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Order and interpret diagnostic tests for a reproductive-aged woman with abdominal pain

Learner Task: Review the following details of focused physical examination and order the diagnostic tests that are most appropriate next step in management of this patient.

  • Vital Signs: BP 110/70, P 101, Respirations 16, afebrile
  • General: awake, alert and oriented x 3 in no acute distress
  • Heart and lung exam: normal other than tachycardia
  • Abdomen: + BS, mildly tender to palpation, guarding, no rebound; no masses appreciated.
  • Pelvic: normal external genitalia, normal urethral meatus, moist rugated vaginal mucosa, small amount of blood from cervical os, no discharge or odor appreciated. On bimanual exam, uterus is mildly enlarged and anteverted, smooth outer contour, mild cervical motion tenderness, cervical os is closed, fullness in right adnexa, left adnexa normal.

Educator Checklist: Ordering and Interpretation of Diagnostic Tests
Mark the appropriate column to indicate whether the learner included each element in his or her response. When completed, tally the “Included” column to calculate the learner’s score.


Included =1 Not included =0
Orders pregnancy test
Orders CBC
Orders blood type and Rh screen
Orders pelvic ultrasound