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Ovarian torsion — USMLE Step 2 CK MCQ

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ModerateObstetrics & GynecologyOvarian torsionUSMLE Step 2 CK

A 27-year-old Middle Eastern woman comes to the clinic because of pelvic symptoms or pregnancy-related concerns. History and focused examination are notable for sudden unilateral pelvic pain, nausea, enlarged ovary, and reduced Doppler flow. Temperature is 98.6°F (37.0°C), blood pressure is 126/78 mmHg, pulse is 84/min, respirations are 16/min, and oxygen saturation is 98% on room air. Physical examination confirms the key finding and shows no unrelated abnormality that would better explain the presentation. Focused laboratory studies and initial testing support the clinical pattern described in the stem. Which of the following is the most likely diagnosis?

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

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Correct answer: D — Ovarian torsion

The vignette describes Ovarian torsion, supported by sudden unilateral pelvic pain, nausea, enlarged ovary, and reduced Doppler flow. Ovarian torsion is the single best answer because it matches the diagnostic or management priority in this clinical setting. The other choices are plausible alternatives in related presentations, but they do not best fit the timing, findings, and guideline-directed approach described here.

Reference: https://www.acog.org/clinical/clinical-guidance#stage-9-order-45