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Ovarian torsion — MCCQE Part 1 MCQ

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ModeratePelvic PainOvarian torsionMCCQE Part 1

A 27-year-old woman has sudden severe unilateral pelvic pain with vomiting, negative pregnancy test and ultrasound showing an enlarged ovary with reduced flow. Which of the following is the most appropriate next step?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: D — Urgent gynaecologic surgical assessment

Urgent gynaecologic surgical assessment is the single best answer because the age, timing, examination findings and investigations in the vignette fit Ovarian torsion 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 SOGC adnexal torsion guidance, with attention to acuity, safety-netting and local provincial pathways.

Reference: SOGC adnexal torsion guidance