Women's Health Clinical Scenario PDF

Women’s Health Clinical Scenario Rosy Marceleno Student Lead Discussion and Presentation October 29, 2024  Scenario + A 19 year old female with c/c of pelvic pain + Pelvic pain started 2 months ago. + She describes it as a constant cramping pain in her pelvic area + She is currently not bleedin...

Women’s Health Clinical Scenario Rosy Marceleno Student Lead Discussion and Presentation October 29, 2024  Scenario + A 19 year old female with c/c of pelvic pain + Pelvic pain started 2 months ago. + She describes it as a constant cramping pain in her pelvic area + She is currently not bleeding. + She takes Tylenol for the pain, and it helps for a couple of hours, but then wears off. Patient History + History of PCOS + last ultrasound 2 years ago with different provider that showed a cyst, did not follow up with provider + she was previously on birth control and stopped taking it + 2023 she had an ectopic pregnancy + her LMP 10/03/2023, she missed her period in September + Irregular menstrual periods + States having same sexual partner for the last 2 years Diagnosis + UTI + STD – PID + Ectopic Pregnancy + Cyst + Challenges: This is a clinic that helps the uninsured and the only day available for ultrasound is Saturday Patient instructed to go to ER if pain is unbearable with active bleeding Actions taken in clinical setting + Vaginal exam with no significant findings + UA was negative for UTI + STD panel + Negative pregnancy test + Scheduled for ultrasound Clinical Setting Literature Pregnancy test Pregnancy status to be ruled out UA to rule out UTI Ultrasound first line diagnostic Pelvic exam technique Ultrasound Distinguish if this is Urinary tract pathology (UA), gynecologic pathology (HCG-pregnancy test), GI pathology CT to be performed if ultrasound does not have any significant findings MRI is second line technique (Dewey & Wittrock, 2019)(Franco, et al., 2023) (Franco, et al., 2023) Question References + Dewey, K., & Wittrock, C. (2019). Acute pelvic pain. Emergency Medicine Clinics of North America, 37(2), 207–218. https://doi.org/10.1016/j.emc.2019.01.012 + Franco, P., García-Baizán, A., Aymerich, M., Maino, C., Frade-Santos, S., Ippolito, D., & Otero-García, M. (2023). Gynaecological causes of acute pelvic pain: Common and not-so-common imaging findings. Life, 13(10), 2025. https://doi.org/10.3390/life13102025