Finding-the-Path: Case 19
History
A 29-year-old woman presents to the emergency room with nausea, vomiting and abdominal pain. The pain was initially in the periumbilical area and later localized to the right lower quadrant. On physical exam, her temperature is 38 degrees Celsius. She has guarding and mild rebound tenderness in the right lower quadrant of her abdomen. On pelvic examination, there is right adnexal tenderness. Her
white blood cell count (WBC) is 12K/µl and her urine B-HCG is negative.
Which study do you request first?
