A 33-year-old woman comes to the emergency department because of a 1-hour history of severe pelvic pain and nausea. She was diagnosed with a follicular cyst in the left ovary 3 months ago. The cyst was found incidentally during a fertility evaluation. A pelvic ultrasound with Doppler flow shows an enlarged, edematous left ovary with no blood flow. Laparoscopic evaluation shows necrosis of the left ovary, and a left oophorectomy is performed. During the procedure, blunt dissection of the left infundibulopelvic ligament is performed. Which of the following structures is most at risk of injury during this step of the surgery?
ABladder trigone
BUterine artery
CKidney
DUreter
A 20-year-old woman is brought to the emergency department 6 hours after the onset of colicky lower abdominal pain that has been progressively worsening. The pain is associated with nausea and vomiting. She has stable inflammatory bowel disease treated with 5-aminosalicylic acid. She is sexually active with her boyfriend and they use condoms inconsistently. She was diagnosed with chlamydia one year ago. Her temperature is 38.1°C (100.6°F), pulse is 94/min, respirations are 22/min, and blood pressure is 120/80 mm Hg. Examination shows right lower quadrant guarding and rebound tenderness. The remainder of the examination shows no abnormalities. Which of the following is the most appropriate next step in management?
AUrine culture
BErect abdominal x-ray
CSerum β-hCG concentration
DTransvaginal ultrasound
ECT scan of the abdomen
A 25-year-old homeless woman presents to an urgent care clinic complaining of vaginal bleeding. She also has vague lower right abdominal pain which started a few hours ago and is increasing in intensity. The medical history is significant for chronic hepatitis C infection, and she claims to take a pill for it 'every now and then.' The temperature is 36.0°C (98.6°F), the blood pressure is 110/70 mmHg, and the pulse is 80/min. The abdominal examination is positive for localized right adnexal tenderness; no rebound tenderness or guarding is noted. A transvaginal ultrasound confirms a 2.0 cm gestational sac in the right fallopian tube. What is the next appropriate step in the management of this patient?
ATubal ligation
BMethotrexate
CIV fluids, then surgery
DSurgery
EPelvic CT without contrast
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