Pelvic Pain

Question 1

Most common cause of pelvic pain in women

Answer 1

Primary dysmenorrheoa

Question 2

What is mittelschmertz

Answer 2

Transient pain in middle of cycle (secondary to ovulation)

Question 3

Differential: 
6-8 weeks amenorrhoea
Presents with lower abdo pain, followed by vaginal bleeding
Shoulder tip pain 
Cervical excitation

Answer 3

Ectopic pregnancy

Question 4

Differential:

Dysuria and frequency

Answer 4

UTI

Question 5

Differential: 
Pain in centre of abdo, then moves to Rif
Anorexia
Pyrexia
Vomiting

Answer 5

Appendicitis

Question 6

Differential:
Pelvic pain, fever, deep dyspareunia, vaginal discharge
Dysuria + menstrual irregularities may occur
Cervical excitation

Answer 6

PID

Question 7

Differential:
Sudden-onset unilateral lower abdo pain
N+V
Onset may coincide with exercise

Answer 7

Ovarian torsion

Question 8

Differential:

Vaginal bleeding + crampy lower abdo pain following a period of amenorrhoea

Answer 8

Miscarriage

Question 9

Differential: 
Chronic pelvic pain
Dysmenorrhoea (often starts days before bleeding)
Deep dyspareunia
Subfertility

Answer 9

Endometriosis

Question 10

Differential:
Abdo pain, bloating, change in bowel habit
Lethargy, nausea + back ache may also be present

Answer 10

IBS

Question 11

Differential:
Unilateral dull ache (may only occur during intercourse)
Possible abdo swelling or pressure on bladder

Answer 11

Ovarian cyst
(severe pain in torsion or rupture)