A 16-year-old girl presents with lower abdominal pain and fever. On physical examination, a tender adnexal mass is felt. Further questioning in private reveals the following: she has a new sexual partner; her periods are irregular; she has a vaginal discharge. Which of the following is the most likely diagnosis?
- Appendiceal abscess
- Tuboovarian abscess
- Ovarian cyst
- Renal cyst
- Ectopic pregnancy
the answer is below…
The United States Medical Licensing Examination, or USMLE for short, is a three-part licensing examination that is required in order to receive a license to practice medicine within the United States.
The USMLE assesses a physician’s ability to apply knowledge, concepts, and principles, and to determine fundamental patient-centered skills that are important in health and disease and that constitute the basis of safe and effective patient care.Examination committees composed of medical educators and clinicians from across the United States and its territories prepare the examination materials each year.
This exam is designed by the Federation of State Medical Boards and the National Board of Medical Examiners to determine whether or not an individual understands and can apply the knowledge necessary to practice medicine safely and intelligently.
The USMLE is actually comprised of three different exams that are referred to as steps, which examine the individual’s knowledge of specific topics related to the field of medicine such as basic science, medical knowledge, medical skills, clinical science, and the application of all of these skills and areas of knowledge in the medical field.
All three steps of the USMLE include a series of computerized multiple-choice questions, but the format of the exam and the information covered in each multiple-choice section is different for each step of the USMLE. The USMLE Step II also has a clinical skills portion that examines an individual’s ability to work with real patients and the USMLE Step III has a computerized patient simulation portion in addition to the multiple-choice section of the exam. In order for an individual to receive a license to practice medicine, the individual must pass all three steps of the USMLE.
The answer is b, Tuboovarian abscess.[7-9]
Each year, a diagnosis of pelvic inflammatory disease (PID) is made in more than 1 million women. Sexually active teenagers are at great risk of acquiring PID because of their high-risk behavior, exposure to multiple partners, and failure to use contraceptives. The strong likelihood of PID in the patient presented should not preclude consideration of serious conditions requiring surgical intervention, such as appendiceal abscess, ectopic pregnancy, and ovarian cyst. Renal cyst does not present in the manner described. An episode of PID raises the risk of ectopic pregnancy, and about 20% of women become infertile following one episode of PID. Other sequelae include dyspareunia, pyosalpinx, tuboovarian abscess, and pelvic adhesions. Endometriosis is not related to PID.