1. MMC Practice Exam 2017.2 Question 5 (12 marks)

2. Pass rate 75% (needed 8/12 to pass)

3. List 4 investigations you would order for this patient in the ED with one rationale for each choice. (8 marks) 
urine or serum bHCG- high risk for ectopic with hx of PID (REQUIRED ANSWER)
eFAST – confirm free fluid in ruptured ectopic
fbc (> WCC suggestive of bacterial infection)
urine dipstick and m/c/s- exclude UTI/ blood for renal colic
First pass urine for STI PCR
high vaginal swab- STI
formal pelvic ultrasound (tuboovarian abscess, appendicitis, torsion etc.)
other tests may be accepted. Eg VBG
A 29 y.o female with past history of pelvic inflammatory disease presents with severe abdominal pain.

4. NOTES:
Did not accept bHCG for “pregnancy”, must mention high possibility of ectopic.
Did not accept U/S- needed to specify pelvic
Did not accept CT abdo or other random, non-specific to this scenario tests.

5. Systemic toxicity
Severe pain
Unable to tolerate oral meds
Pregnancy
Pre-pubertal- sexual abuse
Tubo-ovarian absess
Regarding pelvic inflammatory disease, list four (4) admission criteria.

6. NOTES:
Did not accept vague reference to social issues as reason for admission.