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67240 Gynaecology & Obstetrics

A 31-year-old woman comes to the emergency depament because of abdominal pain and vaginal spotting. She states that the pain began 2 days ago and has been worsening since. The spotting occurred this morning. Her last menstrual period was 6 weeks ago. She has no medical problems. She takes no medications and has no known drug allergies. Her temperature is 37 C (98.6 F), blood pressure is 90/50 mm Hg, pulse is 110/minute, and respirations are 14/minute. Abdominal examination reveals significant lower abdominal tenderness. Speculum examination shows scant blood in the vagina with a closed cervical os. Bimanual examination demonstrates significant left adnexal tenderness. Urine hCG is positive. Serum hCG is 5,000 mIU/mL. Pelvic ultrasound shows a normal uterus with a left adnexal mass surrounded by free fluid. Which of the following is the most likely diagnosis?

AAppendicitis
BEctopic pregnancy
COvarian cancer
DPelvic inflammatory disease
Gynaecology & Obstetrics
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67247 Unknown

A 55-year-old woman undergoes elective cholecystectomy. On postoperative day 6 she has mild abdominal discomfo and bloating. She has received antibiotics, morphine for pain and metoclopramide for nausea. She has not passed flatus or stools since the surgery. On auscultation bowel sounds are hypoactive. The doctor on duty orders an abdominal x-ray for the same. What is the most possible cause for her symptoms?

AImpaction of a gallstone in the ileum
BAdhesions following the surgery
CProlonged postoperative ileus
DAbsence of bile storage reservoir
Unknown
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