A 16-year-old female complains of sudden left-sided lower ...

[daltonest1984]

A 16-year-old female complains of sudden left-sided lower quadrant abdominal pain. Last menstrual period was 2 weeks ago. On physical examination, the abdomen is non-tender with no masses and no organomegaly.
 
  Bowel sounds are normal in 4 quadrants. Pelvic examination is within normal limits. Abdominal CT scan is negative. Pregnancy test is negative. These signs and symptoms are consistent with:
  A. Ovarian cancer
  B. Hydatidiform mole
  C. Endometriosis
  D. Follicular cyst

Question 2

The definitive diagnosis of endometriosis is made with:
 
  A. Hysterosalpingoscop y
  B. Pelvic CT scan
  C. Laparoscopy
  D. Pelvic MRI

[vboyd24]

Answer to Question 1

ANS: D
Ovarian cysts are common in the younger population and tend to occur in the latter half of the menstrual cycle. Many spontaneously resolve. Others may need surgical intervention if they become twisted, owing to the risk of gangrene. Right or left lower quadrant pain is usually the presenting complaint. Pelvic examination reveals significant tenderness in the affected adnexal area. Rebound tenderness may be present. Follicular cysts are most common, and the pain typically occurs in the second half of the menstrual cycle. These cysts usually resolve with menses and require no further treatment.

Answer to Question 2

ANS: C
The history and physical examination generally lead you to suspect endometriosis, but the definitive diagnosis is made through laparoscopic surgery and biopsy. The lesions seen in endometriosis, termed endometrial implants, appear as dark red to dark brown lesions that give the appearance of a powder burn from a gunshot. They appear on the peritoneal, bladder, uterine, and ovarian surfaces.