Female Reproductive System and Breast

Question 1

Sx: Recurrent mild and unilateral mid cycle pain prior to ovulation

Timing: Pain lasts hours to days

Do US/what findings?

Answer 1

Mittelschmertz

US not indicated

Question 2

Sx: Amenorrhea, abdominal/pelvic pain, vaginal bleeding

Lab: positive Beta hCG

Do US/what findings?

Answer 2

Ectopic pregnancy

No intrauterine pregnancy found in US.

Question 3

Sx: sudden onset, severe, unilateral lower abdominal pain, nausea, vomiting.

PE: unilateral, tender adnexal mass on exam

Do US/what findings?

Answer 3

Ovarian torsion

Enlarged ovary with decreased or absent blood flow

Question 4

Sx: sudden onset, severe, unilateral abdominal pain immediately following strenuous (i.e. sports) or sexual activity.

Do US/what findings?

Answer 4

Ruptured ovarian cyst

Free pelvic fluid

Question 5

Sx: fever/chills, vaginal discharge, lower abdominal pain and cervical motion tenderness

Do US/what findings?

Answer 5

Pelvic inflammatory disease

+/- tuboovarian abscess

Question 6

What is this:

sudden onset, severe, unilateral abdominal pain immediately following strenuous (i.e. sports) or sexual activity

possible diffuse severe abd pain, pleuritic chest pain, shoulder pain, hemodynamic instability, decreased Hct

Answer 6

Ruptured ovarian cyst with hemoperitoneum