Women's Health Interactive educational quiz    from Women's Health CD, medi+WORLD International     Author: Professor Gabor Kovacs

Problem 2

Hanna complains of a lower abdominal pain for the last two or three days.  Hanna is 23 and married. She uses no contraception as she is hoping to conceive. Her last normal period was six weeks ago. Since then she has had some blood spotting. On examination she is normotensive but has lower abdominal tenderness. On pelvic examination the cervix was closed and the uterus was slightly tender. The left fornix was also a little tender. What will you do next?

Tell Hanna that irregular bleeding is common in young women
Do a urine pregnancy test
Organise a pelvic ultrasound to exclude an ectopic pregnancy
Start Hanna on antibiotics, because you think she has pelvic inflammatory disease (PID) again
Prescribe emergency contraception

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