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Questions and Answers
What is the primary symptom described by the 19-year-old female patient?
Which condition does the patient have a history of that may contribute to her current symptoms?
Which imaging technique is considered the first-line diagnostic tool for this patient's condition?
What was the result of the urinalysis (UA) performed on the patient?
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In the event of significant findings in ultrasound, what is the next diagnostic step indicated?
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What should the patient do if her pelvic pain becomes unbearable?
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Which of the following is NOT a possible diagnosis mentioned for the patient's condition?
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What is a common characteristic of the patient's menstrual cycle?
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Study Notes
Patient Information
- 19 year old female with c/c of pelvic pain
- Pelvic pain started 2 months ago.
- Describes pain as constant cramping in pelvic area.
- No current bleeding.
- Takes Tylenol for pain, provides temporary relief.
- History of PCOS.
- Had an ultrasound 2 years ago showing a cyst, did not follow up.
- Previously on birth control, stopped taking it.
- Experienced an ectopic pregnancy in 2023.
- Last menstrual period (LMP) was 10/03/2023.
- Missed her period in September.
- Irregular menstrual periods.
- In a monogamous relationship for the last 2 years.
Potential Diagnoses
- UTI
- STD - PID (Pelvic Inflammatory Disease)
- Ectopic Pregnancy
- Cyst
Challenges
- Patient is uninsured and receives care at a clinic with limited resources.
- Only day available for ultrasound is Saturday.
- Patient instructed to go to ER if pain becomes unbearable with active bleeding.
Actions Taken in Clinical Setting
- Vaginal exam with no significant findings.
- UA (urinalysis) was negative for UTI.
- STD panel ordered.
- Negative pregnancy test.
- Ultrasound scheduled.
Diagnostic Approach
- Pregnancy test: To rule out pregnancy.
- UA: To rule out UTI.
- Pelvic exam: To assess for any abnormalities.
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Ultrasound: First-line diagnostic technique to distinguish between:
- Urinary tract pathology (UA)
- Gynecologic pathology (HCG - pregnancy test)
- GI pathology
- CT: To be performed if ultrasound doesn't reveal significant findings.
- MRI: Second-line technique.
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Description
This quiz explores the clinical assessment of a 19-year-old female presenting with pelvic pain. Participants will analyze the patient's history, potential diagnoses, and challenges faced in a clinical setting. Test your knowledge on how to approach similar cases in medical practice.
