testicular disease

Question 1

what is the differential for painful scrotal swelling?

Answer 1

1. torsion of the appendix testis
2. testicular torsion
3. strangulated hernia
4. infection: orchitis, epididymitis

Question 2

presentation of torsion of the appendix testes?

Answer 2

prepubertal child with a severe onset scrotal pain and swelling

Question 3

presentation of testicular torsion ?

Answer 3

a neonate or a pubertal child
severe onset scrotal pain and swelling
nausea and vomitting
absent cremasteric reflex

Question 4

management of both testicular torsion and torsion of the appendix testes?

Answer 4

both need an urgent surgical repair within a 6 hour window

Question 5

differential for painless scrotal swelling?

Answer 5

1. hydrocele
2. varicocele
3. inguinal hernia;

Question 6

all hernias in children are generally?

Answer 6

indirect

Question 7

management of inguinal hernia in children?

Answer 7

surgical repair, urgent if incarcerated (irreducible) or strangulated

Question 8

what is required to confirm the diagnosis of cryptorchidism?

Answer 8

must confirm that the testes are present in the abdomen; physical palpation and ultrasound (especially if impalpable bilaterally)

Question 9

undescended testes usually descend spontaneously by …. of age

Answer 9

4 months

Question 10

if it is a true cryptoorchidism and yet they have no descended spontaneously by …., refer to a pediatric urologist between ….-…. months for surgical correction

Answer 10

4 months
4-12 months

Question 11

what are the risks of non-correction of cryptorchidism by 12 months of age? 4

Answer 11

1. infertility
2. testicular torsion
3. testicular trauma
4. testicular cancer