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Q1: Bell-clapper & age peaks (2 min)
- Intravaginal torsion adolescents; extravaginal neonates; horizontal lie
Q2: Clinical diagnosis (2 min)
- Sudden pain, vomiting, high-riding horizontal testis, absent cremasteric — explore
Q3: Why not wait for Doppler (2 min)
- Time = testis; false-negative Doppler; imaging only if truly equivocal and non-delaying
Q4: Operative steps (3 min)
- Untwist, assess viability, orchidopexy ipsilateral, contralateral fixation always discuss/do
- Orchidectomy if necrotic
Q5: Manual detorsion (1 min)
- Open-book outward rotation often; still explore
Q6: Differentials (2 min)
- Epididymo-orchitis, hydatid torsion (blue dot), hernia, tumour, referred stone
Q7: Undescended testis torsion (2 min)
- Empty scrotum + inguinal pain/mass — urgent exploration
Q8: Medicolegal & fertility (2 min)
- Missed torsion classic claim; counsel salvage odds by time; contralateral fixation rationale
Q9: Intermittent torsion (2 min)
- Recurrent acute pain that resolves; horizontal lie history; still needs urgent urology — risk of future complete torsion
Q10: Blue-dot management (2 min)
- If classic hydatid and senior confident, conservative possible in some units — but explore if any doubt
Q11: Fixation technique principle (2 min)
- Three-point non-absorbable fixation to prevent retorsion; always address contralateral risk
Q12: Communication (2 min)
- Parents: time-critical; possible loss of testis; bilateral fixation rationale; fertility generally preserved with one healthy testis