Testes and scrotum

Question 1

ipsilateral contraction of scrotum when inner thigh is stroked?

Answer 1

cremasteric reflex

Question 2

where do the majority of torsions occur?

Answer 2

within the tunica vaginalis

Question 3

Sudden onset of severe testicular pain, that can wake a patient up from sleep an make walking difficult

Answer 3

testicular torsion

Question 4

where can you get pain?

Answer 4

testicle, groin, lower abdomen

Question 5

how would testicle be lying in testicular torsion ?

Answer 5

lying high in the scrotum on a horizontal plane

Question 6

what is untwisting and bilateral fixation called?

Answer 6

orchidoplexy

Question 7

what is orchidectomy ?

Answer 7

removal of testicle

Question 8

if the testicle is necrotic, what is done?

Answer 8

removal of necrotic testicle and fixing of the other one

Question 9

how does torsion of the testicular appendage present?

Answer 9

slower onset of symptoms, visible blue dot on testes, presence of creamsteric reflex

Question 10

what is the mangement of torsion of the test appendage?

Answer 10

nil - majority will resolve spontaneously

Question 11

swollen red testicle with itch and mild pain?

Answer 11

idiopathic scrotal oedema

Question 12

what is typical age for idiopathic scrotal oedema

Answer 12

under 19

Question 13

causative organisms of epididymo orchitis ?

Answer 13

chlamydia, gonorrhoea, e-coli and mumps

Question 14

what infections can eo be caused by?

Answer 14

UTI and STI

Question 15

investigations for epididymo orchitis?

Answer 15

1st pass urine (PCR for chlamydia and gonorrhoea)

MSSU: dipstick and culture

Question 16

STI more likely for EO in which patient group?

Answer 16

less than 35 with new sexual partner

Question 17

treatment if under 35 and new sexual parnter?

Answer 17

doxycycline + 500mg IM ceftriaxone if gonorrhoea confirmed

Question 18

in EO, if UTI is more likely (i.e. over 35 and no new sexual partner) - treatment ?

Answer 18

ofloxacin or ciprofloxacin

Question 19

why is variocele common on the left hand side?

Answer 19

testiular vein joins the renal vein at 90 degrees

Question 20

investigation of variocele?

Answer 20

doppler US

Question 21

main complication of variocele?

Answer 21

reduced fertility, with surgery not improving pregnancy outcomes

Question 22

where does fluid normally accumulate relative to the testicle in a hydrocele?

Answer 22

anterior and inferior