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  #1  
Old 05-18-2012
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ObGyn What is the cause of this chronic abdominal pain?

A 17 -year-old teenage girl presents to your office with a 10-month history of lower abdominal pain that radiates to the upper thighs and back. The pain is colicky in nature and usually starts a few hours prior to menses, lasting 3-4 days. Menses have occurred at regular 28-day intervals over the past 2 years. She has no inter-menstrual bleeding. She became sexually active 6-months ago and does not use contraception. Physical examination shows healthy external genitalia and well-developed secondary sexual characteristics; the uterus is normal in size and freely mobile. Examination shows no other abnormalities. Which of the following is the most likely cause of her pelvic pathology?

A. Ureteric stone
B. Pelvic infection
C. Abnormal myometrial growth
D. Increased prostaglandins
E. Ectopic endometrial implants
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Old 05-18-2012
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d. premanstrual syndrome
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Old 05-18-2012
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Increased prostaglandins, this is primary dysmenorrhea <? premenstrual synd?>
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Why not E?? Pain starts right before menses and lasts during menses.
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Old 05-18-2012
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Quote:
Originally Posted by haga View Post
Why not E?? Pain starts right before menses and lasts during menses.
she's 17, and this is not a typical for endometriosis, though u can consider it in DDx but still this is more likely to be Dysmenorrhea i think, esp given her age
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Old 05-18-2012
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E. Ectopic endometrial implants
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Old 05-19-2012
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D. Increased Prostaglandins
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Old 05-19-2012
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Ya d
It's primary dysmenorrhea
I wonder van it present at 17.
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Old 05-19-2012
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Primary dysmenorrhea usually starts during adolescence or several years later ((though not typical)) and tends to lessen with age
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