Family Nurse Practitioner Exam

Which of the following is a characteristic sign of acute epididymitis?

1. Negative cremasteric reflex

2. Swollen left scrotum with severe pain

3. Positive urine dipstick for leukocytes

4. Unilateral scrotal pain without nausea

The correct answer is: Positive urine dipstick for leukocytes

Acute epididymitis is an inflammation of the epididymis, often caused by infection, and it presents with distinct signs and symptoms. A positive urine dipstick for leukocytes indicates the presence of white blood cells in urine, which suggests a urinary tract infection or inflammation. This is relevant because inflammatory processes, including infection leading to conditions like epididymitis, typically result in leukocyturia. Therefore, the presence of leukocytes on a urine dipstick test aligns with the common presentation of acute epididymitis. In cases of acute epididymitis, additional common clinical findings may include unilateral scrotal pain, swelling of the affected scrotum, and often increased vascularity on ultrasound. However, while these features help in diagnosis, the presence of leukocytes in urine specifically supports the diagnosis of epididymitis as an infection that may also affect the urinary tract. Understanding that acute epididymitis frequently correlates with urinary tract infections helps to contextualize why a positive urine dipstick for leukocytes is a characteristic sign.