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Testicular torsion — MCCQE Part 1 MCQ

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ModerateScrotal PainTesticular torsionMCCQE Part 1

A 15-year-old boy develops sudden severe left testicular pain with nausea. The testis is high-riding with absent cremasteric reflex. Which of the following is the most appropriate next step?

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Correct answer: E — Immediate urologic exploration without delaying for ultrasound if torsion is strongly suspected

Sudden testicular pain, high-riding testis and absent cremasteric reflex are classic torsion, where testicular salvage depends on rapid detorsion. Doppler ultrasound can help uncertain cases but must not delay surgery when suspicion is high. Epididymitis is usually more gradual and often has urinary symptoms.

Reference: Canadian Urological Association practice; paediatric urology emergency pathways