#july2020mccqe1
A 16-year-old girl is brought to the Emergency Department by her mother. The girl complains of persistent dull right-sided lower abdominal pain which has been recently increasing in severity. She also has spotting of blood per vaginam. Her last normal period was seven weeks ago. The mother informs you that her daughter has not been sexually active. On examination, the daughter looks unwell and is sweating with clammy cold skin, her temperature is 36.5°C. BP 80/50mmHg and pulse 140/min The lower abdomen shows rebound tenderness and guarding in the right iliac fossa. Which one of the following is the most appropriate immediate next step in her care?
(A) Speak privately to the daughter about her sexual activity
(B) Perform a vaginal pelvic examination
(C) Commence intravenous fluid resuscitation
(D) Perform urinary beta-hCG pregnancy test
(E) Arrange for urgent transvaginal ultrasound
A 16-year-old girl is brought to the Emergency Department by her mother. The girl complains of persistent dull right-sided lower abdominal pain which has been recently increasing in severity. She also has spotting of blood per vaginam. Her last normal period was seven weeks ago. The mother informs you that her daughter has not been sexually active. On examination, the daughter looks unwell and is sweating with clammy cold skin, her temperature is 36.5°C. BP 80/50mmHg and pulse 140/min The lower abdomen shows rebound tenderness and guarding in the right iliac fossa. Which one of the following is the most appropriate immediate next step in her care?
(A) Speak privately to the daughter about her sexual activity
(B) Perform a vaginal pelvic examination
(C) Commence intravenous fluid resuscitation
(D) Perform urinary beta-hCG pregnancy test
(E) Arrange for urgent transvaginal ultrasound
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