Surgery & perioperative · History + examination

Sudden severe pain in one testicle - Emergency Department

HardYear 5 · Curtin style · 10 min + 2 min reading · 4 tasks

Ready

2 min reading, 10 min station, warning at 2 min

Focus the timer and press Space to start or pause.

Station - Instructions for candidate

You are an intern working in the Emergency Department of a metropolitan hospital in Perth. It is 7 am. The surgical registrar is on site and can be phoned.

Ricky Salazar, 16, is in a cubicle with his mum, who drove him in. The triage note and observations are on your sheet.

Triage note (7 am)	16 M. Sudden onset severe L testicular pain at 5 am, woke him; vomited x2. No trauma. No urinary symptoms. Last ate 8 pm. No medical history, no medicines, NKDA. Weight 62 kg. Urine dipstick: negative for leucocytes, nitrites and blood. Category 2.
Observations	HR 108 /min, BP 128/78 mmHg, RR 20 /min, SpO2 99% on room air, T 37.2 degrees C, pain 9/10

Your tasks are to:

Take a focused history from Ricky, with his mother present.
Describe to the examiner the examination of the abdomen, scrotum and testes you would perform, including the cremasteric reflex; the examiner will provide the findings. Do NOT examine the simulated patient.
Request any investigations you consider necessary; the examiner will provide results where appropriate. State your most likely diagnosis and the differential diagnoses to the examiner.
Outline your immediate management plan to the examiner, including who you will call, and explain what is happening and what will happen next to Ricky and his mother.

You do NOT need to summarise your findings to the examiner.
No genital examination is performed on the simulated patient; the findings are read out by the examiner when you describe what you would examine.
State drug, dose (per kilogram and total, with the maximum), route and frequency for anything you prescribe.

This is a 10-minute station, with 2 minutes of reading time.

Ask the examiner

Say what you want out loud, then open it below. Each result stays hidden until you reveal it.

Investigations

Ask for a category the way you would in the station: “Can I have the obs and a set of bloods?”

Examination

Say what you would examine and how; the examiner reports what you would find.

After treatment

Once you have acted, ask how the patient has responded.

Generated by AI for practice; check doses and pathways against eTG / AMH before relying on them.

Tasks

Take a focused history from Ricky, with his mother present.
Describe to the examiner the examination of the abdomen, scrotum and testes you would perform, including the cremasteric reflex; the examiner will provide the findings. Do NOT examine the simulated patient.
Request any investigations you consider necessary; the examiner will provide results where appropriate. State your most likely diagnosis and the differential diagnoses to the examiner.
Outline your immediate management plan to the examiner, including who you will call, and explain what is happening and what will happen next to Ricky and his mother.