30 Questions
What is the main cause of testicular torsion?
Inadequate fixation of the testis to the tunica albuginea
At what age group is testicular torsion more common?
Teenagers and postpubertal boys
What percentage of adult patients hospitalized with acute scrotal pain have testicular torsion?
Around 50%
What is the consequence of the testis suffering irreversible damage after 12 hours of ischemia due to torsion?
Development of anti-sperm antibodies
How is testicular torsion usually diagnosed?
By acute onset of severe symptoms and physical findings
What is the primary mechanism leading to ischemia in testicular torsion?
Reduced arterial inflow and venous outflow obstruction
What is the congenital anomaly called when the tunica vaginalis has an inappropriately high attachment, allowing the testicle to rotate freely?
Bell clapper deformity
At what angle twist is required during testis torsion to compromise flow through the testicular artery and cause ischemia?
720°
What is the most common cause of testis loss in the US?
Testicular torsion
Which type of testicular torsion occurs when the testicle twists spontaneously on the spermatic cord?
Intravaginal torsion
What is the term used for when the testicle has not yet descended into the scrotum in neonates, predisposing it to torsion?
Inguinal retention
What does testicular torsion typically present with?
Rapid onset of severe pain and swelling
What is a classic physical examination finding in testis torsion?
Exquisitely tender testicle with a high, horizontal lie
In which age group should torsion be considered in evaluating men with scrotal pain?
Men 40-50 years old
What may occasionally occur in men 40-50 years old according to the text?
Torsion
What is the recommended action with a high degree of suspicion of testis torsion?
Recommend surgical exploration without delay
What may be indistinguishable from epididymoorchitis at a later stage of testis torsion?
Confluent mass without identifiable landmarks
What is the most useful adjunct to history and physical examination in the diagnosis of torsion?
Scrotal ultrasonography
What physical examination findings may be present in blunt testicular injury?
Swelling, tenderness, or ecchymosis
When is surgical exploration recommended for scrotal injuries?
For penetrating injuries to the scrotum
Which ultrasound finding is highly predictive of testicular rupture?
Marked loss of internal homogeneity of the testis
What is the appropriate therapy for intratesticular hematoma?
Observation, rest, cold packs, and analgesics
In what scenario is testicular rupture unlikely?
When the testis is entirely normal to palpation
Which scrotal injury may benefit from drainage?
Large or painful hematoceles
What is the alternative to detorsion for pain relief in affected patients?
Bilateral scrotal orchiopexy
What is a classic feature of 'intermittent' testicular torsion?
Normal physical examination
What sign is observed when the appendage is ecchymotic?
Blue-dot sign
What happens to the infarcted appendage over time if not surgically explored?
It undergoes atrophy
In which area is the appendix testis most commonly affected by torsion?
Upper pole of the testis
What procedure is done if exploration for the infarcted appendage is pursued?
Excision of the appendage
Test your knowledge on appendiceal torsion, testicular infarction, trauma, and testicular torsion in this quiz. Learn about various urologic emergencies related to testicular conditions.
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