You are performing a sports physical on a 14-year old boy wh…

You are performing a sports physical on a 14-year old boy who wants to join the basketball team. He reports a dull, achy pain in his scrotum when standing that has been present for more than a week. Upon examination of the scrotum you note a “bag of worms” texture. There is no apparent transillumination and the cremasteric reflex is intact. What is the most likely diagnosis?  

You are seeing a 2 year old girl for at an urgent care clini…

You are seeing a 2 year old girl for at an urgent care clinic. Mom reports her daughter had a 104 degree fever for 4 days and then yesterday a horrible rash appeared on her chest. Upon exam you note a non-blanching maculopapular pink rash on the trunk, extremities and head. There is no sign of escoriation, no associated adenopathy. The rash is depicted in the photograph below. What is the most likely diagnosis?    

A 3- year old boy is brought to the office by his father bec…

A 3- year old boy is brought to the office by his father because of a 3 month history of decreased activity, poor appetite, clumsiness, and speech regression. Since his birth his family has lived in an old area of the city where there is demolition of old buildings. The parents report that he has eaten dirt in the past. Examination of a peripheral blood smear is likely to show which of the following?

The clinician is seeing a 64-year-old women who reports havi…

The clinician is seeing a 64-year-old women who reports having several episodes of light vaginal bleeding. Her final menstrual period was at age 53 and she has had no bleeding since then. She has no current or prior use of hormone therapy. You understand that she will need which of the following: