Practice Paper 2: Answers
Anthony B. Starr, Hiruni Jayasena, David Capewell, Saran Shantikumar in Get ahead! Medicine, 2016
Epididymo-orchitis, literally meaning inflammation of the epididymis and testicle, can be caused by a number of pathogens. It may occur secondary to cystitis, chlamydial/gonococcal urethritis or prostatitis and following urethral instrumentation. Less commonly, the mumps virus is responsible. Patients present with an acute scrotum (an acutely painful and swollen testicle) with discoloration of the scrotal skin. There may also be a history of unprotected sex and urethral discharge, although it often presents anew. In young men presenting with an acute scrotum, it is essential to exclude testicular torsion before diagnosing epididymo-orchitis. Further investigation of suspected epididymo-orchitis should include a full blood count, blood cultures, urine culture and urethral swabs for sexually transmitted infection (STI). The treatment of epididymo-orchitis is with oral antibiotics (e.g. ciprofloxacin for 4–6 weeks), scrotal support, analgesia and bed rest. If an STI is confirmed, the patient should be given advice on how to access the genitourinary medicine (GUM) clinic for further advice, testing, and partner tracking and notification.
Urinary Tract Infections, Genital Ulcers and Syphilis
Miriam Orcutt, Clare Shortall, Sarah Walpole, Aula Abbara, Sylvia Garry, Rita Issa, Alimuddin Zumla, Ibrahim Abubakar in Handbook of Refugee Health, 2021
Orchitis can occur with epididymitis as a result of bacteria/STIs. It can occur with mumps virus or coxsackie B. In mumps, it occurs 4–6 days after parotitis; three-quarters of cases are unilateral. Prescribe analgesia, ice and scrotal elevation. If the patient is younger than 35 years or sexually active, cover for STIs; an example of antibiotic regimen is a stat dose of 500 mg ceftriaxone intramuscularly plus doxycycline 100 mg orally twice daily for 10 days. If the patient is older than 35 years and/or has a low risk of STIs, prescribe 500 mg levofloxacin orally for 10 days, 500 mg ciprofloxacin twice daily for 10 days or co-trimoxazole for 10 days. If suspicion of testicular torsion, which is a surgical emergency, refer to hospital.
Cough Formation in Viral Infections in Children
Sunit K. Singh in Human Respiratory Viral Infections, 2014
The human parainfluenzaviruses (PIV 1–3) are frequently associated with initial clinical presentation of cough, usually with accompanying fever,152 and have a particularly strong association with croup during the cooler months in children and the elderly.153,154 Both mumps virus (MuV) and measles virus (MV) infections occur most often during childhood. MV infection is characterized by dry cough during the prodromal phase of infection155,156 and is part of a more sensitive case definition for measles when combined with fever and rash.157 Cough is not a clinical feature of MuV infection.158
The effects and molecular mechanism of heat stress on spermatogenesis and the mitigation measures
Published in Systems Biology in Reproductive Medicine, 2022
Yuanyuan Gao, Chen Wang, Kaixian Wang, Chaofan He, Ke Hu, Meng Liang
The mumps virus can cause a range of complications. These include orchitis, oophoritis, encephalitis, and meningitis. Studies have shown that the mumps virus is highly testicular tendentious, inducing a testicular cell immune response, and damaging testicular function. Mumps orchitis is a rare complication, and is mainly seen in post-pubertal males with mumps (Wu et al. 2021). It often occurs in young men and is characterized by headache and fever in the early stages and swelling and pain in the testicles in the later stages. The mumps virus damages testicular tissue and causes substantial edema in testicular tissue. Increased pressure on the seminiferous tubules due to parenchymal edema can lead to necrosis of the seminiferous tubules and atrophy of the spermatogenic epithelium, eventually resulting in testicular atrophy (Yang et al. 2020).
Waning immunity of one-dose measles-mumps-rubella vaccine to mumps in children from kindergarten to early school age: a prospective study
Published in Expert Review of Vaccines, 2018
Yuanbao Liu, Zhihao Liu, Xiuying Deng, Ying Hu, Zhiguo Wang, Peishan Lu, Hongxiong Guo, Xiang Sun, Yan Xu, Fenyang Tang, Feng-Cai Zhu
Notably, 8.8% of the participants may have contracted a silent or asymptomatic infection. Sabine Dittrich et al. assessed the serological evidence for mumps virus infection in vaccinated children and found that 7–10% of MMR-vaccinated children may have an asymptomatic infection in primary schools with intermediate vaccine coverage during a mumps outbreak [23]. Therefore, although the immunity waned with time, a one-dose MuV schedule can still protect children from apparent infection even with relatively low mumps immunity. In addition, this implies that protection may be afforded by other persisting immune responses, such as the cellular immune response, by receiving an MMR vaccine. Another study also showed that high vaccination coverage for at least one dose of MuV can limit the extent of a mumps outbreak [14]. This finding may provide useful information when studying transmission patterns and mumps vaccine effectiveness to protect children with other diseases from infection.
Hyperbaric Oxygen Therapy for Mumps-Associated Outer Retinitis with Frosted Branch Angiitis
Published in Ocular Immunology and Inflammation, 2022
Jihene Sayadi, Imen Ksiaa, Ines Malek, Raja Ben Sassi, Leila Essaddam, Moncef Khairallah, Leila Nacef
Results of physical examination were unremarkable. Systemic work-up and investigations, including a pediatric examination, complete blood count, erythrocyte sedimentation rate, C-reactive protein titer, angiotensin-converting enzyme titer, tuberculin skin test, Quantiferon test, chemistry panel, urine analysis, syphilis serology, and chest X-ray were normal or negative. Brain magnetic resonance imaging did not show any abnormality. Results of cerebrospinal fluid analysis were negative for sugar, protein, and lymphocytes. Culture was negative for bacteria and fungi. Results of multiplex PCR on aqueous sample were negative for HSV, VZV, CMV, and EBV. Serological testing with ELISA showed positive IgM and IgG antibodies against mumps virus.
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