Question 12 · LEK · Acute abdomen
A 27-year-old woman, with no chronic diseases was admitted to the Emergency Department due to fainting and severe abdominal pain lasting for 30 minutes. Blood pressure 80/60 mmHg, HR: 105 beats/min. Blood test: Hb: 12.5 g/dL, Hct: 41.5%, PLT: 251 000/mm³, Na: 135 mmol/L, K: 4.5 mmol/L, amylase: 463 U/L, total bilirubin: 0.7 mg/ dL, β-hCG: 1.15 mIU/mL. The ultrasound examination in FAST algorithm showed trace of fluid around the spleen and in the pouch of Douglas. Indicate the most likely cause of the patient’s abdominal pain:
- A. ectopic pregnancy miscarriage.
- B. acute pancreatitis.
- C. ureteric colic.
- D. mesenteric artery ischemia.
- E. both A and B are correct.
Hint
Interpret the beta-hCG value and the amylase level first; one of them rules out a key diagnosis in young women.
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