#january2020mccqe1
An 18-year-old woman is evaluated in the emergency department because of a 3-day history of lower abdominal pain. She does not have urinary frequency, dysuria, flank pain, nausea, or vomiting. Her only medication is an oral contraceptive agent.
On physical examination, temperature is 38.3°C (101.0°F), blood pressure is 118/68 mm Hg, pulse rate is 104/min, and respiration rate is 16/min. Abdominal examination is normal. There is no flank tenderness. Pelvic examination shows cervical motion tenderness, fundal tenderness, and bilateral adnexal tenderness on bimanual examination.
The leukocyte count and urinalysis results are normal. Urine and serum pregnancy tests are negative.
Which of the following is the most appropriate treatment?
(A) Ampicillin and gentamicin, intravenously
(B) Azithromycin, orally
(C) Cefoxitin, intramuscularly
(D) Ceftriaxone, intramuscularly, and doxycycline, orally
An 18-year-old woman is evaluated in the emergency department because of a 3-day history of lower abdominal pain. She does not have urinary frequency, dysuria, flank pain, nausea, or vomiting. Her only medication is an oral contraceptive agent.
On physical examination, temperature is 38.3°C (101.0°F), blood pressure is 118/68 mm Hg, pulse rate is 104/min, and respiration rate is 16/min. Abdominal examination is normal. There is no flank tenderness. Pelvic examination shows cervical motion tenderness, fundal tenderness, and bilateral adnexal tenderness on bimanual examination.
The leukocyte count and urinalysis results are normal. Urine and serum pregnancy tests are negative.
Which of the following is the most appropriate treatment?
(A) Ampicillin and gentamicin, intravenously
(B) Azithromycin, orally
(C) Cefoxitin, intramuscularly
(D) Ceftriaxone, intramuscularly, and doxycycline, orally
