Question of the Week # 245

August 3, 2011 4:06 am9 Comments
Archer USMLE Step 3

245 )  A 52-year-old man presents with acute onset of pain in his left testis which started abruptly after unprotected sexual intercourse. The pain started 3 hours ago, it is severe and constant. He denies any fever, chills, nausea or vomiting. On physical examination, the patient is afebrile and in severe distress. Testcular examination reveals a normal sized diffusely tender left testicle. Cremasteric reflex is absent on the left. A routine testicular ultrasound reveals normal testicles. A Complete Blood Count and Urinalysis are normal. What is the next step in management of this condition?

A)     Observation and Antibiotics

B)      Surgical exploration

C)      Repeat Testicular Doppler Ultrasound

D)     Laparotomy

E)      Observation alone

Posted in USMLE Test PrepTagged archer surgery, ARCHER UROLOGY, usmle step 3 surgery, usmle step 3 urology

9 Thoughts on “Question of the Week # 245”

  1. isabella on August 3, 2011 at 6:13 am said:

    B is the answer.
    this pt has testicular torsion which is an surgical emergency.

    Reply↓
  2. sidiya on August 3, 2011 at 8:21 am said:

    cccccccccc

    Reply↓
  5. Yogi on August 5, 2011 at 7:30 pm said:

    B. Testicular torsion is an surgical emergency.. must salvage it within 6 hours..

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  6. Yogi on August 5, 2011 at 7:36 pm said:

    per medscape “Early in the course of testicular torsion, gray-scale ultrasonographic examination may be absolutely normal.”…

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  7. Ahmed El-dugdug on August 6, 2011 at 3:28 pm said:

    B. :
    absent Cremasteric reflex >> Torsion >> surgical explor.

    Reply↓
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