A 13-year-old boy is brought to the emergency department by his parents for evaluation of severe groin pain for the past 4 hours. His symptoms began while he was participating in a basketball game. On arrival to the ED, the resident on call notes a swollen, tender, and elevated left testicle with absence of the cremasteric reflex. A urology consult is requested and the patient is scheduled for surgery. An abnormality in which of the following anatomical structures is most likely responsible for this patient’s condition?
ATunica vaginalis
BCremasteric muscle
CTunica dartos
DTunica vasculosa
ETunica albuginea
A pathologist examining a tissue sample notes the presence of pseudostratified columnar epithelium with goblet cells and cilia. This tissue was most likely obtained from which of the following locations?
ABronchi
BSmall intestine
CSkin
DEsophagus
EUrinary bladder
A 34-year-old man comes to the physician because of a 3-week history of left testicular swelling. He has no pain. He underwent a left inguinal hernia repair as a child. He takes no medications. He appears healthy. His vital signs are within normal limits. Examination shows an enlarged, nontender left testicle. When the patient is asked to cough, there is no bulge present in the scrotum. When a light is held behind the scrotum, it does not shine through. There is no inguinal lymphadenopathy. Laboratory studies show: Hemoglobin 14.5 g/dL Leukocyte count 8,800/mm3 Platelet count 345,000/mm3 Serum Glucose 88 mg/dL Creatinine 0.8 mg/dL Total bilirubin 0.7 mg/dL Alkaline phosphatase 35 U/L AST 15 U/L ALT 14 U/L Lactate dehydrogenase 60 U/L β-Human chorionic gonadotropin 80 mIU/mL (N < 5) α-Fetoprotein 6 ng/mL (N < 10) Which of the following is the most likely diagnosis?
ASeminoma
BLeydig cell tumor
CChoriocarcinoma
DSpermatocele of testis
EYolk sac tumor
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