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Medical Council of Canada Qualifying Examination Part 1 Exam MCCQE Question # 41 Topic 5 Discussion

Medical Council of Canada Qualifying Examination Part 1 Exam MCCQE Question # 41 Topic 5 Discussion

MCCQE Exam Topic 5 Question 41 Discussion:
Question #: 41
Topic #: 5

A 16-year-old girl is brought to the Emergency Department with a 12-hour history of worsening right lower quadrant abdominal pain and nausea. She is in no distress and vital signs are normal. Her abdomen is soft but locally tender in the right iliac fossa, and bowel sounds are active. White blood cell count is 7.6 × 10⁹/L (4–10), C-reactive protein is 2.3 mg/L ( < 10) and serum beta human chorionic gonadotropin is undetectable. Ultrasound reveals a small amount of fluid in the pelvis, and the appendix is not clearly apparent. Which one of the following is the best next management step?


A.

Enhanced computed tomography scan of the abdomen and pelvis.


B.

Laparoscopic appendectomy.


C.

Serial radiography of the abdomen.


D.

Intravenous ceftriaxone and metronidazole.


E.

Monitoring and reassessment in 12 hours.


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