OVERVIEW
This page is dedicated to organizing various examples of standardized exam questions whose answer is testicular torsion. While this may seem a odd practice, it is useful to see multiple examples of how testicular torsion will be characterized on standardized exams (namely the boards and the shelf exams). This page is not meant to be used as a tradition question bank (as all of the answers will be the same), however seeing the classic “test” characterization for a disease is quite valuable.
QUESTION EXAMPLES
Question # 1
A 8 year old boy is brought to the clinic because of a 5 hour history of increasingly severe lower abdominal pain. The patient also is experiencing nausea (but has not vomited). He denies any fever, diarrhea, or constipation. There is no recent history of any kind of trauma. HIs temrpature is 100.0°F, pulse is 120/min, and respirations are 20/min. Physical examination shows a soft, contender abdomen with normal bowel sounds. There is edema and erythema of the right scrotal sac, and it appears full. Palpation of the right testis produces pain. The cremasteric reflex is absent on the right. What is the most likely diagnosis?
Explanation: testicular tenderness + testicular swelling + absent cremasteric reflex = testicular torsion
Question # 2
A 15 year old boy is brought to the hospital because he has been experiencing severe left scrotal pain and swelling for the past 2.5 hours. He denies any history of trauma. He was first sexually active 3 months ago and did not use a condom. He has not had sex since then. A genital exam shows tenderness and swelling in the region of the left testicle. There is no cremasteric reflex on the left side. What is the likely diagnosis?
Explanation: testicular tenderness + testicular swelling + absent cremasteric reflex = testicular torsion
Question # 3
A 25 year old male comes to the ER with complaints of severe testicular pain. He was sitting in his apartment playing video games where the pain came on suddenly. His past medical history is unremarkable. He has a temperature of 100.1°F, heart rate of 108 ppm, respiratory rate of 24/min, and a blood pressure of 150/105 mm Hg. A testicualr exam shows a scrotal sac that trans-illuminates, and the left testicle is in horizontal lie.
Explanation: testicle in horizontal lie = testicular torsion
Page Updated: 11.08.2016