Testicular torsion — RACGP Fellowship MCQ
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Correct answer: B — Arrange immediate emergency referral for suspected testicular torsion
Explanation lettering: B = shown as A · D = shown as B · A = shown as D
Testicular torsion is a surgical emergency requiring immediate referral. The clinical presentation is classic: adolescent boy with acute scrotal pain, nausea, and a high-riding tender testis. Normal urinalysis excludes epididymitis. The patient is within the critical 6-hour window for salvage—the most important determinant of outcome. Salvage rates decline sharply beyond 6 hours, and delays in diagnosis and referral result in preventable testicular loss. All distractors represent dangerous delays or misdiagnosis: outpatient ultrasound (A) wastes critical time; antibiotics alone (B) fail to address torsion; reassurance based on urinalysis (C) ignores the clinical diagnosis; and rest with review (E) allows ischaemia to progress irreversibly.
Reference: RACGP Australian Family Physician, 'Acute scrotal pain' (2013); supported by systematic review of testicular torsion management emphasizing urgent exploration within six hours (Cureus 2025, PMC12535219), https://www.racgp.org.au/afp/2013/november/acute-scrotal-pain