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- Nov 26, 2013
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15 yo girl came to the ER b/c of nausea, vomiting, lower abdominal pain for 4 days. last menstrual period was 9 days ago. she is sexually active and does not use contraception. temp 39.7C, puls 105, bp 110/75, exam shows bilateral lower abdominal tenderness and peritoneal signs. pelvic exam shows copious yellow cervical discharge and exquisite uterine tenderness. which of the following is the most appropriate next step in management?
A. admission to the hospital for IV antibiotic therapy
B. admission to the hospital for laparoscopy
C. admission to the hospital for laparotomy
D. CT of the pelvis
E. discharge w/ analgesic therapy
F. discharge w/ oral antibiotic therapy only
G. discharge w/ oral and IM antibiotic therapy
H. limited stay observation and evaluation
I. MRI of the pelvis
J. uterine evacuation in the emergency dept
K. uterine evacuation in the OR
--> So I am debating among A, B, C. I am leaning toward B, any thoughts?
A. admission to the hospital for IV antibiotic therapy
B. admission to the hospital for laparoscopy
C. admission to the hospital for laparotomy
D. CT of the pelvis
E. discharge w/ analgesic therapy
F. discharge w/ oral antibiotic therapy only
G. discharge w/ oral and IM antibiotic therapy
H. limited stay observation and evaluation
I. MRI of the pelvis
J. uterine evacuation in the emergency dept
K. uterine evacuation in the OR
--> So I am debating among A, B, C. I am leaning toward B, any thoughts?