QuestionSBA
QuestionChoice
NICE advises sending an urgent CA-125 and/or performing ultrasound in cases of new onset IBS, early satiety, abdominal bloating, pelvic pain and urinary frequency. In cases of ascites, an urgent two-week wait referral is the priority as the likelihood of cancer is increased.
10035933
b
Urgent CA-125
QuestionChoice
This is correct. This scenario is suspicious for ovarian cancer with abdominal bloating and pelvic pain. The presence of ascites on initial examination circumvents the need for an initial CA-125 before referral (although it would likely be performed alongside the referral in practice).
10035932
a
Urgent 2-week wait gynaecology referral
QuestionChoice
This scenario is more suspicious for ovarian pathology than malignancy within the renal tract which is more likely to present with haematuria.
10035935
d
Urgent renal tract imaging
QuestionChoice
This is very inappropriate as the patient has signs and symptoms which are concerning of possible metastatic ovarian malignancy and needs urgent investigation.
10035936
e
Reassure
QuestionChoice
NICE advises sending an urgent CA-125 and/or performing ultrasound in cases of new onset IBS, early satiety, abdominal bloating, pelvic pain and urinary frequency. In cases of ascites, an urgent two-week wait referral is the priority as the likelihood of cancer is increased.
10035934
c
Urgent abdominal ultrasound
Concept
Chapter
2693
6168
Ovarian Cancer
Topic
333
Obstetrics and Gynaecology
19590
Abdominal bloating, pelvic pain, and ascites in women over 50 warrant urgent gynaecology referral due to potential ovarian cancer.
A 54-year-old woman attends the GP with abdominal bloating, pelvic pain and urinary frequency. She reports these symptoms have been bothersome for the last two months. Examination reveals abdominal distension with shifting dullness, with no masses felt.

What is the most appropriate management?
a