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

Groin lump

Clinical Discipline(s)/Organ System(s)
Digestive System, Gastroenterology & Hepatology, General Surgery, Oncology, General Practice
Progress Test Topic(s)
You are on an attachment in a General Practice and are asked to see a 25 year old Samoan man with a lump in his left groin. It has been there for 3 weeks and is not getting any smaller. He is otherwise fit and well.
Progress Test-Type Questions:   Question 1
Applied Science for Medicine 
   - Embryological origin of testes, including their passage to the scrotum
   - Anatomy of the inguinal canal, femoral triangle and veins of the lower limbs
   - Anatomical features relevant to hernia formation
   - Immunological basis for lymphadenopathy
Clinical and Communication Skills 
   - History relating to a groin lump in male and female
   - Perform an examination of a the groin and scrotum; clinically differentiate a direct and indirect inguinal hernia
   - Examine for lymphadenopathy
   - Systematically describe a lump
   - Differential diagnosis of groin lump
   - List the different types and locations of hernias
   - Indications for abdominal and duplex ultrasound, CT abdomen/pelvis, biopsy
   - Management of groin mass
   - Complications of hernias
   - Management and complications of an undescended testis
Personal and Professional Skills 
   - Consent for intimate examination and use of chaperone
   - Manage possible embarrassment arising from examination of groin
   - Awareness of boundaries with patients in own age group
Hauora Māori 
   - Inequalities in incidence, stage at diagnosis, and survival of genito-urinary cancers between Māori and non-Māori
   - Whānau role in ‘breaking bad news’ including impact on fertility
Population Health 
   - Prevention, education and awareness related to hernias
   - Prevalence of undescended testis
Conditions to be considered relating to this scenario
lymphadenopathy (reactive), inguinal hernia (direct or indirect), femoral hernia, saphena varix, sebaceous cyst, lipoma, hydrocoele, varicocele, soft tissue abscess
Less common but 'important not to miss'
lymphoma, testicular cancer in an undescended testis, strangulated hernia, melanoma, common femoral artery aneurysm, sarcoma, metastatic cancer
neuroma, lymphocele, varicose vein, obturator hernia
Related Scenarios
[Bowel obstruction]