[usmleguy]

A healthy 24-year-old woman comes for a routine health maintenance examination. Menses occur at regular 28-day intervals and last 5 to 6 days. Her last menstrual period was 3 weeks ago. She takes no medications. Bimanual examination shows a 5-cm, mildly tender left adnexa. A pregnancy test is negative. Which of the following is the most appropriate next step in management?

A) Repeat examination in 2 weeks

B) Measurement of serum CA 125 level

C) Measurement of serum α-fetoprotein level

D) CT scan of the pelvis

E) Diagnostic laparoscopy

 

[1TA2B]

A.

I would just leave it for now. I suppose she is asymptomatic.

 

[7802]

hmmmm I think...

A. Her complaint is not Very serious thus could be managed with observation especially with repeat examination at the beginning of her period. The rest of the choices seem too unreasonable at this point.

 

[marco]

hmm

If sonogram was in the options I would go for that to see of its complex or simple . Dont forget simple cysts more then 6 cm need evaluation .