Celiac disease responds well to a diet with no gluten. In your kitchen cupboards at home and in your refrigerator, identify all the products that include wheat, oats, barley, rye, or their derivatives. Some other common ingredients to avoid include modified food starch, natural flavoring, malt, and flavorings and spices that are not specifically identified. Summarize what Celiac disease is and what type of foods can be eaten, then using what you have in your kitchen plan a menu for one day for someone with celiac disease. This includes breakfast, lunch, and dinner.

Epididymitis and testicular torsion are both causes of scrotal pain. Testicular torsion requires prompt recognition and surgical intervention to avoid testicular damage. Epididymitis is easily managed with antibiotics.

Differentiation between the two disorders is important. Review the case and answer the questions

 

Case: A 15-year-old presents to the emergency department complaining of sudden onset of right-sided scrotal and groin pain. He states the pain is constant and extreme.

He said it started about 2 hours ago during basketball practice at school, but he denies any trauma to the scrotum. He is worried that he has a sexually transmitted infection as he just started having sexual intercourse with his girlfriend and he did not use condoms.

He says he feels nauseated and thinks he is going to vomit. He said he noticed this same pain once before, but it went away within a few seconds and he did not tell anyone.

Vital signs: Temperature 98.9° F; pulse 100 beats per minute; respirations 20 breaths per minute; blood pressure 120/70 mmHg. Physical examination reveals a healthy-appearing adolescent who is anxious and grimacing.

The patient has edema and erythema of his right scrotum. His scrotum is tender, and the patient only tolerated superficial palpation.

 

1. The most likely diagnosis based on his history is: a. Epididymitis b. Testicular torsion

 

2. Erythema and edema of the scrotum are only present with epididymitis. a. True b. False

 

3. Which of the following clinical manifestations are consistent with epididymitis, and which are consistent with testicular torsion? a. Positive Prehn sign 1. Testicular torsion b. Negative cremasteric reflex 2. Epididymitis c. Testis elevated on affected side d.

Fever   4. Which diagnostic test is most appropriate to confirm the suspected diagnosis?

a. A complete blood count with differential b. An MRI of the scrotum c. A Doppler ultrasound of the scrotum d. A urine culture and sensitivity 5. Discuss the treatment plans for testicular torsion and epididymitis.

 

A 54-year-old schoolteacher is seeing your today for complaints of passing bright red blood when she had a bowel movement this morning. She stated the first episode occurred last week. The episode today was accompanied by nausea, sweating, and weakness. She states she has had some LLQ pain for several weeks but described it as “coming and going”.

She says she has had a fever and abdominal cramps that have worsened this morning.

Diagnosis is lower GI bleed secondary to diverticulitis.

Question:

1.     What can cause diverticulitis in the lower GI tract?