Return to Diagnosis ListShow Learning Points most relevant to Phase 1:

Abdominal or inguinal lump

Clinical Discipline(s)/Organ System(s)
Genitourinary System, Paediatrics, Digestive System, General Practice, General Surgery
Progress Test Topic(s)
Child health
An 8 month old NZ European boy comes to his GP as his mother has noticed he has a 'lump in the lower part of his tummy on the right'.
Progress Test-Type Questions:   Question 1 | Question 2
Applied Science for Medicine 
   - Embryology and anatomy of genitourinary tract and gastrointestinal system
   - Normal and abnormal testicular descent
   - Principles of oncogenesis (lymphoma, Wilms tumour, neuroblastoma)
Clinical and Communication Skills 
   - History from caregiver including antenatal history
   - Examination of the abdomen including genitals
   - List the common causes and know the distinguishing features of infant abdominal and scrotal masses
   - Identify important associated features of examination of a mass that might represent malignancy and the necessary secondary investigations
   - Recognise acute (those requiring immediate surgical management) and non-acute swellings of the scrotum
   - Establish a relationship with patient and family/whānau
Personal and Professional Skills 
   - Communicate empathetically with child and caregivers
   - Perform physical and genital examination in a sensitive manner; acknowledge the potential for embarrassment in an older child
   - Communicate with the patient and family/whānau in a way that ensures they have sufficient knowledge and understanding to be able to make informed decisions and give informed consent (regarding surgery)
Hauora Māori 
   - Awareness of whānau dynamics (who is/are carers), whānau care giving issues, impact of illness on whānau employment/income (if needing to take time off work to be with child)
   - Consideration of access to cultural/spiritual support for whānau (including accommodating return of any body parts to whānau if requested post surgery)
   - Understanding inequities in access to health (including oncology) services and quality of cancer care for Māori, and application of this to clinical decision making and management
Population Health 
   - Provision of paediatric surgical and oncology services nationally; access and referral for children
Conditions to be considered relating to this scenario
inguinal lymph nodes, hydrocoele, retractile testes, constipation
Less common but 'important not to miss'
intussusception, inguinal hernia, testicular torsion, undescended or ectopic testes, neuroblastoma, nephroblastoma (Wilms tumour), lymphoma
pelvoureteric junction (PUJ) obstruction