sera
Forum Senior
Topics: 14
Posts: 141
|
. A healthy 24-year-old woman comes for a routine health maintenance examination. Menses occur at regular 28-day intervals and last 5 to 6 days. Her last menstrual period was 3 weeks ago. She takes no medications. Bimanual examination shows a 5-cm, mildly tender left adnexa. A pregnancy test is negative. Which of the following is the most appropriate next step in management?
A
) Repeat examination in 2 weeks
B
) Measurement of serum CA 125 level
C
) Measurement of serum a-fetoprotein level
D
) CT scan of the pelvis
E
) Diagnostic laparoscopy
___________________
syra
|
| vradojc1
Forum Elite
Topics: 21
Posts: 309
|
A - mass smaller than 7 cm can be expectantly managed, but should be evaluated by ultrasound first.
It looks like luteal cyst
|
| sera
Forum Senior
Topics: 14
Posts: 141
|
i also picked A
but the mass is mildly tender.thats what confused me.
___________________
syra
|
| jehanzebali
Forum Newbie
Topics: 4
Posts: 76
|
i would go with D, to confirm the nature of the mass, whether its simple or complex.
if its simple then we can re examine again in 2 weeks provided:
its less then 7cm
pt was NOT on prior contraception.
if its complex, then laproscopy or laporotomy, dependin on whats the avaiable choice.
|
| jehanzebali
Forum Newbie
Topics: 4
Posts: 76
|
steroid contraception *
|
| chinda11
Forum Junior
Topics: 19
Posts: 48
|
A. A mass less than 7 cm need not be investigated.
|
| sera
Forum Senior
Topics: 14
Posts: 141
|
i'm also thinking about D as the mass is tender.
___________________
syra
|
| jehanzebali
Forum Newbie
Topics: 4
Posts: 76
|
chinda11 i totally agree with the fact that mass less than 7cm needs no investigation but one has to confirm the nature of it, and v cant simply comment on that without some imaging technique
|
| docnikki
Forum Guru
Topics: 93
Posts: 680
|
I think we can wait for 2 weeks before any imaging technique coz if its leuteal cyst it will go away amnd after 2 weeks if it remains we can start with CT ...
even though its mildly tender we can wait that much I think...
|
| yasmeen
Forum Guru
Topics: 70
Posts: 942
|
A
|
|
| |
| | | | | | | | | | |
