QuestionSBA
QuestionChoice
In a female patient presenting with abdominal pain, it would be important to first do a pregnancy test to rule out ectopic pregnancy as a cause.
10007635
e
CT abdomen
QuestionChoice
When a female presents with abdominal pain, it is important to rule out an ectopic pregnancy. A pregnancy test is essential to rule this out. An ectopic pregnancy is a pregnancy that implants outside the uterus, most commonly in the fallopian tube. It presents as pelvic pain that can radiate to the shoulder, abnormal vaginal bleeding and haemodynamic instability. All of these features are seen in this patient.
10007631
a
Urine hCG
QuestionChoice
This may be a useful investigation if you suspected this patient’s abdominal pain was caused by a bowel obstruction. However, as this patient's bowels have been opening normally, a bowel obstruction is less likely.
10007632
b
Abdominal X ray
QuestionChoice
In a female patient presenting with abdominal pain it is important to rule out ectopic pregnancy as an initial cause, so a urine hCG would be the most important initial investigation.
10007633
c
Ultrasound Abdomen
QuestionChoice
It may be useful to do a urine dipstick for this patient if you suspected cystitis. However, this patient does not have any urinary frequency or dysuria, so cystitis is less likely. The right iliac fossa pain that radiates to the shoulder tip points us in the direction of an ectopic pregnancy, therefore a urine hCG would be the best initial investigation.
10007634
d
Urine dipstick
Concept
Chapter
2693
4612
Ectopic Pregnancy
Topic
176
Gynaecology
14073
A 26-year-old female presents to A&E with abdominal pain that began 2 days ago. She says it began as an ache but has become gradually more severe. There is also pain in the tip of her shoulder. She denies any urinary frequency or dysuria. Her bowels are opening normally.

On examination, her heart rate is 94 and her blood pressure 100/72. She appears clammy and pale.

Which of the following is the most important initial investigation?
a