Surprisingly got it in 1!

Blinding and shoulder shrugging: two prototypical examples of classic simple motor tics. Emergence of this new tic in a different body region is also characteristic. 

Onset before age 18 and duration >1 year are both criteria requireed for persistent/chronic tic disorder diagnosis. 

Tics characteristically worsen during periods of stress and diminish when the individual is engaged in focused activities. This pattern helps distinguish tics from seizures (which are not stress-modulated in this way) and from stereotypies (which tend to occur during excitement or boredom rather than stress).

 The absence of vocal/phonic tics is the key feature that distinguishes persistent (chronic) motor tic disorder from Tourette syndrome, which requires both motor and at least one phonic tic.

Was considering testicular torsion vs epididymitis. Didn't seem like trauma. 

Got it in 2. 

Retrograde spread of bacteria, likely a sexually transmitted bacterial infection. Workout with UA, UCx, STI testing, scrotal ultrasound. 

Tx with abxs, NSAIDs, scrotal support, ice.

Wasn't sure if the fussiness was pathologic. Positional changes made me think maybe something cardiac based on how they were held.

Got it in 2. 

Firm, non-tender fusifom mass: "sternocleidomastoid pseudotumor"

The secondary positional plagiocephaly (contralateral occipital flattening) results from the infant's persistent preferential head position during sleep, a well-recognized complication present in ~41% of infants with CMT.

First thought was diabetes because of polyuria + polydipsia + fatigue. In terms of DM1 vs DM2, I leaned toward DM2 first because it is more common and because I thought DM1 would have been diagnosed earlier. 

The polydipsia made me briefly consider primary (psychogenic) polydipsia but wouldn't have explained her fatigue.

Got it in 3. Trauma to the posterior pituitary from the MVC resulted in impaired ADH production, leading to decreased ability of her kidneys to reabsorb free water.

Very dilute urine and very concentrated serum because free water is being lost.

This ruled out primary polydipsia. If she had just been drinking too much water, restriction would have corrected urine osm.

Desmopressin is synthetic ADH and corrects for her decreased secretion. Cool!