skip to main content

Pelvic inflammatory disease — USMLE Step 3 MCQ

Instant feedback + full explanation. One question, done properly.

HardOB/GYNPelvic inflammatory diseaseUSMLE Step 3

A 16-year-old has sudden unilateral pelvic pain and vomiting. Ultrasound shows an enlarged ovary with peripheral follicles and reduced venous flow. A 6-cm benign-appearing cyst is present. Which management is most appropriate?

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

Reveal the answer and explanation

Correct answer: D — Perform urgent laparoscopy with detorsion and ovarian preservation when feasible

The best answer is “Perform urgent laparoscopy with detorsion and ovarian preservation when feasible”. Torsion is a surgical diagnosis and threatened ovarian perfusion requires urgent laparoscopy. The ovary is detorsed and preserved even when its appearance is concerning; Doppler flow does not safely exclude torsion. Delayed imaging or elective treatment risks loss of function. The alternatives are less suitable because they mistime the intervention, omit a necessary component, or apply treatment for a different physiologic problem; the stem's decisive findings determine the sequence.

Reference: ACOG, Adnexal Torsion in Adolescents: https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2019/08/adnexal-torsion-in-adolescents