Lower abdominal pain in a young woman
PLAB 2 practice station

The task

You are a doctor in an emergency department. Miss Chloe Bennett, aged 24, has come in with lower abdominal pain. She has come on her own. Take a focused history. Then explain to her what you think needs to happen next and why, answering her questions, and tell her what to do if things change. Vital signs have been taken by the nurse. Ask the examiner for any results you need. Otherwise the examiner will not take part in the conversation.

What this station tests

• Ectopic pregnancy must be excluded in any woman of reproductive age with abdominal pain and a missed period.
• Always do a pregnancy test and ask about a last menstrual period in this group.
• Shoulder tip pain and light-headedness suggest intraperitoneal blood.
• Ask sensitive history in private and protect confidentiality.
• A fast pulse and low-normal blood pressure with these symptoms need senior and specialist review, not discharge.

Sources for the clinical content

• NICE NG126: Ectopic pregnancy and miscarriage: diagnosis and initial management
• GMC: Confidentiality: good practice in handling patient information

An original practice scenario with invented patients. Not an exam question.

Practise next

• Severe headache since yesterday
• Chest tightness that comes and goes
• Breathlessness and cough in a long-term smoker
• Low mood and poor sleep
• Weight loss and a change in bowel habit