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A 19-year-old G0 woman presents to her family physician complaining of dysmenorrhea for the past year. She reports severe right-sided pain that coincides with days 1–5 of her menstrual cycle. Her menses occur regularly every 28 days, and she requires three to four pads per day for the first two days of her bleeding and one to two pads per day for the remainder. She has never had surgery. She is not sexually active and does not smoke. Her last menstrual period was 1 week ago. Vital signs are temperature 36.7°C (98.1°F), blood pressure 121/74 mm Hg, heart rate 80/min, and respiratory rate 14/min. Physical examination reveals a thin, healthy-appearing young female. Pelvic examination reveals a normal sized uterus and no cervical motion tenderness. What is the most likely diagnosis?
(A) Ectopic pregnancy
(B) Endometriosis
(C) Leiomyoma
(D) Pelvic inflammatory disease
(E) Polycystic ovary syndrome
 
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