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.
sclera injection and munchies
In the words of afroman. I was gonnna go to work....but then I got high...
Warmest welcome back to Step 1 by NBME lol