A 23-year-old woman reports lower abdominal pain in the vaginal area after intercourse, purulent vaginal discharge, and low-grade fever, with a history of gonorrhea and recent menses. Which condition should you suspect?

Prepare for the Paramedic Readiness Exam 4 with our engaging quiz. Hone your skills with targeted questions, hints, and in-depth explanations. Excel on your exam with confidence!

Multiple Choice

A 23-year-old woman reports lower abdominal pain in the vaginal area after intercourse, purulent vaginal discharge, and low-grade fever, with a history of gonorrhea and recent menses. Which condition should you suspect?

The situation points to pelvic inflammatory disease, an ascending infection of the upper female genital tract. The combination of lower abdominal or pelvic pain, purulent vaginal discharge, and low-grade fever in a sexually active young woman—especially with a history of gonorrhea and recent menses—fits PID well, because bacteria from the lower tract (often gonorrhea or chlamydia) can ascend to involve the uterus, fallopian tubes, or ovaries. This pattern explains the symptoms after intercourse, since sexual activity can introduce and spread bacteria, and menses can enhance susceptibility. Ovarian torsion typically causes sudden, severe unilateral pain with nausea and little or no discharge or fever. Ectopic pregnancy presents with abdominal pain and vaginal bleeding and a positive pregnancy test, not the purulent discharge and fever described. Mittelschmerz is midcycle ovulatory pain that is usually mild and not associated with discharge or fever.

The situation points to pelvic inflammatory disease, an ascending infection of the upper female genital tract. The combination of lower abdominal or pelvic pain, purulent vaginal discharge, and low-grade fever in a sexually active young woman—especially with a history of gonorrhea and recent menses—fits PID well, because bacteria from the lower tract (often gonorrhea or chlamydia) can ascend to involve the uterus, fallopian tubes, or ovaries. This pattern explains the symptoms after intercourse, since sexual activity can introduce and spread bacteria, and menses can enhance susceptibility.

Ovarian torsion typically causes sudden, severe unilateral pain with nausea and little or no discharge or fever. Ectopic pregnancy presents with abdominal pain and vaginal bleeding and a positive pregnancy test, not the purulent discharge and fever described. Mittelschmerz is midcycle ovulatory pain that is usually mild and not associated with discharge or fever.

More practice questions