Scrotal fluid: clear or complex?

Question 1What does a simple hydrocele look like?

1. aBright echoes with shadowing
2. bBlack fluid with no echoes around the testis
3. cSeptated fluid with debris
4. dA thick-walled mass inside the testis

Question 2A man has a tense, swollen scrotum after a kick. The scan shows complex fluid and an irregular testicular outline. What next?

1. aAspirate the fluid in the emergency department
2. bUrgent urology review for possible testicular rupture
3. cRepeat the scan in six weeks
4. dAnalgesia and discharge

Question 3Why look carefully at the testis inside a new hydrocele in a young man?

1. aA reactive hydrocele can hide a testicular tumour
2. bIt is not necessary
3. cThe testis is never visible through fluid
4. dTo measure the fluid volume only

Question 4Complex scrotal fluid with fever and tenderness suggests what?

1. aA simple hydrocele
2. bA pyocele
3. cA varicocele
4. dA normal finding

Question 5A boy with sudden scrotal pain has a small hydrocele. What does the hydrocele tell you?

1. aThat the testis is normal
2. bLittle on its own, because reactive fluid accompanies torsion and infection
3. cThat torsion is excluded
4. dThat he only needs reassurance