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Pelvic inflammatory disease — MCCQE Part 1 MCQ

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EasyPelvic PainPelvic inflammatory diseaseMCCQE Part 1

A 22-year-old woman has lower abdominal pain, fever, cervical motion tenderness, negative pregnancy test and mucopurulent cervical discharge. Which of the following is the most appropriate next step?

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Correct answer: D — Treat empirically for pelvic inflammatory disease and arrange STI testing and partner management

Treat empirically for pelvic inflammatory disease and arrange STI testing and partner management is the single best answer because the age, timing, examination findings and investigations in the vignette fit Pelvic inflammatory disease better than the alternatives. The most tempting distractor is less appropriate because it either treats a neighbouring presentation, delays a time-critical intervention, or ignores a key discriminator in the stem. The remaining options are suboptimal because they would miss the diagnosis, use an investigation or treatment in the wrong sequence, or fail to address safety and follow-up. Canadian practice should be anchored to PHAC sexually transmitted infection guidelines, with attention to acuity, safety-netting and local provincial pathways.

Reference: PHAC sexually transmitted infection guidelines