Your patient is a 44-year-old woman who is alert and in mild distress. She states that she had an acute onset of sharp, right lower quadrant abdominal pain last evening while having intercourse and that the pain has not subsided. Physical examination reveals tenderness with palpation to the lower right abdominal quadrant. Vital signs are: heart rate 98, respirations 16, blood pressure 116/78 mmHg. She reports she had a tubal ligation ten years ago and that she has several small fibroid tumors. Which of the following is the most likely diagnosis for this patient?

Question

Quizplus · Accepted Answer

The symptoms and physical exam findings suggest a possible ruptured ovarian cyst, which can cause sudden, sharp pain in the lower abdomen during intercourse. The patient's medical history of fibroid tumors is not likely to be related to the current symptoms, and the fact that she had a tubal ligation makes ectopic pregnancy unlikely. Pelvic inflammatory disease may cause abdominal pain but is typically associated with fever, vaginal discharge, and other signs of infection. Mittelschmerz refers to ovulation pain and is generally milder and more short-lived than the pain described by the patient.

Your Patient Is a 44-Year-Old Woman Who Is Alert and in Mild