This patient has a testicular mass. Let's examine a few differentials as we go through the answer choices.
Germinal Cell Tumor (Testicular Tumor)
Dilated pampiniform venous plexus (Varicocele)
Cystic Dilation of the effect ductules (Spermatocele)
Fluid accumulation within the tunica vaginalis testis (Hydrocele)
Vascular Trauma (Hematocele/Ruptured Testis)
This question is tricky. I used to always miss this presentation. This is laterally medullary syndrome- which most of us have memorizes is a PICA infarct. Fun fact, PICA comes off the vertebral artery.
This is how I remember the sx. If this helps at least one person I will be glad I am exposing my twisted brain.
3+5=8 & 9-11 & B-P.
3: Horner's syndrome 5:spinal trigeminal- ipsi face pain and temp loss 8: vestibular signs, vertigo diplopia
9-11: Nucleus ambiguous, diminshed gag, dysphagia B: Cerebellar - inferior cerebellar peduncle, ipsi ataxia P: Contra pain and temp, cuz this shit was so painful to memorize I throw it to the other side.
Cramping abdominal pain with distention, N/V should make you think SBO
Air-fluid levels in the small bowel but no gas in the colon tells you it's an upper GI issue
Hyperactive bowel sounds + pneumobilia = gallstone ileus
Very few things put air in the liver
ABI<0.9 is diagnostic of peripheral artery disease. First-line treatment is graded exercise program. Revascularization is only indicated for critical limb ischemia (rest pain, non-healing ulcers)