shakespeare
Forum Newbie
Topics: 4
Posts: 15
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A 25-year-old nulligravid woman comes to the emergency department because of severe pain in the right lower quadrant of the abdomen for 4 hours. She has had no nausea, vomiting, fever, or chills. Three weeks ago, a right adnexal mass was found on routine examination. Her last menstrual period was 3 days ago. Her temperature is 37.2°C (99°F), blood pressure is 110/70 mm Hg, and pulse is 92/min. Pelvic examination shows right adnexal tenderness. Hemoglobin level is 13 g/dL, and leukocyte count is 9000/mm3. Pelvic ultrasonography shows a small amount of free fluid in the cul-de-sac. Which of the following is the most likely cause of the pain?
A) Appendicitis
B) Endometriosis
C) Ovarian hemorrhage
D) Ruptured ovarian cyst
E) Torsion of the adnexa
F) Tubal obstruction
--- please help... I went for E but while searching the forums for what other people's answer I've seen most of them selected D....
how do you decide between these two?
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| nyimalay
Forum Elite
Topics: 11
Posts: 294
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First thing came into my mind is torsion of the preexisting adnexal mass.
I may be wrong. The free fluid may indicate rupture.
More input please.
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| nany
Forum Guru
Topics: 14
Posts: 1,060
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yes, free fluid goes with rupture
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| nyimalay
Forum Elite
Topics: 11
Posts: 294
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Thanks .
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