nbme3 q - sweetiful

[ArchivalUser]

27. 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?
O A) Appendicitis
O B) Endometriosis
O C) Ovarian hemorrhage
O D) Ruptured ovarian cyst
O E) Torsion of the adnexa
0 F) Tubal obstruction

[ArchivalUser]

anyone??

is it torsion or rupture??

[ArchivalUser]

anyone??

is it torsion or rupture??

[ArchivalUser]

anyone?/

[ArchivalUser]

anyone??

[ArchivalUser]

ddddd

[ArchivalUser]

E... not rupture b/c no signs of shock for rupture..
correct me

[ArchivalUser]

E... not rupture b/c no signs of shock for rupture..
correct me

[ArchivalUser]

''

[ArchivalUser]

It's sure for torsion, E

Q.....Pelvic ultrasonography shows a small amount of free fluid in the cul-de-sac. ....No mass seen.

In torsion, ovarian mass is twisted along with ovarian pedicles and blood vessels, SO, sometimes USS can't be seen the mass, like in this case. Small amount of fluid can be seen in torsion bec of irritation n inflamatory changes.

In rupture,.... USS can still show the mass of ovarian cyst and fluid in POD may be more than small amount. Vitals and Hct will be definitely low.

Sure for E.