Testicular torsion — MCCQE Part 1 MCQ

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HardScrotal PainTesticular torsionMCCQE Part 1

A 15-year-old boy has sudden severe unilateral scrotal pain, nausea and a high-riding testis with absent cremasteric reflex. Which of the following is the most appropriate next step?

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Correct answer: D — Call urology urgently for surgical exploration

Call urology urgently for surgical exploration is the single best answer because the age, timing, examination findings and investigations in the vignette fit Testicular torsion better than the alternatives. The most tempting distractor is less appropriate because it either treats a neighbouring presentation, delays a time-critical intervention, or ignores a key discriminator in the stem. The remaining options are suboptimal because they would miss the diagnosis, use an investigation or treatment in the wrong sequence, or fail to address safety and follow-up. Canadian practice should be anchored to Canadian Urological Association guidance, with attention to acuity, safety-netting and local provincial pathways.

Reference: Canadian Urological Association guidance