Urology: epididymo-orchitis: practice question

A General Surgery question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Surgery · Urology: epididymo-orchitis

Sample item

A 25-year-old sexually active man has gradual scrotal pain and fever. Elevation of the scrotum relieves the pain and urinalysis shows pyuria. Which sign is this?

ANegative Prehn sign, suggesting torsionBPositive Prehn sign, suggesting epididymitisCCremasteric reflex absentDTransillumination positive

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Positive Prehn sign, suggesting epididymitis

Relief of pain on elevation of the testis (Prehn sign) favours epididymitis over torsion, in which pain is not relieved. In young men the usual organisms are Chlamydia and gonococcus, and treatment includes ceftriaxone with doxycycline. Torsion must always be considered if the diagnosis is uncertain.

Option by option

A. Negative Prehn sign, suggesting torsion
A negative sign would favour torsion, not relief.
B. Positive Prehn sign, suggesting epididymitis (correct)
Correct. Relief on elevation favours epididymitis.
C. Cremasteric reflex absent
An absent cremasteric reflex is a feature of torsion.
D. Transillumination positive
Transillumination is a test for hydrocele.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this General Surgery question

What is the answer to this General Surgery question?

The best answer is B, Positive Prehn sign, suggesting epididymitis. Relief of pain on elevation of the testis (Prehn sign) favours epididymitis over torsion, in which pain is not relieved.

Why is "Negative Prehn sign, suggesting torsion" not the answer?

A negative sign would favour torsion, not relief.

Why is "Cremasteric reflex absent" not the answer?

An absent cremasteric reflex is a feature of torsion.

Why is "Transillumination positive" not the answer?

Transillumination is a test for hydrocele.

What concept does this question test?

It tests Urology: epididymo-orchitis in General Surgery. In young men the usual organisms are Chlamydia and gonococcus, and treatment includes ceftriaxone with doxycycline. Torsion must always be considered if the diagnosis is uncertain.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Urology: epididymo-orchitis?

Learn classic signs and eponyms alongside what they diagnose. Then use the flashcards and the other General Surgery questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.