A 24-year-old male presents to the clinic with acute onset l…

A 24-year-old male presents to the clinic with acute onset left-sided scrotal pain and swelling that began 8 hours ago. He reports progressive worsening pain and difficulty walking due to discomfort. He denies trauma. He is sexually active with one current partner and three partners in the last year. He reports mild nausea but no vomiting. On examination, the left hemiscrotum is erythematous, edematous, and tender to palpation. The affected testicle appears slightly elevated compared to the right. The cremasteric reflex is difficult to elicit due to guarding. Prehn sign is inconclusive due to severe tenderness. Which of the following conditions must be included in the original list of  differential diagnoses for this patient’s presentation?

A 58-year-old male presents with a right groin bulge that he…

A 58-year-old male presents with a right groin bulge that he first noticed 3 months ago. He reports that the bulge becomes more prominent when standing or coughing and decreases when lying down. He describes a dull ache in the area after prolonged standing but denies severe pain, nausea, vomiting, or bowel changes.  On physical examination, a soft mass is palpated in the right groin. The mass enlarges with Valsalva maneuver and is reducible when the patient lies supine. When the examiner invaginates the scrotal skin and advances a finger into the inguinal canal, a bulge is felt striking the fingertip during coughing. Which of the following is the most likely diagnosis?

A 46-year-old male presents with acute rectal pain that bega…

A 46-year-old male presents with acute rectal pain that began suddenly 2 days ago after straining during a bowel movement. He describes severe, constant pain that makes sitting uncomfortable. He denies fever, abdominal pain, or changes in bowel habits. He reports a history of intermittent painless bright red blood on toilet paper in the past.  On examination, there is a 2-cm, tense, bluish, exquisitely tender nodule at the anal verge. No purulent drainage is noted. Digital rectal exam is deferred due to pain. Which of the following is the most likely diagnosis?