iHuman testicular pain real exam 2023 /2024 update
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Primary Diagnosis and ICD-10 code:
Testicular Torsion: ICD-10-CM Code N44.00
Testicular Torsion occurs from the twisting of the spermatic cord, which in turn compromises the
supply of blood to the testicles (Burns et al., 2017). It is one of the most dramatic processes that
affects the supply of blood to the testicles. It is one of the most serious conditions since it affects
scrotal contents and may lead to loss of a testicle. Among the symptoms of the condition is that
the patient experiences a sudden pain in the scrotum, the swelling of the scrotum, vomiting and
nausea, frequent urination, fever, and one of the testicles is positioned higher at an unusual angle.
Differential diagnosis. Other possible conditions that could be caused by the symptoms
exhibited by the patient include;
1. Epididymitis: ICD-10-CM Code N45.1
Acute epididymitis is the inflammation of the epididymis and the pain is so severe. The condition
is caused by chlamydia trachomatis and Neisseria gonorrhea. It can also be caused by
dysfunctional voiding, anomalies of the genitourinary tract, tubercular infection, and coliform
bacterial (Burns et al., 2017). Some of the common symptoms of the condition may include:
blood in the semen, discharge from the penis, testicular pain, and painful urination. I would not
consider this since the patient did not have penis discharge, blood in semen, painful urination,
and based on the information provided, the patient was not sexually active.
2. Hernia
An incarcerated inguinal hernia may also be present with the sudden onset of pain and vomiting.
There might also be a presence of redness and swelling of the scrotum. However, the testicles
will be normal and the cremasteric reflex is preserved, hence making this a less likely alternative
hypothesis. Incarceration is a must not miss diagnosis, which should be ruled out in view of the
risk of bowel ischemia and its consequences.
3. Urolithiasis
The differential diagnosis should be included because the following symptoms are associated
with kidney stones: the sudden onset of the pain may be severe and the patient may experience
nausea and vomiting. The physical findings of the illness may include the following: the patient
appears restless, there is CVA tenderness, which may be unilateral. On the same note, hematuria
may be present.
4. Torsion of the testicular appendage: ICD-10-CM Code N44. 03
It is an emergency condition where there is the twisting of the vestigial appendage that is situated
alongside the testicle. The twisting is a common cause of acute scrotal pain and in most cases, it
occurs on individuals in the pre-pubertal age group (Burns et al., 2017). Typically, an individual
suffering from the condition will experience a steady onset of scrotal pain and they will have a
present “blue dot sign.” When the vestigial appendage twists, the testicle loses its blood supply.
It happens suddenly for no apparent reason and if it is not treated within six to twelve hours, the
testicle can be lost. The following symptoms may be associated with the illness: sudden onset of
testicular pain, the swelling may not be present, and it is not associated with vomiting and
nausea.
5. Appendicitis: ICD-10 code N44. 03 [Show Less]