A 24-year-old female presents with acute bilateral lower abdominal pain, purulent cervical discharge, and post-coital bleeding. Bimanual pelvic examination elicits marked cervical motion tenderness (the 'chandelier sign') and bilateral adnexal tenderness. What is the diagnosis?
Answer and explanation
Correct answer: B. Acute pelvic inflammatory disease (PID)
- Step 1: Acute PID is an ascending polymicrobial infection of the upper genital tract (endometrium, fallopian tubes, ovaries).
- Step 2: The presence of uterine, adnexal, or cervical motion tenderness in a sexually active young woman with cervical discharge fulfills diagnostic criteria for PID.
Answer
Acute pelvic inflammatory disease (PID).
Why not the others: 'Ruptured corpus luteum cyst' presents with sudden unilateral pelvic pain without cervical purulence or chandelier sign; 'Acute appendicitis' features migratory right lower quadrant pain and anorexia; 'Ovarian torsion' presents with sudden, severe, unilateral ischemic pain accompanied by vomiting.
Practise more Obstetrics, Gynecology and Maternal-Fetal Medicine.
Free questions with an explanation for every one, and full timed National Health Regulatory Authority Licensure Examination (NHRA Bahrain) mock tests.
More Obstetrics, Gynecology and Maternal-Fetal Medicine questions
- A 28-year-old primigravida at 34 weeks gestation presents with a blood pressure of 165/110 mmHg, persistent severe frontal headache, visual…
- A 26-year-old female presents with 7 weeks of amenorrhea, severe acute right lower quadrant pelvic pain, and light vaginal bleeding. On phys…
- A 32-year-old gravida 3 para 2 at 32 weeks gestation presents with sudden, painless, bright red vaginal bleeding. She denies abdominal pain…
- A 36-year-old multigravida at 38 weeks gestation presents with sudden severe, continuous abdominal pain, dark vaginal bleeding, and high ute…
- Following an uncomplicated vaginal delivery of a 4.0 kg infant, a 28-year-old mother experiences heavy continuous vaginal bleeding. The plac…
- What is the first-line medication administered routinely for active management of the third stage of labor to prevent postpartum hemorrhage?