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MMLU-Pro / 6437 / A previously healthy 17-year-old girl comes to the emergency department because…

Problem

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question

A previously healthy 17-year-old girl comes to the emergency department because of a 5-day history of progressive lower abdominal pain, fever, and malodorous vaginal discharge. Menarche was at the age of 12 years, and her last menstrual period was 2 weeks ago. She is sexually active with one male partner and uses a combination contraceptive patch. Her temperature is 37.8°C (100°F), pulse is 90/min, respirations are 22/min, and blood pressure is 110/70 mm Hg. Abdominal examination shows severe lower quadrant tenderness bilaterally. Pelvic examination shows a purulent cervical discharge, cervical motion tenderness, and bilateral adnexal tenderness. Her hemoglobin concentration is 10.5 g/dL, leukocyte count is 13,000/mm3 , and platelet count is 345,000/mm3 . A urine pregnancy test is negative. Which of the following is the most appropriate pharmacotherapy?

category

health

options

  1. Oral azithromycin
  2. Vaginal clindamycin
  3. Intravenous penicillin and vancomycin
  4. Intramuscular ceftriaxone and oral doxycycline

src

ori_mmlu-professional_medicine

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