Can You Determine the Cause of This Patient’s Pelvic Pain?

Welcome to the next episode of The Reveal where we take you inside the mind of a test-taker to deconstruct and connect the dots of a board-style question so you can become a better student, transform how you learn, and excel not only on high-stakes exams, but also in your general medical knowledge. Let’s get started.

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A 32-year-old G0P0 woman presents with dull, crampy pelvic pain that has been intermittent over the last six months. She is currently menstruating and notes the pain seems to worsen with menses. She also reports pain with intercourse but denies any vaginal discharge. On examination, she is in no acute distress and is afebrile. She has scant blood in the vaginal vault and no significant focal tenderness. No masses are appreciated. Her pregnancy test is negative. What is the most likely diagnosis?

A) Endometriosis

B) Mittelschmerz

C) Pelvic inflammatory disease

D) Ruptured ovarian cyst

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