36 year old woman with abdominal pain

Grace Huang on May 26, 2013

A 36 year old G2P2 female presents to you in clinic with 2 days of abdominal pain and spotting.  Her last menstrual period was 9 weeks ago. Before that, her period occurred regularly at a 30 day interval. She has two living children, ages 9 and 13, and is divorced. Her means of contraception include OCPs.

Upon further questioning regarding her sexual history, you are informed that she is not currently in a stable relationship and has not been for the last 4 years. She has multiple sexual partners and does not use barrier contraception of any sort. 

What portion of the physical exam would you choose to focus on?

Expand all answers
Abdominal exam
Rectal exam
Genitourinary exam
Musculoskeletal exam

You perform a thorough physical exam. During your GU exam, you observe a non-enlarged uterus, cervical motion tenderness and right adnexal tenderness but no mass on palpation. Bimanual exam reveals no frank vaginal bleeding. 

Which of these labs would be most helpful in establishing a diagnosis?

Expand all answers
CBC
Vaginal ultrasound
Abdominal ultrasound
serum beta-hCG

A 36 year old G2P2 female presents to you in clinic with 2 days of abdominal pain and spotting.  Her last menstrual period was 9 weeks ago. Before that, her period occurred regularly at a 30 day interval. She has two living children, ages 9 and 13, and is divorced. Her means of contraception include OCPs.

Upon further questioning regarding her sexual history, you are informed that she is not currently in a stable relationship and has not been for the last 4 years. She has multiple sexual partners and does not use barrier contraception of any sort. 

What portion of the physical exam would you choose to focus on?

Expand all answers
Abdominal exam
Rectal exam
Genitourinary exam
Musculoskeletal exam

You perform a thorough physical exam. During your GU exam, you observe a non-enlarged uterus, cervical motion tenderness and right adnexal tenderness but no mass on palpation. Bimanual exam reveals no frank vaginal bleeding. 

Which of these labs would be most helpful in establishing a diagnosis?

Expand all answers
CBC
Vaginal ultrasound
Abdominal ultrasound
serum beta-hCG

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