A 30-year-old female presents at a rural clinic with sudden-onset right iliac fossa pain, nausea, and vaginal spotting. Her last menstrual period was ...

Question

A 30-year-old female presents at a rural clinic with sudden-onset right iliac fossa pain, nausea, and vaginal spotting. Her last menstrual period was 6 weeks ago. She has a positive pregnancy test. She is tachycardic at 115 bpm but her blood pressure is currently 115/70 mmHg. She appears anxious and pale. What is the key clinical concern?

Accepted Answer

She may be compensating for significant blood loss from a ruptured ectopic pregnancy - young healthy patients can maintain blood pressure until >30% blood volume is lost, then decompensate rapidly

Answer

Tachycardia indicates anxiety, not blood loss

Answer

The positive pregnancy test is a false positive

Answer

She is haemodynamically stable so there is no urgency

Answer

She has appendicitis and the pregnancy is coincidental

uk-dipimc MCQ (SBA): Compensated Haemorrhagic Shock in Young Adults