Review Questions

1. A 27-year-oid woman comes to the emergency department because of severe abdominal and pelvic pain for the past 12 hours. She says she has two sexual partners that she has been with for "years." She is not sure if they are involved with any other women. Her last menstrual period was 4 days ago, and it was normal. She denies any rectal pain or change in bowel habits. Physical examination shows cervical motion tenderness, bilateral lower abdominal tenderness, and right-upper quadrant tenderness. Which of the following is the most likely diagnosis?

A. Endometriosis

B. Leiomyoma

C. Pelvic inflammatory disease

D. Polycystic ovary disease

E. Torsion of a teratoma

2. A 32-year-old woman comes to the physician with her husband because "she just can't seem to get pregnant." They have been unsuccessfully trying to conceive for the past 14 months, having unprotected sexual intercourse during her "fertile days." Her menstrual periods arrive at regular 28-day intervals, but they are accompanied by severe abdominal cramps. She says that often experiences rectal pain during defecation and pelvic pain during sexual intercourse. She says that she has been to many physicians "over the years" because of "chronic pelvic pain." An explorative laparoscopy is scheduled to determine the cause of her infertility. Which of the following is the most likely finding at laparoscopy?

A. "Grapelike" soft tissue mass protruding from the uterus into the peritoneal cavity

B. Multiple well circumscribed subserosal uterine tumors

C. Red-brown serosal nodules and ovarian "chocolate" cysts

D. Ruptured ovarian cyst containing hair, teeth, cartilage, thyroid, and greasy material

E. "Violin-string" adhesions between the fallopian tubes and liver capsule

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