event occurred six to nine months earlier and resolved
spontaneously, according to the patient. A swollen, erythematous right scrotum with an excruciatingly sensitive right testicle, no
masses, a negative Prehn sign, an absent cremasteric reflex on the right, no blue dot sign, and no transillumination of the scrotum
are discovered on ph​‌‍‍‍‌‍‌‍‍‍‌‌‌‍‌‌‌‌‌‌​ysical examination.
IV. Differential Diagnosis
Based on what you have learned from the history and physical examination, list up to 3 diagnoses that might explain this patient’s
complaint(s). List your most likely diagnosis first, followed by two other reasonable possibilities. For some cases, fewer than 3 diagnoses will be
appropriate. Then, enter the positive or negative findings from the history and the physical examination that support each diagnosis.
Leading dx: Testicular torsion
History Finding(s) Physical Exam Finding(s)
Acute pain onset of 4 hours Vital signs are normal
Severe right groin pain radiating to right scrotum Swollen, tender, and erythematous right scrotum
Associated nausea without other symptoms Negative Prehn sign
No pain reliving factors Absent blue dot sign
Pain 10/10 No scrotal transillumination
No history of groin injury or trauma Absent cremasteric reflex of right scrotum
Alternative dx: Epididymitis
This study source was downloaded by 100000820572760 from CourseHero.com on 07-27-2022 14:53:43 GMT -05:00
https://www.coursehero.com/file/143252481/CAT-FM27docx/
History Finding(s) Physical Exam Finding(s)
Acute pain onset of 4 hours Vital signs are normal
Severe right groin pain radiating to right scrotum Negative Prehn sign
Associated nausea without other symptoms Swollen, tender, and erythematous right scrotum
No pain reliving factors Absent cremasteric reflex of right scrotum
Pain 10/10
No history of groin injury or trauma
Alternative dx: Trauma
History Finding(s) Physical Exam Finding(s)
Severe right groin pain radiating to right scrotum Vital signs are normal
Associated nausea without other symptoms Swollen, tender, and erythematous right scrotum
No pain reliving factors Absent cremasteric reflex of right scrotum
Pain 10/10
No history of groin injury or trauma
Acute pain onset of 4 hours
V. Explanation of Diagnostic Plan (including tests, labs, imaging studies, etc.) and Treatment Plan in prioritized order:
Diagnostic Plan Rationale
Color doppler sonography Color doppler sonography is extremely specific and sensitive in
detecting torsion and other disorders that might affect the scrotum
(Hyun, 2018).
Radionuclide scintigraphy This test is used to determine testicular viability. Non-viable
testis manifests as a photopenia in the testis region on
radionuclide scrotal scintigraphy; in situations when infarction is
due to undetected torsion, there may be a surrounding ring of
hyper-perfusion around the photopenia (Krishnaraju et al., 2018).
Complete blood count This is in order to get an idea of what is going on in the body. The
leukocyte count is elevated in individuals with testis torsion,
according to numerous research; it acts as a sign of the
inflammatory response (Yucel & Ozlem Ilbey, 2019).
Urinalysis UA is useful in ruling out other possible causes of scrotal
discomfort, such as epididymitis or kidney stones, rather than
diagnosing torsion (Hyun, 2018).
Urine with culture and sensitivity A urine culture can be useful in ruling out the possibility of a
urinary tract infection.
Treatment Plan Rationale
Manual detorsion of the testicle In patients with testicular torsion, preoperative manual detorsion
was linked to better surgical salvage (Dias Filho et al., 2017).
Orchidopexy Testicular torsion is a serious surgical emergency that
necessitates immediate surgical intervention in order to save the
patient’s testicular viability (Hy​‌‍‍‍‌‍‌‍‍‍‌‌‌‍‌‌‌‌‌‌​un, 2018).
I

Get Help With Your Essay

"Place your order now for a similar assignment and have exceptional work written by our team of experts, guaranteeing you A results."

For This or a Similar Paper Click To Order Now