1-A 32-year-old man complains of right scrotal swelling for one week. He noticed it after carrying a big screen TV. His past medical, surgical and family histories are unremarkable. Examination reveals enlarged right scrotal mass that can be reduced by pushing it back through the external inguinal ring. Upon coughing, it protrudes with no pain or tenderness. Testicles appear normal in both sides.
What is your diagnosis?. What are the contents of the inguinal canal?. What is the main complication of this condition?
This is a case of reducible inguinal hernia. The contents of the inguinal canal are the spermatic cord and its coverings and the ilioinguinal nerve. The main complication of inguinal hernia is incarcerated and strangulated hernia. It can compromise the blood supply to a part of intestine and immediate surgery should be performed to avoid intestinal obstruction and gangrene.
2- A 24-year-old woman visits her physician for her routine annual examination. She has no complaints. She is taking oral contraceptive pills for 3 years and she has regular menstrual cycles. Her Pap smear shows irregular, hypochromic nuclear enlargement and perinuclear cytoplasmic vacuoles.
What is your diagnosis? What is the causative organism? What is the next step of action?
This is a low-grade squamous intraepithelial lesion (LGSIL) caused by infection with human papilloma virus (HPV). The next step of action is colposcopy.